OBJECTIVETo compare different techniques of endoscope sampling to assess residual bacterial
contamination.DESIGNDiagnostic study.SETTINGThe endoscopy unit of an 1,100-bed university hospital performing ~13,000 endoscopic
procedures annually.METHODSIn total, 4 sampling techniques, combining flushing fluid with or without a commercial
endoscope brush, were compared in an endoscope model. Based on these results, sterile
physiological saline flushing with or without PULL THRU brush was selected for
evaluation on 40 flexible endoscopes by adenosine triphosphate (ATP) measurement and
bacterial culture. Acceptance criteria from the French National guideline (<25
colony-forming units [CFU] per endoscope and absence of indicator microorganisms) were
used as part of the evaluation.RESULTSOn biofilm-coated PTFE tubes, physiological saline in combination with a PULL THRU
brush generated higher mean ATP values (2,579 relative light units [RLU]) compared with
saline alone (1,436 RLU; P=.047). In the endoscope samples, culture
yield using saline plus the PULL THRU (mean, 43 CFU; range, 1–400 CFU) was significantly
higher than that of saline alone (mean, 17 CFU; range, 0–500 CFU;
P<.001). In samples obtained using the saline+PULL THRU brush
method, ATP values of samples classified as unacceptable were significantly higher than
those of samples classified as acceptable (P=.001).CONCLUSIONPhysiological saline flushing combined with PULL THRU brush to sample endoscopes
generated higher ATP values and increased the yield of microbial surveillance culture.
Consequently, the acceptance rate of endoscopes based on a defined CFU limit was
significantly lower when the saline+PULL THRU method was used instead of saline alone.Infect Control Hosp Epidemiol 2017;38:1062–1069