Will Ethylene Oxide Make a Comeback In Endoscopy?

The Chicago Tribune recently reported that Lutheran General Hospital had started to sterilize its endoscopes between patients after 38 patients were found to have contracted an antibiotic resistant strain of bacteria after endoscopic procedures.

It is well known that hospital acquired infections are a major problem for healthcare in the US and abroad and that endoscopes have been found to sometimes transfer disease from one patient to another.

In most prior cases, the cause of the problem was usually failure to adequately clean and properly disinfect the endoscopes between patients; however in this latest case Lutheran General found that correct procedures had been followed, but were apparently ineffective. The hospital has been using ethylene oxide to sterilize their scopes since September and has not had any further problems.

Ethylene oxide is a very effective sterilant but the cycle times are longer than other high level disinfection and sterilization methods suitable for endoscopes. Some people are concerned about the toxicity of ethylene oxide, since like all sterilants and high level disinfectants it is toxic (or else it would not work), but as with hydrogen peroxide and peracetic acid etc., it can be used used safely with modern sterilization equipment, appropriate engineering controls (ventilation etc.), continuous gas monitoring and good work practices.