Investigation of an outbreak of bloody diarrhea: association with endoscopic cleaning solution and demonstration of lesions in an animal model

Am J Med. 1992 May;92(5):476-80. doi: 10.1016/0002-9343(92)90743-u.

Abstract

OUTBREAK INVESTIGATION: An outbreak of diarrhea, bloody diarrhea, and abdominal cramps occurred among persons undergoing flexible sigmoidoscopy at a branch clinic of a local health center. Illness was associated with use of sigmoidoscopes cleaned by one clinic assistant and appeared to be caused by 2% glutaraldehyde disinfectant solution left in the instruments after cleaning.

Animal studies: In subsequent animal studies, colonic instillation of 2% glutaraldehyde solutions caused bloody diarrhea and a distinctive pattern of mucosal damage; similar changes were seen in a review of pathologic samples from other human cases of glutaraldehyde disinfectant-associated diarrhea.

Conclusion: Our data indicate that improper endoscopic reprocessing can result in serious illness and underscore the importance of adequate training and quality control in this area.

MeSH terms

  • Animals
  • Colon / drug effects
  • Colon / pathology
  • Diarrhea / chemically induced*
  • Diarrhea / epidemiology
  • Diarrhea / pathology
  • Disease Outbreaks*
  • Disinfectants / adverse effects*
  • Disinfectants / toxicity
  • Disinfection / standards
  • Gastrointestinal Hemorrhage / chemically induced*
  • Gastrointestinal Hemorrhage / epidemiology
  • Glutaral / adverse effects*
  • Glutaral / toxicity
  • Humans
  • Intestinal Mucosa / drug effects
  • Intestinal Mucosa / pathology
  • Quality Control
  • Rats
  • Rats, Inbred Strains
  • Sigmoidoscopes*

Substances

  • Disinfectants
  • Glutaral