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World J Gastrointest Endosc. Sep 16, 2014; 6(9): 390-406
Published online Sep 16, 2014. doi: 10.4253/wjge.v6.i9.390
Is peracetic acid suitable for the cleaning step of reprocessing flexible endoscopes?
Günter Kampf, Patricia M Fliss, Heike Martiny
Günter Kampf, Patricia M Fliss, Bode Science Center, Bode Chemie GmbH, 22525 Hamburg, Germany
Günter Kampf, Institute for Hygiene and Environmental Medicine, Ernst Moritz Arndt University, 17489 Greifswald, Germany
Heike Martiny, Technische Hygiene, Charité-Universitätsmedizin Berlin, 12203 Berlin, Germany
Author contributions: All authors contributed to the conception of the manuscript, and to the review and interpretation of the studies; all authors drafted parts of the manuscript and revised it critically; all authors approved the final version.
Correspondence to: Dr. Günter Kampf, Professor, Bode Science Center, Bode Chemie GmbH, Melanchthonstrasse 27, 22525 Hamburg, Germany.
Telephone: +49-40-54006203 Fax: +49-40-54006165
Received: November 28, 2013
Revised: August 1, 2014
Accepted: September 4, 2014
Published online: September 16, 2014
Core Tip

Core tip: Some formulations based on peracetic acid (PAA) are recommended by manufacturers for cleaning flexible endoscopes. We reviewed 243 studies to analyse the evidence for this recommendation. No study demonstrated that PAA-based cleaners were as effective as conventional cleaners, and some PAA-based formulations had clear biofilm-fixation potential. Dried blood and nerve tissue were substantially fixed by PAA. Some outbreaks, especially of highly multidrug-resistant gram-negative pathogens, indicated that insufficient cleaning could not be compensated for by using PAA in the disinfection step. PAA-based formulations should not be used for cleaning flexible endoscopes.