Anforderungen an die Hygiene bei der Aufbereitung flexibler Endoskope und endoskopischen Zusatzinstrumentariums Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention beim Robert Koch-Institut (RKI)

doi:10.1007/s00103-002-0395-2

Cited by 32 publications

(5 citation statements)

References 14 publications

(22 reference statements)

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“…Bronchoscopy with BALF was performed on these patients according to national guidelines with 200 ml normal saline in fractions of 20 ml each [14]. Sterilizing procedures were performed following national guidelines [15]. For this study, we retrospectively included 63 bio-banked specimens from patients with a confirmed diagnosis of TB, NTM-LD, or non-infectious inflammatory lung disease.…”

Section: Methodsmentioning

confidence: 99%

Serratia sp. dominates the lung microbiome of patients with tuberculosis and non-tuberculous mycobacterial lung diseases

Belheouane,

Kalsdorf,

Niemann

et al. 2024

Preprint

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Background Pathogenic mycobacteria, such as the Mycobacterium tuberculosis complex (Mtbc), and non-tuberculous mycobacteria (NTMs) can cause severe chronic pulmonary infections. However, not all infected patients develop active disease. Yet, it is unclear whether certain key taxa in the lung microbiome play a role in the pathogenesis of tuberculosis (TB) and NTM lung disease (LD). Material and methods We employed 16S rRNA amplicon sequencing (V3-V4) to characterize the baseline microbiome in bronchoalveolar lavage fluid from a patient cohort diagnosed with TB (n=23), NTM-LD (n=19), or non-infectious disease (n=4) prior to the initiation of therapy. The analysis included the depletion of human cells, removal of extracellular DNA, implementation of a decontamination strategy, and exploratory whole-metagenome sequencing (WMS) of selected specimens. Results The genera Serratia and unclassified Yersiniaceae dominated the lung microbiome of all patients with a mean relative abundance of >15% and >70%, respectively. However, at the sub-genus level, as determined by amplicon sequence variants (ASVs), TB-patients exhibited increased community diversity, and TB specific ASV_7 (unclassified Yersiniaceae), and ASV_21 (Serratia) signatures. Exploratory analysis by WMS and ASV similarity analysis suggested the presence of Serratia liquefaciens, Serratia grimesii, Serratia myotis and/or Serratia quinivorans in both TB and NTM-LD patients. Overall, presence/absence of certain Serratia ASVs was significantly associated with disease state. Conclusion The lung microbiome of TB patients harbors a distinct, and heterogenous microbiome structure with specific occurrences of certain Serratia traits. Serratia sp. plays a pivotal role in our understanding of microbial interactions in the lung microbiome of patients infected with Mtbc.

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Section: Methodsmentioning

confidence: 99%

Serratia sp. dominates the lung microbiome of patients with tuberculosis and non-tuberculous mycobacterial lung diseases

Belheouane,

Kalsdorf,

Niemann

et al. 2024

Preprint

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“…All procedures were performed using Olympus scopes (Olympus, Hamburg, Germany), which were disinfected according to the guidelines of the Robert Koch Institute and contamination was excluded by regular testing [8]. Fluid from the captivity was aspirated through an aspiration catheter without previous flushing.…”

Section: Methodsmentioning

confidence: 99%

Microbiological Analysis of Fluids in Postsurgical Gastroesophageal Intrathoracic Leaks Obtained by Endoscopy: A New Way to Optimize Antibiotic Therapy

Erichsen

Vonberg²,

Lenzen³

et al. 2015

Digestion

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Background/Aims: Postsurgical gastroesophageal intrathoracic leakage is a potentially life-threatening condition that is frequently accompanied by mediastinitis and subsequent sepsis. Aspiration of fluids from intrathoracic leaks during endoscopy for microbiological analysis is rarely performed in clinical routine. The aim was to evaluate the role of routine microbiological analysis of intrathoracic leaks via endoscopy and its impact on antibiotic therapy. Methods: This is aprospective, observational single-center study. Seventeen consecutive patients who presented for endoscopic treatment of intrathoracic leaks were included. Concomitantly, fluids from intrathoracic leaks during endoscopic intervention and blood cultures were obtained and a microbiological analysis was performed. Results: Bacteria and/or fungi were detected by culture of fluid aspirated from intrathoracic leaks in 88% cases, but in none of the blood cultures. In 15 patients, microbial colonization of the leakage was detected despite previous empiric antibiotic therapy; treatment had to be adjusted in all patients according to the observed antibiotic susceptibility profile. Conclusions: The microbiological colonization of postsurgical gastroesophageal intrathoracic leaks in patients is frequent. Only the direct microbiological analysis of fluids from intrathoracic leaks, but not of blood cultures, is effective for optimizing an antibiotic therapy in such patients.

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“…These contacts should not be left until an outbreak occurs but should occur at the first signs of a problem. In Germany there is a duty to report to the BfArM, in the USA to the FDA [12,36]. This is essential to enable the manufacturer to respond to problems with the instruments, provide solutions and assistance.…”

Section: Ensuring Reprocessing Quality and Infection Preventionmentioning

confidence: 99%

“…The European guidelines (ESGE - ESGENA 2000, 2003, 2007, 2008) have been revised and amended several times in recent years [1,8,9,10,11]. The German recommendations of the Robert Koch Institute (Hygiene requirements for the reprocessing of flexible endoscopes and additional endoscopic equipment) were last revised in 2012 [12,13]. US and Australian guidelines are revised regularly [3,4,14,15,16].…”

Section: Standards and Recommendationsmentioning

confidence: 99%

“…A separate, purpose-equipped reprocessing room is a requirement in all national and international guidelines and is now the standard [1,2,3,4,8,9,10,11,12,13,14,15,16,35]. Strict spatial and procedural separation of contaminated and clean work steps is crucial for occupational safety and prevention of recontamination, with the current trend towards two-room concepts [35].…”

Section: Ensuring Reprocessing Quality and Infection Preventionmentioning

confidence: 99%

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Hygiene: The Looming Achilles Heel in Endoscopy

Jung¹,

Beilenhoff²

2016

Visc Med

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Background: Since the late 1970s there have been sporadic reports of nosocomial infections linked to endoscopic procedures. Infections by multidrug-resistant organisms (MDRO) have an increasing impact on healthcare systems worldwide. Since 2010 outbreaks involving MDRO have been reported as a result of endoscopic retrograde cholangiopancreatography (ERCP) from the USA, France, Germany and the Netherlands. Methods: This article evaluates the recent outbreaks and developments and demonstrates a structural approach to how to prevent future infections. Current national and international guidelines were used as a basis for discussions. Results: In some cases insufficient cleaning or drying supported the outbreak. In the majority of cases, outbreaks occurred despite the apparently appropriate reprocessing protocols being in use. Microlesions were identified on a number of endoscopes, which supported the growth of bacteria and represented a vehicle for the transmission of infectious material. National official bodies responded with warnings. Manufacturers informed their customers accordingly. Separate, purpose-designed reprocessing rooms and a sufficient number of competent staff provide the structural quality for a safe reprocessing. The process quality includes a thorough cleaning of all endoscope channels and crucial instrument components, followed by an automated and validated reprocessing procedure. Strict adherence to manufacturers' recommendations is essential. The outcome quality should be evaluated by regular audits, validation of reprocessing procedures and microbiological surveillance. If outbreaks occur, a close co-operation with official bodies and manufacturers is essential. Conclusion: Health care professionals and manufacturers should be aware of their responsibility to ensure patient safety. A structural approach is key in prevention of endoscopy-associated infections.

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Anforderungen an die Hygiene bei der Aufbereitung flexibler Endoskope und endoskopischen Zusatzinstrumentariums Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention beim Robert Koch-Institut (RKI)

Cited by 32 publications

References 14 publications

Serratia sp. dominates the lung microbiome of patients with tuberculosis and non-tuberculous mycobacterial lung diseases

Serratia sp. dominates the lung microbiome of patients with tuberculosis and non-tuberculous mycobacterial lung diseases

Microbiological Analysis of Fluids in Postsurgical Gastroesophageal Intrathoracic Leaks Obtained by Endoscopy: A New Way to Optimize Antibiotic Therapy

Hygiene: The Looming Achilles Heel in Endoscopy

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