Can Whipple's Disease Be Transmitted by Gastroscopes?

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Abstract
Objective: : To determine whether disinfection protocols currently used for gastroscopes are effective against cultures ofTropheryma whipplei.Design: : The bactericidal activity of 2% glutaraldehyde and two peracetic acids on the Twist-Marseille strain ofT. whippleigrown in cell monolayers was determined.Patients: : Two patients who were diagnosed as having Whipple's disease 3 years after they had had intestinal biopsies.Results: : The disinfectants reduced bacteria by approximately 2 log10to 3 log10after 5 to 60 minutes of contact.Conclusion: : The bactericidal activity of a disinfectant is usually considered significant if it causes a 5 log10or greater reduction in viable bacterial titers. Disinfecting gastroscopes with2%glutaraldehyde or peracetic acids for 20 minutes may be insufficient to prevent transmission ofT. whippleion the instruments or stop false-positive results on polymerase chain reaction.