Efficient endoscope inner channel surface disinfection using a two-step treatment

Flexible endoscopes are ubiquitously used in modern medicine to diagnose and treat a variety of gastrointestinal ailments; however, the inner channels of these complex devices provide an ideal environment for biofilm development. Incomplete or ineffective endoscope reprocessing introduces the potential for cross-contamination between patients, highlighting the need for a new approach to disinfection. In this study, the antibiofilm po-tential of a two-step disinfection process using cold atmospheric pressure plasma and plasma activated water is considered. It was revealed that the combined approach achieved a 5.72 log reduction of clinically relevant mixed species biofilms from the narrow lumens found within a typical endoscope. To investigate potential surface damage resulting from the decontamination process, the surface composition and morphology were examined using XPS, FTIR and AFM. Following multiple disinfection cycles, few changes to the surface composition or morphology were detected and the corresponding ability of bacteria to adhere on the surface was not enhanced.