Disinfection of endoscopes from Helicobacter pylori–positive subjects: Evaluation of the effectiveness of the Chinese Calijing disinfection kit

Background The aim of this study was to evaluate the effectiveness of the Calijing disinfection kit (an endoscope disinfection method used in Chinese hospitals) in eradicating Helicobacter pylori and assess whether use of the kit in 1994 during endoscopies in the Shandong Intervention Trial (SIT), Shandong, China, could have resulted in iatrogenic transmission of H pylori. Methods Bacterial culture studies at the Veterans Affairs Medical Center, Houston, Texas, using endoscopes and forceps from 49 H pylori-positive patients were performed on contaminated endoscopes before and after disinfection with the Calijing kit. Results At least 1 endoscope culture site was H pylori positive in 39 of 49 (79.6%) specimens predisinfection, whereas H pylori was not isolated from any endoscopic culture site postdisinfection. Non-H pylori bacteria and fungi were recovered from 22.6% of the postdisinfection cultures. Conclusion Although no viable H pylori were recovered following the disinfection procedures, levels of H pylori below the detection threshold of the bacteriologic assay may have contributed to an increase in H pylori seroprevalence noted in the SIT. In addition, the kit was unable to provide disinfection against non-H pylori organisms, suggesting the need to adhere to internationally accepted disinfection procedures for endoscope reprocessing.