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Can Whipple's Disease Be Transmitted by Gastroscopes?

  • Bernard La Scola (a1), Jean-Marc Rolain (a1), Max Maurin (a1) and Didier Raoult (a1)
Abstract
AbstractObjective:

To determine whether disinfection protocols currently used for gastroscopes are effective against cultures of Tropheryma whipplei.

Design:

The bactericidal activity of 2% glutaraldehyde and two peracetic acids on the Twist-Marseille strain of T. whipplei grown in cell monolayers was determined.

Patients:

Two patients who were diagnosed as having Whipple's disease 3 years after they had had intestinal biopsies.

Results:

The disinfectants reduced bacteria by approximately 2 log10 to 3 log10 after 5 to 60 minutes of contact.

Conclusion:

The bactericidal activity of a disinfectant is usually considered significant if it causes a 5 log10 or greater reduction in viable bacterial titers. Disinfecting gastroscopes with 2% glutaraldehyde or peracetic acids for 20 minutes may be insufficient to prevent transmission of T. whipplei on the instruments or stop false-positive results on polymerase chain reaction.

Copyright
Corresponding author
Unité des Rickettsies, CNRS UMR 6020, Faculté de médecine, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
References
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1.La Scola B, Fenollar F, Fournier PE, Altwegg M, Mallet MN, Raoult D. Description of Tropheryma whipplei gen. nov. sp. nov., the Whipple's disease bacillus. Int J Syst Evol Microbiol 2001;51:14711479.
2.Misbah SA, Mapstone NP. Whipple's disease revisited. J Clin Pathol 2000;53:750755.
3.Fenollar F, Raoult D. Whipple's disease. Clin Diagn Lab Immunol 2001;8:18.
4.Maiwald M, Reiman DA. Whipple's disease and Tropheryma whippelii: secrets slowly revealed. Clin Infect Dis 2001;32:457463.
5.Wilson KH, Blitchington R, Frothingham R, Wilson JAP. Phytogeny of the Whipple's disease-associated bacterium. Lancet 1991;338:474475.
6.Reiman DA, Schmidt TM, MacDermott RP, Falkow S. Identification of the uncultured bacillus of Whipple's disease. N Engl J Med 1992;327:293301.
7.Raoult D, Birg ML, La Scola B, et al.Cultivation of the bacillus of Whipple's disease. N Engl J Med 2000;342:620625.
8.Raoult D, La Scola B, Lecocq P, Lepidi H, Fournier PE. Culture and immunological detection of Tropheryma whipplei from the duodenum of a patient with Whipple's disease. JAMA 2001;285:10391043.
9.Maiwald M, Schuhmacher F, Ditton HJ, von Herbay A. Environmental occurrence of the Whipple's disease bacterium (Tropheryma whippelii). Appl Environ Microbiol 1998;64:760762.
10.Best M, Sattar SA, Springthorpe VS, Kennedy ME. Efficacies of selected disinfectants against Mycobacterium tuberculosis. J Clin Microbiol 1990;28:22342239.
11.Maurin M, Benoliel AM, Bongrand P, Raoult D. Phagolysosomal alka-linization and the bactericidal effect of antibiotics: the Coxiella burnetii paradigm. J Infect Dis 1992;166:10971102.
12.Baisden BL, Lepidi H, Raoult D, Argani P, Yardley JH, Dumler JS. Diagnosis of Whipple disease by immunohistochemical analysis: a sensitive and specific method for the detection of Tropheryma whipplei (the Whipple bacillus) in paraffin embedded tissue. Am J Clin Pathol 2002;118:742748.
13.Roosendaal R, Kuipers EJ, van den Brule AJC, et al.Importance of fiberoptic endoscope cleaning procedure for detection of Helicobacter pylori in gastric biopsy specimens by PCR. J Clin Microbiol 1994;32:11231126.
14.Spach DH, Silverstein FE, Stamm WE. Transmission of infection by gastrointestinal endoscopy and bronchoscopy. Ann Intern Med 1993;118:117128.
15.Kaczmarek RG, Moore RM, McCrohan J. Multi-state investigation of the actual disinfections/sterilization of endoscopes in health care facilities. Am J Med 1992;92:257261.
16.Rutala WA Selection and use of disinfectants in health care. In: Mayhall CG, ed. Hospital Epidemiology and Infection Control. Baltimore: Williams & Wilkins; 1996:913936.
17.Ehrbar HU, Bauerfeind P, Dutly F, Koelz HR, Altwegg M. PCR-positive tests for Tropheryma whippelii in patients without Whipple's disease. Lancet 1999;353:2214.
18.Maiwald M, von Herbay A, Persing DH, et al.Tropheryma whippelii DNA is rare in the intestinal mucosa of patients without other evidence of Whipple disease. Ann Intern Med 2001;134:115119.
19.Hanson PJV, Gor D, Clarke JR, et al.Contamination of endoscopes used in AIDS patients. Lancet 1989;2:8688.
20.Vesley D, Norlien KG, Nelson B, Ott B, Steifel AJ. Significant factors in the disinfections and sterilization of flexible endoscopes. Am J Infect Control 1992;20:291300.
21.Walsh SE, Maillard JY, Russell AD, Hann AC. Possible mechanisms for the relative efficacies of ortho-phtalaldehyde and glutaraldehyde against glutaraldehyde-resistant Mycobacterium chelonae. J Appl Microbiol 2001;91:8092.
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
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