Impact of different final rinsing parameters of automated endoscopic reprocessors on peracetic acid residuals_West China Medical Journal

Authors：

WANG Ping ¹ , SHI Qingfeng ² , LI Chenxu ³ , ZHANG Minhao ³ , YUN Xinxin ³ , YOU Yufeng ³ , XIAO Yifan ³ , GONG Sirui ³ , YAN Ying ⁴ ,  FAN Liming ¹

1. Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China;
2. Department of Infection Control, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China;
3. Endoscopy Center, Shanghai Geriatric Medical Center, Shanghai 201104, P. R. China;
4. Department of Infection Control, People’s Hospital of Zhengzhou, Zhengzhou, Henan 450014, P. R. China;

Corresponding?author：

FAN Liming, Email: fanliming_zs@163.com

Keywords：

Final rinsing; drying; endoscope; peracetic acid; disinfectant residues

DOI：

10.7507/1002-0179.202602115

Video：

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Objective To investigate the impact of different final rinsing parameters of automated endoscopic reprocessors on peracetic acid (PAA) residuals in gastrointestinal endoscope channels, and to provide scientific evidence for optimizing endoscope cleaning and disinfection processes in clinical settings and reducing patient exposure risks. Methods From January to March 2025, 86 gastroscopes and 6 automated endoscopic reprocessors regularly used in the Endoscopy Center, Zhongshan Hospital, Fudan University were selected as the research subjects. They were divided into 3 groups based on the duration and frequency of final rinsing (group A: final rinsing for 2 times, with each rinsing lasting for 2.5 minutes, and a total rinsing time of 5 minutes; group B: final rinsing for 3 times, with each rinsing lasting for 2 minutes, and a total rinsing time of 6 minutes; group C: final rinsing for 3 times, with each rinsing lasting for 2.5 minutes, and a total rinsing time of 7.5 minutes). The PAA residuals in the endoscope channels of each group before and after drying were detected, and the compliance rates of PAA residues with standards were calculated. Results During the study period, groups A, B, and C underwent 40, 52, and 43 endoscopic disinfection procedures, respectively. Before drying, there was a significant difference in the residual PAA levels among the three groups (median PAA residual levels in groups A, B, and C were 5.34, 2.51, and 0.94 mg/L, respectively; P<0.05). Further pairwise comparisons also showed statistically significant differences (P<0.05). After drying, there was a significant difference in the residual PAA levels among the three groups (median PAA residual levels in groups A, B, and C were 3.37, 0.90, and 0.75 mg/L, respectively; P<0.05). However, further pairwise comparisons revealed no significant difference in PAA residual levels between group B and group C (P>0.05), while the remaining pairwise comparisons showed statistically significant differences (P<0.05). Within-group comparisons of PAA residual levels before and after drying showed significant differences in PAA residual levels in groups A and B before and after drying (P<0.05), while there was no significant difference in PAA residual levels in group C before and after drying (P>0.05). The PAA residual compliance rates in groups A and B after drying were significantly higher than those before drying (group A: 5.00% before drying and 27.50% after drying; group B: 1.92% before drying and 57.69% after drying; P<0.05), while there was no significant difference in the PAA residual compliance rates in group C before and after drying (P>0.05). Conclusions Increasing the number of final rinsing, extending the rinsing duration, and intensifying the drying process can effectively reduce PAA residues. Clinically, it is recommended to optimize the final rinsing parameters of the automated endoscopic reprocessor, combined with intensified drying, to reduce PAA residues and ensure patient safety.

Citation： WANG Ping, SHI Qingfeng, LI Chenxu, ZHANG Minhao, YUN Xinxin, YOU Yufeng, XIAO Yifan, GONG Sirui, YAN Ying, FAN Liming. Impact of different final rinsing parameters of automated endoscopic reprocessors on peracetic acid residuals. West China Medical Journal, 2026, 41(3): 407-410. doi: 10.7507/1002-0179.202602115 Copy

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15.	Gutterman E, Jorgensen L, Mitchell A, et al. Adverse staff health outcomes associated with endoscope reprocessing. Biomed Instrum Technol, 2013, 47(2): 172-179.
16.	李偉紅, 馮惠莉, 何琴琴. 一種高濃縮過氧乙酸對內鏡的消毒效果及其殘留量評價. 中國消毒學雜志, 2024, 41(10): 782-784.
17.	Hervé RC, Kong MG, Bhatt S, et al. Evaluation of cold atmospheric plasma for the decontamination of flexible endoscopes. J Hosp Infect, 2023, 136: 100-109.
18.	陸鳳軍, 戴景華, 李春富, 等. 消化內鏡末洗過程中存在的問題與對策. 醫學理論與實踐, 2014(15): 2096-2097.
19.	李賢煌, 張云, 田信, 等. 內鏡不同干燥儲存方式的應用效果評價. 中國消毒學雜志, 2024, 41(11): 821-824, 827.
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1. 國家衛生和計劃生育委員會. 軟式內鏡清洗消毒技術規范. 北京: 中國標準出版社, 2016.
2. American National Standards Institute/Association for the Advancement of Medical Instrumentation. Flexible and semi-rigid endoscope processing in health care facilities. New York: American National Standards Institute, 2021.
3. Coriat R, Chaput U, Ismaili Z, et al. What induces colitis? Hydrogen peroxide or peracetic acid. Endoscopy, 2008, 40(3): 231.
4. Baccouche C, Ayari M, Abdelaali I, et al. Endoscope disinfectant-induced colonic pseudolipomatosis: case series of a rare condition. Future Sci OA, 2024, 10(1): FSO985.
5. Zhao Q, Yu HT, Wang QY, et al. A rare case report of colonic pseudolipomatosis with distinct endoscopic and histological features. Case Rep Gastroenterol, 2025, 19(1): 127-133.
6. Silva SME, Coura MMA, Seidler HBK, et al. Colonic pseudolipomatosis: a rare but characteristic endoscopic condition. Am J Case Rep, 2022, 23: e936045.
7. Harada N, Hirowatari M, Ihara E, et al. A case of suspicious allergic reaction to peracetic acid following endoscopy. Clin Endosc, 2020, 53(6): 743-745.
8. Speth J. Guidelines in practice: processing flexible endoscopes. AORN J, 2023, 118(3): 169-178.
9. Strohleit D, Galetin T, Kosse N, et al. Guidelines on analgosedation, monitoring, and recovery time for flexible bronchoscopy: a systematic review. BMC Pulm Med, 2021, 21(1): 198.
10. 鄧通洋, 林哈妮, 程琮, 等. 消毒技術規范中消毒效果監測方法的改進研究. 中國消毒學雜志, 2013, 30(3): 258-259.
11. 國家疾病預防控制局. 消毒產品檢測方法. 北京: 國家疾病預防控制局, 2023.
12. Kampf G, Fliss PM, Martiny H. Is peracetic acid suitable for the cleaning step of reprocessing flexible endoscopes?. World J Gastrointest Endosc, 2014, 6(9): 390-406.
13. 張金華, 王湘寧. 戊二醛殘留引起 3 例化學性結腸炎病例分析及討論. 中國中西醫結合消化雜志, 2015, 23(6): 447-448.
14. Jin SG, Meng Y, Johnson J, et al. Concordance of hydrogen peroxide-induced 8-oxo-guanine patterns with two cancer mutation signatures of upper GI tract tumors. Sci Adv, 2022, 8(22): eabn3815.
15. Gutterman E, Jorgensen L, Mitchell A, et al. Adverse staff health outcomes associated with endoscope reprocessing. Biomed Instrum Technol, 2013, 47(2): 172-179.
16. 李偉紅, 馮惠莉, 何琴琴. 一種高濃縮過氧乙酸對內鏡的消毒效果及其殘留量評價. 中國消毒學雜志, 2024, 41(10): 782-784.
17. Hervé RC, Kong MG, Bhatt S, et al. Evaluation of cold atmospheric plasma for the decontamination of flexible endoscopes. J Hosp Infect, 2023, 136: 100-109.
18. 陸鳳軍, 戴景華, 李春富, 等. 消化內鏡末洗過程中存在的問題與對策. 醫學理論與實踐, 2014(15): 2096-2097.
19. 李賢煌, 張云, 田信, 等. 內鏡不同干燥儲存方式的應用效果評價. 中國消毒學雜志, 2024, 41(11): 821-824, 827.
20. 國家衛生健康委員會. 血液凈化標準操作規程(2021 版). 北京: 國家衛生健康委員會, 2021.

West China Medical Journal

Impact of different final rinsing parameters of automated endoscopic reprocessors on peracetic acid residuals

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