Surveillance cultures to monitor quality of gastrointestinal endoscope reprocessing

Abstract

The use of environmental endoscope culturing is a rapid, simple, inexpensive method to monitor effectiveness of standard reprocessing procedures. Disinfection is less effective with poor mechanical cleansing, and high-titer positivity is a marker for poor cleaning technique. Standard upper and lower scopes are commonly culture negative. Duodenoscopes, because of their inherent complexity, and other scopes used in emergent conditions require particular attention. Surveillance culture results can be used to identify patterns of poor technique, to reinforce proper procedure, and to modify clinical practice. No associated clinical illness was apparent during this study.

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

“…Inadequate cleaning and disinfection are more linked to GI-endoscopes related outbreaks compare to other medical devices. The number of contaminated endoscopes in our investigation (9%) is less than those reported on the results of Moses and Lee that from 12% to 24% of the microbiological cultures yielded microorganisms during a 10-year study period [15]. Moses and Lee examined only endoscopes used in a clinical institution and reprocessed in an automated washer.…”

“…It measures the quantity of emitted light, when the luciferase enzyme contacts with ATP molecule [11]. Therefore, ATP measurement is a suitable method to audit rapidly the quality of an endoscope reprocessing [12][13][14][15].…”

Anforderungen an die Hygiene bei der Aufbereitung von Medizinprodukten

“…Mögliche mikrobielle Kontaminationen am Endoskop und endoskopischen Zusatzinstrumentarium sowie die daraus resultierende Infektionsgefährdung für Patienten und Personal machen es unabdingbar, die Qualität der Aufbereitung flexibler Endoskope und des endoskopischen Zusatzinstrumentariums regelmä-ßig zu überprüfen [61,63,64,[161][162][163][164]. Multizentrische Untersuchungen Ende der 80er-/Anfang der 90er-Jahre ergaben, dass die hygienische Aufbereitung von Endoskopen in knapp der Hälfte der Fälle nicht den Empfehlungen der Kommission für Krankenhaushygiene beim Robert Koch-Institut bzw.…”

Transmission of Infection by Flexible Gastrointestinal Endoscopy and Bronchoscopy

“…It is appropriate to trace contaminations of endoscopes and to prevent contaminations and infections in patients after endoscopic procedures (2,3). The use of environmental endoscope culturing is a rapid and simple method to monitor the effectiveness of standard reprocessing procedures (374). Other organizations recommend microbiological surveillance of flexible endoscopes only in response to epidemiologic investigations when instruments may be microbial sources of health care-associated disease transmission or in the case of testing the effectiveness of new or modified cleaning or disinfection procedures (375).…”