Assessment of postmanual cleaning adenosine triphosphate tests to prevent the use of contaminated duodenoscopes and linear echoendoscopes: the DETECT study

Rauwers, Arjan W.; holt, Anne F. Voor in ‘t; Buijs, Jolanda G.; Groot, Woutrinus de; Erler, Nicole S.; Vos, Margreet C.; Bruno, Marco J.

doi:10.1016/j.gie.2022.03.022

Cited by 3 publications

(3 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This might have stimulated better cleaning performance of the staff. However, this effect was not seen in the culturing results post-HLD 15 . We found some very high maximum RLU levels, but these were mostly incidental outliers.…”

Section: Discussionmentioning

confidence: 76%

“…In the first part of this study, we investigated whether the contamination of patient-ready DLEs could be reduced by introducing ATP tests to monitor manual cleaning efficacy. The results of that research question have been reported in a separate article by Rauwers et al 15 and showed no reduction in contamination of patient-ready DLEs. These study data are further investigated in the current study in order to assess whether there is a relationship between ATP level after manual cleaning and presence of viable microorganisms in duodenoscopes and linear echoendoscopes after HLD.…”

Section: Introductionmentioning

confidence: 65%

“…The study design was previously described by Rauwers et al 15 . In short, after manual cleaning, ATP samples were acquired and post-HLD microbiological cultures were collected of DLE used in endoscopic procedures in the tertiary care Erasmus Medical Center (Rotterdam, the Netherlands) between July 2017 and October 2018.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

No relation between adenosine triphosphate after manual cleaning and presence of microorganisms on endoscopes after automated high-level disinfection

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background and study aims Adenosine triphosphate (ATP) tests are increasingly used to detect biological material; however, their reliability to detect bacterial contamination in endoscopes is not proven. We investigated the predictive value of ATP tests after manual cleaning for presence or absence of microorganisms as shown by culture after automated high-level disinfection (HLD) in duodenoscopes and linear echoendoscopes (DLEs). Patients and methods After manual cleaning, ATP tests were performed on swab samples taken from the detachable cap and forceps elevator, and on flush samples of the DLE working channels. These results were compared to the growth of any microorganisms in cultures acquired after automated HLD. ATP tests with > 200 relative light units (RLU) were considered positive. Receiver operator characteristic (ROC) curves were used to compare the RLU levels with microbial presence in cultures. Results In total, 903 procedures were performed involving 26 distinct DLEs. Depending on sample site, 20.8 % (cap) to 63.8 % (channel brush) of the ATP negative samples were accompanied by positive post-HLD cultures. 54.4 % of the cap samples with a positive culture (growth of any kind of microorganism) and 91.8 % of the channel samples with a positive culture had a negative ATP test after manual cleaning. ROC curves per sample site, DLE type and microorganism type all had area under the curves below 0.6. Conclusions In our study, ATP tests performed after manual cleaning could not predict presence or absence of microorganisms after automated HLD as shown by culture. More than half of the positive cultures were preceded by a negative ATP test.

show abstract

Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 65%