Endoscopy-related infection: relic of the past?

Seoane‐Vazquez, Enrique; Rodríguez-Monguió, Rosa

doi:10.1097/qco.0b013e328301396b

Cited by 38 publications

(27 citation statements)

References 40 publications

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“…The microbiological safety of endoscopes can also be affected by occult endoscope damage and contaminated automated endoscope reprocessors, and thus quality control for endoscope reprocessing is extremely important. However, there is continuing debate about the role and value of surveillance cultures in the quality assurance program of endoscope reprocessing (24). Many authors recommend endoscope surveillance cultures, and several recent reports of endoscopy-related outbreaks have stressed the importance that these cultures have played or could have played in the prevention of these adverse events (4,15,19,20).…”

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confidence: 99%

“…To ensure the quality of the reprocessing, strict compliance with the disinfection procedure is mandatory, and a regular audit of all of the steps in reprocessing is crucial. Despite the publication of reprocessing guidelines, breaches in reprocessing practices continue to be reported, and failure to follow cleaning or disinfection guidelines can result in outbreaks involving a large number of patients (24). The microbiological safety of endoscopes can also be affected by occult endoscope damage and contaminated automated endoscope reprocessors, and thus quality control for endoscope reprocessing is extremely important.…”

mentioning

confidence: 99%

“…Very few studies have attempted to evaluate the efficacy of the sampling methods of endoscope channels (17). In addition, and despite increasing evidence of the implication of biofilms in endoscope contamination, no published data are available on how efficient these methods are on bacterial biofilms (6,22,24).…”

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Assessment on Experimental Bacterial Biofilms and in Clinical Practice of the Efficacy of Sampling Solutions for Microbiological Testing of Endoscopes

et al. 2012

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Opinions differ on the value of microbiological testing of endoscopes, which varies according to the technique used. We compared the efficacy on bacterial biofilms of sampling solutions used for the surveillance of the contamination of endoscope channels. To compare efficacy, we used an experimental model of a 48-h Pseudomonas biofilm grown on endoscope internal tubing. Sampling of this experimental biofilm was performed with a Tween 80-lecithin-based solution, saline, and sterile water. We also performed a randomized prospective study during routine clinical practice in our hospital sampling randomly with two different solutions the endoscopes after reprocessing. Biofilm recovery expressed as a logarithmic ratio of bacteria recovered on bacteria initially present in biofilm was significantly more effective with the Tween 80-lecithin-based solution than with saline solution (P ‫؍‬ 0.002) and sterile water (P ‫؍‬ 0.002). There was no significant difference between saline and sterile water. In the randomized clinical study, the rates of endoscopes that were contaminated with the Tween 80-lecithin-based sampling solution and the saline were 8/25 and 1/25, respectively (P ‫؍‬ 0.02), and the mean numbers of bacteria recovered were 281 and 19 CFU/100 ml (P ‫؍‬ 0.001), respectively. In conclusion, the efficiency and therefore the value of the monitoring of endoscope reprocessing by microbiological cultures is dependent on the sampling solutions used. A sampling solution with a tensioactive action is more efficient than saline in detecting biofilm contamination of endoscopes.

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Assessment on Experimental Bacterial Biofilms and in Clinical Practice of the Efficacy of Sampling Solutions for Microbiological Testing of Endoscopes

et al. 2012

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“…Nursing performance is recognized as a fundamental factor in the effectiveness of decontamination of the endoscope and is widely recognized as essential to the specific qualifications of health professionals who work in endoscopy services (1,3,4,7,15,17,18,19,21) . Endoscope pre-washing was not a commonly observed practice.…”

Section: Discussionmentioning

confidence: 99%

Endoscope reprocessing using glutaraldehyde in endoscopy services of Goiânia, Brazil

Barbosa¹,

Souza

Tipple

et al. 2010

Arq. Gastroenterol.

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-Context -The endoscopic procedure safety depends on the use of an adequately reprocessed device which quality is related to each of its operational steps. Objective -To characterize the reprocessing of endoscopes using glutaraldehyde in endoscopy services Methods -Study was conducted by observing the reprocessing of 60 endoscopes from 20 medical practices of the municipality of Goiânia, GO, central area of Brazil. Results -This study showed failure in all reprocessing steps. The pre-washing was performed in 24 (40.0%) of the endoscope. In the cleaning steps, was identify the improper use of enzymatic detergent, and in 27 (45.0%) cases, the brushing of internal channels was not performed. All 60 endoscopes were submitted to this disinfectant. However, for 33 (55.0%) of the cases the internal channels was not filled. The total immersion of endoscope in the glutaraldehyde was not performed in 39 (65.0%) cases. The recommended minimum total immersion time for exposure to 2% glutaraldehyde solution was followed only for 12 (20.0%) endoscopes. There was no filter for water treatment used in the rinse of most endoscopes 54 (90.0%) and to dry the internal channels only 6 (10.0%) of them used compressed air. Adequate storing conditions were identified. Conclusion -Considering the particularities of the endoscope and its reprocessing, it is imperative to establish protocols to ensure the quality of the disinfection and the prevention of cross-contamination.

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“…The benefit of endoscopy when compared to the risks has been clearly demonstrated throughout literature [3]. Despite the large number of GI endoscopic procedures performed, estimated at over 24 million procedures in 2004 in the United States alone, instances of infectious complications remain rare [4,5].…”

Section: Epidemiologymentioning

confidence: 99%

Inadequate Decontamination Procedures: Sepsis Following Uneventful Endoscopy

Smith¹,

Chaput²,

Geme³

2017

Vignettes in Patient Safety - Volume 1

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Exogenous infection following endoscopy remains rare, however, recent attention in the media and the rise of antibacterial resistant strains of bacteria have emphasized the importance of proper sterilization techniques involved in the reprocessing of endoscopes and accessory devices. This chapter serves as comprehensive review into the epidemiology of exogenous infections as well as basic reprocessing techniques and guidelines for all medical professionals that treat patients that would benefit from endoscopy.

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Endoscopy-related infection: relic of the past?

Abstract: Although the risk of endoscopy-related infection is very low, continued efforts are needed to ensure that quality is maintained during endoscope reprocessing to reduce the incidence of endoscopy-related infections.

Cited by 38 publications

References 40 publications

Assessment on Experimental Bacterial Biofilms and in Clinical Practice of the Efficacy of Sampling Solutions for Microbiological Testing of Endoscopes

Assessment on Experimental Bacterial Biofilms and in Clinical Practice of the Efficacy of Sampling Solutions for Microbiological Testing of Endoscopes

Endoscope reprocessing using glutaraldehyde in endoscopy services of Goiânia, Brazil

Inadequate Decontamination Procedures: Sepsis Following Uneventful Endoscopy

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