{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:45:04Z","timestamp":1787028304024,"version":"build-2736575974"},"reference-count":26,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2019,11,19]],"date-time":"2019-11-19T00:00:00Z","timestamp":1574121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Disinfection and sterilization are needed for guaranteeing that medical and surgical instruments do not spread contagious microorganisms to patients. The aim of this study was to evaluate the efficacy of a simple manual technique of high-level disinfection (HLD) of flexible fiberoptic nasofibroscopes (FFNs) with wipes impregnated with a chlorine dioxide solution (Tristel Trio Wipes System\u2014TTW) against a conventional automated washer machine (Soluscope ENT, Cimrex 12\u2014AW). FFNs used in 62 patients undergoing endoscopy at an ENT clinic were sampled according to an aseptic procedure. For each nasoendoscopy, microbiological samples were taken at two times: (1) after a patient\u2019s nasoendoscopy and (2) immediately after high-level disinfection. Ten microliters of each prepared sample were inoculated onto specific culture media for the detection of nasopharyngeal flora microorganisms. The microbiological results obtained from 62 post-disinfection samples revealed bacterial growth on two FFNs disinfected with AW, and five FFNs disinfected with TTW, but this difference is not statistically significant. None of the isolates were pathogenic bacteria. Our results are different than the results obtained by two previously published studies on the TTW system. In both studies, sampling was carried out by swabbing the tip and the handle surface of FFNs. This sampling method was the least effective method means of detecting bacteria on a surface. It can be concluded that the two disinfection systems allow providers to obtain a reduction of the saprophytic and pathogenic microbial load.<\/jats:p>","DOI":"10.3390\/ijerph16224583","type":"journal-article","created":{"date-parts":[[2019,11,19]],"date-time":"2019-11-19T11:30:17Z","timestamp":1574163017000},"page":"4583","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Using Microbiological Sampling to Evaluate the Efficacy of Nasofibroscope Disinfection: The Tristel Trio Wipes System in Ear\u2013Nose\u2013Throat (ENT) Endoscopy"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1590-9009","authenticated-orcid":false,"given":"Savina","family":"Ditommaso","sequence":"first","affiliation":[{"name":"Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Giacomuzzi","sequence":"additional","affiliation":[{"name":"Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaella","family":"Cipriani","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology and Virology, Citt\u00e0 della Salute e della Scienza Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Zaccaria","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology and Virology, Citt\u00e0 della Salute e della Scienza Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8655-8707","authenticated-orcid":false,"given":"Rossana","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Department of Public Health and Pediatrics, University of Turin, Laboratory of Microbiology and Virology, Citt\u00e0 della Salute e della Scienza Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Boggio","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Otolaryngology Unit, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Albera","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Otolaryngology Unit, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla M.","family":"Zotti","sequence":"additional","affiliation":[{"name":"Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,11,19]]},"reference":[{"key":"ref_1","unstructured":"Centers for Disease Control and Prevention (2008). Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008."},{"key":"ref_2","first-page":"5","article-title":"Chemical disinfection and antisepsis in the hospital","volume":"9","author":"Spaulding","year":"1957","journal-title":"J. Hosp. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.ajic.2006.09.010","article-title":"Prevention of disease transmission during flexible laryngoscopy","volume":"35","author":"Muscarella","year":"2007","journal-title":"Am. J. Infect. Control."},{"key":"ref_4","first-page":"903","article-title":"Transmission of neonatal listeriosis in a delivery room","volume":"139","author":"Nelson","year":"1985","journal-title":"Am. J. Dis. Child."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/0195-6701(95)90282-1","article-title":"The laryngoscope as a potential source of cross-infection","volume":"29","author":"Foweraker","year":"1995","journal-title":"J. Hosp. Infect."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/0195-6701(95)90267-8","article-title":"The neonatal laryngoscope as a potential source of cross-infection","volume":"30","author":"Neal","year":"1995","journal-title":"J. Hosp. Infect."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1017\/S0022215116008860","article-title":"A randomised, single-blind comparison of high-level disinfectants for flexible nasendoscopes","volume":"130","author":"Hitchcock","year":"2016","journal-title":"J. Laryngol. Otol."},{"key":"ref_8","unstructured":"Food and Drug Administration FDA (2019, November 11). FDA-Cleared Sterilants and High Level Disinfectants with General Claims for Processing Reusable Medical and Dental Devices, Available online: https:\/\/www.fda.gov\/medicaldevices\/deviceregulationandguidance\/reprocessingofreusablemedicaldevices\/ucm437347.htm."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1055\/a-0759-1629","article-title":"Reprocessing of flexible endoscopes and endoscopic accessories used in gastrointestinal endoscopy: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology Nurses and Associates (ESGENA)\u2014Update 2018","volume":"50","author":"Beilenhoff","year":"2018","journal-title":"Endoscopy"},{"key":"ref_10","unstructured":"Tristel (2019, February 20). Tristel User Guide. Available online: http:\/\/www.tristel.com\/sites\/default\/files\/trl_247-2_trio_user_guide_gb.pdf."},{"key":"ref_11","unstructured":"ENT, UK (2010). Guidance on the Decontamination and Sterilization of Rigid and Flexible Endoscopes, ENT UK."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Ditommaso, S., Giacomuzzi, M., Ricciardi, E., and Zotti, C. (2018). Experimental Study to Develop a Method for Improving Sample Collection to Monitor Laryngoscopes after Reprocessing. Clin. Endosc.","DOI":"10.5946\/ce.2018.012"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.clinbiochem.2010.06.017","article-title":"MALDI-TOF mass spectrometry tools for bacterial identification in clinical microbiology laboratory","volume":"44","author":"Carbonnelle","year":"2011","journal-title":"Clin. Biochem."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.mimet.2012.10.014","article-title":"Use of MALDI-TOF mass spectrometry for identification of bacteria that are difficult to culture","volume":"92","author":"Biswas","year":"2013","journal-title":"J. Microbiol. Methods"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1056\/NEJM198810133191504","article-title":"Mycobacterium chelonae causing otitis media in an ear-nose-and-throat practice","volume":"319","author":"Lowry","year":"1988","journal-title":"N. Engl. J. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1086\/501925","article-title":"Nosocomial transmission of imipenem-resistant Pseudomonas aeruginosa following bronchoscopy associated with improper connection to the Steris System 1 processor","volume":"22","author":"Sorin","year":"2001","journal-title":"Infect. Control. Hosp. Epidemiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1007\/s10156-008-0645-9","article-title":"An outbreak of Pseudomonas aeruginosa infections following thoracic surgeries occurring via the contamination of bronchoscopes and an automatic endoscope reprocessor","volume":"14","author":"Shimono","year":"2008","journal-title":"J. Infect. Chemother."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s15010-013-0544-6","article-title":"Klebsiella spp. in endoscopy-associated infections: we may only be seeing the tip of the iceberg","volume":"42","author":"Gastmeier","year":"2014","journal-title":"Infection"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.1016\/j.cmi.2015.09.017","article-title":"Cluster of Fusarium solani isolations in a Bronchoscopy Unit","volume":"22","author":"Levy","year":"2016","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.ajic.2016.11.024","article-title":"Transmission of Salmonella enteritidis after endoscopic retrograde cholangiopancreatography because of inadequate endoscope decontamination","volume":"45","author":"Robertson","year":"2017","journal-title":"Am. J. Infect. Control"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1308\/003588412X13171221589937","article-title":"Evaluation of disinfection of flexible nasendoscopes using Tristel wipes: a prospective single blind study","volume":"94","author":"Tzanidakis","year":"2012","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1007\/s00253-009-2136-z","article-title":"Efficient methods for large-area surface sampling of sites contaminated with pathogenic microorganisms and other hazardous agents: current state, needs, and perspectives","volume":"84","author":"Edmonds","year":"2009","journal-title":"Appl. Microbiol. Biotechnol."},{"key":"ref_23","unstructured":"Centers for Disease Control and Prevention (2017). Essential Elements of a Reprocessing Program for Flexible Endoscopes\u2014Recommendations of the HICPAC."},{"key":"ref_24","unstructured":"National Health Service (2018, September 26). Management and Decontamination of Flexible Endoscopes (HTM 01-06), Available online: https:\/\/www.gov.uk\/government\/publications\/management-and-decontamination-of-flexible-endoscopes."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1055\/s-2006-945181","article-title":"ESGE-ESGENA guideline for quality assurance in reprocessing: microbiological surveillance testing in endoscopy","volume":"39","author":"Beilenhoff","year":"2007","journal-title":"Endoscopy"},{"key":"ref_26","unstructured":"Public Health Agency of Canada (2019, November 11). Infection Prevention and Control Guideline for Flexible Gastrointestinal Endoscopy and Flexible Bronchoscopy, Available online: http:\/\/www.deslibris.ca\/ID\/229834."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/22\/4583\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:35:47Z","timestamp":1760189747000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/22\/4583"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,19]]},"references-count":26,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2019,11]]}},"alternative-id":["ijerph16224583"],"URL":"https:\/\/doi.org\/10.3390\/ijerph16224583","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,19]]}}}