Objective: To determine the efficacy of an endotracheal tube (ETT) disinfection method and the impact of its different steps. Study design: A prospective randomized study. Methods: The tracheas of 100 dogs undergoing routine clinical procedures were intubated with a sterile polyvinyl chloride ETT. At extubation, each ETT, presenting without gross contamination after extubation, was cultured for bacterial and fungal growth, and randomly and equally assigned to the ‘enzymatic solution, peracetic acid, water and drying’ (ESPAWD) protocol or one of its constituent steps: enzymatic solution soaking (ES protocol), peracetic acid soaking for 30 minutes (PA protocol), tap water rinsing for 1 minute (W protocol) or drying in ambient air for 24 hours (D protocol). Another swab was performed at the end of the assigned protocol. Post-treatment fungal and bacterial growth was evaluated using aerobic and anaerobic culture media and subsequently analysed. Statistical analysis was performed using R (version 4.3.2). Quantitative variables were compared with non-parametric tests (Wilcoxon, Mann–Whitney U, Kruskal–Wallis with Holm's correction), whereas categorical data were analysed with Chi-square and McNemar's tests. Statistical significance was set at p < 0.05. Results: The ESPAWD protocol was effective at disinfecting all ETTs (failure relative frequency 0%). Among the different steps, PA showed the lowest failure frequency (20%), followed by D (35%), W (90%) and ES (100%) protocol. Comparison between ESPAWD and PA protocols did not reveal any significant difference in terms of both post-treatment number of microbial species (p = 0.09) and reduction of microbial load (p = 0.09). Conclusions and clinical relevance: In the ESPAWD protocol, all ETTs were successfully disinfected, and the protocol may represent a promising option for disinfecting previously used ETTs presenting without gross contamination.
Efficacy of an endotracheal tube disinfection protocol and the impact of its steps on tubes collected from dogs anaesthetized for routine clinical procedures
Ventura, Laura;
2025
Abstract
Objective: To determine the efficacy of an endotracheal tube (ETT) disinfection method and the impact of its different steps. Study design: A prospective randomized study. Methods: The tracheas of 100 dogs undergoing routine clinical procedures were intubated with a sterile polyvinyl chloride ETT. At extubation, each ETT, presenting without gross contamination after extubation, was cultured for bacterial and fungal growth, and randomly and equally assigned to the ‘enzymatic solution, peracetic acid, water and drying’ (ESPAWD) protocol or one of its constituent steps: enzymatic solution soaking (ES protocol), peracetic acid soaking for 30 minutes (PA protocol), tap water rinsing for 1 minute (W protocol) or drying in ambient air for 24 hours (D protocol). Another swab was performed at the end of the assigned protocol. Post-treatment fungal and bacterial growth was evaluated using aerobic and anaerobic culture media and subsequently analysed. Statistical analysis was performed using R (version 4.3.2). Quantitative variables were compared with non-parametric tests (Wilcoxon, Mann–Whitney U, Kruskal–Wallis with Holm's correction), whereas categorical data were analysed with Chi-square and McNemar's tests. Statistical significance was set at p < 0.05. Results: The ESPAWD protocol was effective at disinfecting all ETTs (failure relative frequency 0%). Among the different steps, PA showed the lowest failure frequency (20%), followed by D (35%), W (90%) and ES (100%) protocol. Comparison between ESPAWD and PA protocols did not reveal any significant difference in terms of both post-treatment number of microbial species (p = 0.09) and reduction of microbial load (p = 0.09). Conclusions and clinical relevance: In the ESPAWD protocol, all ETTs were successfully disinfected, and the protocol may represent a promising option for disinfecting previously used ETTs presenting without gross contamination.
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