Skip to main content Accessibility help

Can Whipple's Disease Be Transmitted by Gastroscopes?

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



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


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


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


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


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.


Corresponding author

Unité des Rickettsies, CNRS UMR 6020, Faculté de médecine, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France


Hide All
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, WASelection 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.


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed