Prospects for Improved Prevention of Nosocomial Infections: A Review of Plasma Sources for Bacteria and Biofilm Removal in Medical Endoscopes

The decontamination of endoscopes using cold plasma is an increasingly popular research topic due to the growing number of endoscopic procedures and the associated risk of nosocomial infection. This article reviews the research conducted on this topic. Although cold plasma is known to have bactericidal properties, the origin of these properties is still debated, as discussed in this article. We present various plasma setups, which we have grouped into four types: dielectric barrier discharge, plasma jet, plasma-activated water, and low-pressure plasma. Most of these studies yielded positive results with regard to bacterial decontamination; however, the reactive species vary between studies, with the main candidates being reactive nitrogen species, reactive oxygen species, reactive oxygen and nitrogen, and vacuum ultraviolet radiation. We also discuss the potential effects of plasma decontamination on endoscope material and its impact on performance and future decontamination.