Microbiological surveillance post-reprocessing of flexible endoscopes used in digestive endoscopy: a national study.

Abstract

INTRODUCTION:

Microbiological surveillance of endoscopes is a safety measure for verifying the quality of reprocessing procedures and identifying contaminated devices, but duodenoscope-related outbreaks are still reported.

AIM:

To assess the effectiveness of duodenoscope reprocessing procedures in Italy.

METHODS:

Between December 2019 and April 2020, data obtained from microbiological surveillance post-reprocessing in 15 Italian endoscopy units were collected. Sampling was carried out after reprocessing or during storage in a cabinet. In keeping with international guidelines and the Italian position paper, the micro-organisms were classified as high-concern organisms (HCOs) and low-concern organisms (LCOs).

FINDINGS:

In total, 144 samples were collected from 51 duodenoscopes. Of these, 36.81% were contaminated: 22.92% were contaminated with HCOs and 13.89% were contaminated with LCOs [2.08% with an LCO load of 11-100 colony-forming units (CFU)/device and 0.69% with an LCO load of >100 CFU/device]. The contamination rate was 27.5% in samples collected after reprocessing, 40% in samples collected during storage in a cabinet that was compliant with EN 16442:2015 (C-I), and 100% in samples collected during storage in a cabinet that was not compliant with EN 16442:2015 (NC-I). The respective HCO rates were 15.00%, 27.27% and 66.67%. Correlation between LCO contamination and storage time was demonstrated (Spearman's rho=0.3701; P=0.0026). The Olympus duodenoscope TJFQ180V demonstrated the lowest rate of contamination (29.82%), although the contamination rate was 100% for duodenoscopes stored in an NC-I cabinet.

CONCLUSION:

Microbiological surveillance, along with strict adherence to reprocessing protocols, may help to detect endoscope contamination at an early stage, and reduce the risk of duodenoscope-associated infections.

• Authors: B Casini, A M Spagnolo, M Sartini, B Tuvo, M Scarpaci, M Barchitta, A Pan, A Agodi, M L Cristina, Study Group
• Journal: The Journal of hospital infection (J Hosp Infect) Vol. 131 Pg. 139-147 (Jan 2023) ISSN: 1532-2939 [Electronic] England
• PMID: 36244520 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.

Topics

• Humans
• Equipment Contamination
• Disinfection (methods)
• Endoscopes
• Duodenoscopes (microbiology)
• Endoscopy, Gastrointestinal