A new buildup biofilm model that mimics accumulation of material in flexible endoscope channels

Olson, Nancy; DeGagne, Patricia; França, Rodrigo; Tipple, Anaclara Ferreira Veiga; Alfa, Michelle J.

doi:10.1016/j.mimet.2016.06.022

Cited by 15 publications

(7 citation statements)

References 37 publications

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“…In our study, neutralizer was added immediately after sample collection except for samples extracted using Letheen and Dey–Engley as these broths contain neutralizer. The efficacy of the neutralizer used has been demonstrated previously ( 26 ).…”

Section: Discussionmentioning

confidence: 82%

Sterile Reverse Osmosis Water Combined with Friction Are Optimal for Channel and Lever Cavity Sample Collection of Flexible Duodenoscopes

et al. 2017

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IntroductionSimulated-use buildup biofilm (BBF) model was used to assess various extraction fluids and friction methods to determine the optimal sample collection method for polytetrafluorethylene channels. In addition, simulated-use testing was performed for the channel and lever cavity of duodenoscopes.Materials and methodsBBF was formed in polytetrafluorethylene channels using Enterococcus faecalis, Escherichia coli, and Pseudomonas aeruginosa. Sterile reverse osmosis (RO) water, and phosphate-buffered saline with and without Tween80 as well as two neutralizing broths (Letheen and Dey–Engley) were each assessed with and without friction. Neutralizer was added immediately after sample collection and samples concentrated using centrifugation. Simulated-use testing was done using TJF-Q180V and JF-140F Olympus duodenoscopes.ResultsDespite variability in the bacterial CFU in the BBF model, none of the extraction fluids tested were significantly better than RO. Borescope examination showed far less residual material when friction was part of the extraction protocol. The RO for flush-brush-flush (FBF) extraction provided significantly better recovery of E. coli (p = 0.02) from duodenoscope lever cavities compared to the CDC flush method.Discussion and conclusionWe recommend RO with friction for FBF extraction of the channel and lever cavity of duodenoscopes. Neutralizer and sample concentration optimize recovery of viable bacteria on culture.

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Section: Discussionmentioning

confidence: 82%

Sterile Reverse Osmosis Water Combined with Friction Are Optimal for Channel and Lever Cavity Sample Collection of Flexible Duodenoscopes

et al. 2017

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“…Mechanical cleaning is an important step to remove the nidus [1][2][3][4]20]. It was reported that neither the detergent nor the high-level disinfectants could remove or kill the bacteria at the expected level due to thebiofilm formation in the channels [21,22]. Detergents and enzymatic cleaners cannot remove the biofilm in the endoscopes sufficiently, so the mechanical cleaning must be definitely performed.…”

Section: Discussionmentioning

confidence: 99%

The Assessment and Improvement of the Steps in the Endoscope-Reprocessing: A Hospital Report

Gedık¹

2017

JBMOA

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Objective: The aim of this study was to describe the endoscope reprocessing procedure of our hospital that succeeded in an effective cleaning that was validated with the microbiological cultures and ATP-bioluminescence tool kit. Material and methods:The endoscope reprocessing procedure was inspected by the microbiological cultures and then ATP-bioluminescence tool kit in the endoscopy units of gastroenterology and general surgery wards of the Ministry of Health Bakırköy Sadi Konuk Research Hospital between April and December 2014. Results:Of the examined 42 flexible endoscopes, four of them (9%) were contaminated. In microbiological cultures, Stenotrophomonas maltophilia (> 100,000 cfu/mL) was isolated from irrigation bottles. Extended-spectrum betalactamases and plasmid-mediated carbapenamase producing K. pneumonia and AmpC beta-lactamase producing P. aeruginosa (> 100,000 cfu/mL) were isolated from elevator behind. Each step of the reprocessing procedure was inspected and revised, if it was needed. There was not found contamination in the endoscopes after revising procedure. Conclusion:The ATP-bioluminescence method is a cost-effective method to monitor and to evaluate the endoscope reprocessing. Biofilm formation is very important to harbor resistant microorganisms in the endoscopes. The microbiological monitoring and cleaning procedures of endoscopes should be defined taking into the conditions of the setting in the settings. In case of any outbreak related to endoscopes, each step of the procedure should be checked and revised according to the guidelines, reported outbreaks, and instructions of endoscope manufacturers.

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“…Similarly, disinfectants are very good at killing planktonic bacteria but have been shown to have decreased efficacy against biofilms [ 10 ]. The effectiveness of disinfectants is diminished even more if the biofilm is formed on channels within endoscopes that are subjected to multiple cycles of use and decontamination [ 11 , 12 ]. Similarly, biofilms formed on dry surfaces, where they are subjected to low water availability, are also exceedingly difficult to eradicate [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Mild Positive Pressure Improves the Efficacy of Benzalkonium Chloride against Staphylococcus aureus Biofilm

et al. 2022

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Current protocols using liquid disinfectants to disinfect heat-sensitive hospital items frequently fail, as evidenced by the continued isolation of bacteria following decontamination. The contamination is, in part, due to biofilm formation. We hypothesize that mild positive pressure (PP) will disrupt this biofilm structure and improve liquid disinfectant/detergent penetration to biofilm bacteria for improved killing. Staphylococcus aureus biofilm, grown on polycarbonate coupons in the biofilm reactor under shear at 35 °C for 3 days, was treated for 10 min and 60 min with various dilutions of benzalkonium chloride without PP at 1 atmosphere (atm), and with PP at 3, 5, 7, and 10 atm. The effect on biofilm and residual bacterial viability was determined by standard plate counts, confocal laser scanning microscopy, and scanning electron microscopy. Combined use of benzalkonium chloride and PP up to 10 atm significantly increased biofilm killing up to 4.27 logs, as compared to the treatment using disinfectant alone. Microscopy results were consistent with the viability plate count results. PP improved disinfectant efficacy against bacterial biofilm. The use of mild PP is possible in many flow situations or if equipment/contaminated surfaces can be placed in a pressure chamber.

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A new buildup biofilm model that mimics accumulation of material in flexible endoscope channels

Cited by 15 publications

References 37 publications

Sterile Reverse Osmosis Water Combined with Friction Are Optimal for Channel and Lever Cavity Sample Collection of Flexible Duodenoscopes

Sterile Reverse Osmosis Water Combined with Friction Are Optimal for Channel and Lever Cavity Sample Collection of Flexible Duodenoscopes

The Assessment and Improvement of the Steps in the Endoscope-Reprocessing: A Hospital Report

Mild Positive Pressure Improves the Efficacy of Benzalkonium Chloride against Staphylococcus aureus Biofilm

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