Bacteria-free water for automatic washer-disinfectors: an impossible dream?

The ability of a new automatic washer-disinfector system (AWDS), fitted with a water filtration system to provide bacteria-free water and so avoid the risk of mycobacterial contamination of fibreoptic bronchoscopes, was examined. Four new Astec ‘MP’ Safescope washer-disinfectors, with coarse and fine (0.2 μm) filters attached close to the outlet taps, were supplied with non-softened mains water. Water samples from the tank supply and outlet taps were regularly assessed for bacterial quality over a six-month period. Outlet samples were also analysed after fine filter change and purgation with peracetic acid. All bronchoalveolar lavage specimens (BALS) were stained and cultured for mycobacteria. Only 13 out of 53 outlet samples (24%) were culture-negative. There was no improvement after filter change. Residual anti-bacterial effect of peracetic acid lasted up to 48 h following AWDS purgation. No tank samples were bacteria-free. Sixty BALS were processed, two samples were culture-positive and grew M. tuberculosis and one was also smear-positive. Though mycobacterial contamination of bronchscopes was not evident, the water filtration system was unable to reliably provide sterile rinse water.