Direct application of non-thermal plasma technology for the elimination of biofilm from endoscope channels

Endoscopy procedures result in contamination of endoscope devices with potentially infectious organisms derived from the patient. Flexible endoscopes are complex, containing channels and ports that are difficult to clean and disinfect, further complicated by the presence of heat sensitive components, preventing use of high temperature sterilisation. Failure to effectively remove contamination from the internal channels and ports has the potential to result in microbial transmission between patients and subsequent outbreaks of infection. Non-thermal plasma (NTP) is generated by supplying a neutral gas with a continuous source of energy, resulting in the generation of reactive species, charged particles, electrons and ultraviolet (UV) photons, that have been shown to exhibit an antimicrobial effect. This study investigated the efficacy of a novel low energy NTP treatment system coupled with a prototype endoscope plasma applicator for the removal of viable biofilm contamination from the internal lumen of surrogate endoscope channels in an in vitro endoscope biofilm model. The results demonstrated that NTP can completely eliminate biofilms of Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae from surrogate endoscope channels. Therefore, NTP treatment could provide an alternative decontamination technology for reprocessing endoscope devices, to eradicate biofilm and eliminate the risk of cross infection between patients.