HIGH-LEVEL DISINFECTION Figure 1. Flow Diagram of Literature Search Results
Search terms included high-level disinfection, semi-critical item or device, automated endoscope reprocessor, Spaulding schema or criteria, peracetic acid, hydrogen peroxide, glutaralde- hyde, ortho-phthalaldehyde, thermal or heat disinfection, pas- teurization, medical device washer, equipment contamination or reuse, anesthesia equipment, disease transmission, cross- infection, biofilm, bacteria, microbial, spores, fungus, prion, Creutzfeldt-Jacob syndrome, Klebsiella, Pseudomonas aeruginosa, carbapenemase-producing Enterobacteriaceae, Staphylococcus aureus, Pseudomonas putida, Mycobacterium massiliense, stor- age, shelf life, cabinet, transport, protective clothing, eye protec- tive devices, occupational disease or exposure, hypersensitivity, health personnel, medical waste disposal, waste management, and documentation. Subject headings and key words for spe- cific types of endoscopes also were included.
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Included were research and non-research literature in English, complete publications, and publication dates within the time restriction when available. Excluded were non- peer-reviewed publications, older evidence within the time restriction when more recent evidence was available, and research and non-research evidence related to thermal high-level disinfection, specific disinfectants, workplace safety and occupational illness not related to high-level dis- infection, sterile processing activities not associated with high-level disinfection, environmental and surface disinfec- tion, and high-level disinfection of single-use devices. Edito- rials, news items, and other brief items were excluded. Low- quality evidence was excluded when higher-quality evidence was available, and literature outside the time restriction was excluded when literature within the time restriction was
