Estimation of average bioburden values on flexible gastrointestinal endoscopes after clinical use and cleaning: Assessment of the efficiency of cleaning processes

Hamed, Medhat Mohammed Anwar; Alah, Ibrahim Dafa Alah Naeem Dafa; Sawaf, Gamal El Deen El

doi:10.1016/j.ajme.2014.05.002

Cited by 5 publications

(4 citation statements)

References 41 publications

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“…In this context, microbiological surveillance is a valid tool for detecting procedural errors or microlesions of the endoscope, which can facilitate biofilms formation and cause positivity to microbial cultures [ 2 ]. However, infections associated with contaminated endoscopes on which the reprocessing procedure was correctly performed have been reported [ 3 , 4 , 5 , 6 ]. Recently, a meta-analytical study estimated a contamination rate of patient-ready duodenoscopes for endoscopic retrograde cholangio-pancreatography (ERCP) of 16.14% ± 0.019 (95% Cl: 12.43–19.85%) after high-level disinfection [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Improving the Reprocessing Quality of Flexible Thermolabile Endoscopes: How to Learn from Mistakes

Casini

Tuvo

Marciano

et al. 2021

IJERPH

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Background: Failure in the reprocessing of thermolabile flexible endoscopes has been reported as one of the most important threats to patient health. Method: A case report and observational study was conducted, from August 2014 to December 2019, in the Digestive Endoscopy Unit of a University Hospital in Italy, where two cases of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae infections in patients undergoing endoscopic retrograde cholangio-pancreatography were observed. Following the risk/safety management practices, an epidemiological investigation was started, duodenoscopes were removed from use and the reprocessing practices reviewed. Moreover, microbiological surveillance of endoscopes was carried out according to the CDC guidelines. Results: In the first phase of sampling, 10/10 (100%) endoscopes were found to be non-compliant, of which 7 showed results for high-concern organisms (HCOs), such as KPC-K. pneumoniae, P. aeruginosa and E. coli. After implementing corrective actions, 12 out of 17 endoscopes were found to be non-compliant (70.5%), of which 8 showed results for HCOs, such as KPC-K. oxytoca and P. aeruginosa. During the last year of regular microbiological surveillance, only 23% of endoscopes (35/152) were found to be non-compliant, of which 7 showed results for HCOs, such as NDM-K. pneumoniae, P. aeruginosa and A. baumannii. The crucial issues were related to samples collected from the internal channels of duodenoscopes. Conclusion: Managing the risk associated with the reprocessing of digestive endoscopes, through risk assessment at every stage of the process, is important for the prevention of infections associated with the use of these device.

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Section: Introductionmentioning

confidence: 99%

Improving the Reprocessing Quality of Flexible Thermolabile Endoscopes: How to Learn from Mistakes

Casini

Tuvo

Marciano

et al. 2021

IJERPH

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“…No entanto, os equipamentos endoscópicos possuem uma estrutura complexa, constituída por múltiplos canais longos, com lúmens estreitos, o que torna difícil seu acesso, podendo comprometer a sua limpeza e desinfecção (1,5,6) . Durante o exame, os endoscópios gastrointestinais podem tornar-se altamente contaminados (7)(8)(9) , atingindo uma carga microbiana substancial que pode variar entre 6 × 10 4 a 3,7 × 10 8 UFC/mL (10) . Essa contaminação decorre do percurso do equipamento, pois estabelece um contato direto com sangue, secreções e microrganismos potencialmente patogênicos tais como Streptococcus spp., Staphylococcus spp., Escherichia coli, Klebsiella spp.…”

Section: Introductionunclassified

“…Essa contaminação decorre do percurso do equipamento, pois estabelece um contato direto com sangue, secreções e microrganismos potencialmente patogênicos tais como Streptococcus spp., Staphylococcus spp., Escherichia coli, Klebsiella spp. e Helicobacter pylori (10,11) .…”

Section: Introductionunclassified

Processamento endoscópico: quais são os gaps na prática clínica?

Madureira¹,

Oliveira²

2021

Rev. Eletr. Enferm.

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Objetivo: Identificar na prática clínica gaps que interferem na efetividade do processamento endoscópico. Método: Revisão integrativa de artigos publicados entre 2008–2020, identificados em bases de dados por meio de descritores controlados em Ciências da Saúde, adotando-se a estratégia PICO. Os gaps identificados foram classificados segundo nível de evidência (IA, IB, IC, II). Resultados: Foram encontrados 18 artigos registrando 64 gaps, 26,6% no nível de evidência IA e 40,6% IB, predominando: ausência/inadequação da secagem (55,5%), limpeza manual sem escovação dos canais/escovas inapropriadas (50%), omissão do teste de vedação (38,8%), inadequações no armazenamento (33,3%) e no uso da solução desinfetante (27,7%), tempo de imersão ou monitorização da concentração mínima eficaz, ausência de pré-limpeza (16,6%), transporte incorreto para a sala de processamento (11,1%). Conclusão: As diretrizes fortemente recomendadas por entidades internacionais e nacional têm sido descumpridas, representando aspectos críticos no processamento dos endoscópios que implicam em potenciais falhas na segurança do paciente.

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“…Moreover, studies were conducted on the effects of cleaning agents and disinfectants on the cleaning of medical devices and materials [5][6][7]. In several studies, adenosine triphosphate (ATP) tests were conducted, and alternative practical detergency evaluation methods were implemented [8][9][10][11][12][13], which highlighted the importance of monitoring [14][15][16]. Several fundamental studies were conducted with focus on the interaction of blood proteins such as albumin and hemoglobin with surfactants [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Kinetic analysis of hemoglobin detergency by probability density functional method

et al. 2020

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In this study, washing tests were performed using samples prepared by contaminating fabrics with hemoglobin, and a kinetic analysis was conducted based the probability density functional method, which expresses the cleaning power using two parameters σ rl (related to the cleaning mechanism) and μ rl (related to the level of cleaning power). This method allows for the processing of uncertainties specific to protein washing under the assumption that the soil adhesion and detergency are in accordance with a normal distribution. A certain amount of hemoglobin solution was soaked in a cloth, dried, and steam-treated, and then used as a sample for a cleaning test. Two parameters σ rl and μ rl were calculated based on the detergency (%) after 5 min, 10 min, 15 min, and 20 min of washing with respect to different pH and temperature levels, and different sodium dodecyl sulfate (SDS) concentration and temperature levels. Based on the results, the value of σ rl indicated that the hemoglobin was removed by the dissolving action. In addition, μ rl increased in accordance with an increase in the pH, SDS concentration, and temperature. With respect to μ rl , the relationship of ΔX + ΔY = Δ(X+Y) was observed in several cases, where ΔX represents the effect of the pH or SDS concentration, ΔY is the temperature effect, and Δ(X+Y) is the combined effect. Therefore, there may be an additive relationship between the pH and temperature effects, and the SDS concentration and temperature effects.

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Estimation of average bioburden values on flexible gastrointestinal endoscopes after clinical use and cleaning: Assessment of the efficiency of cleaning processes

Cited by 5 publications

References 41 publications

Improving the Reprocessing Quality of Flexible Thermolabile Endoscopes: How to Learn from Mistakes

Improving the Reprocessing Quality of Flexible Thermolabile Endoscopes: How to Learn from Mistakes

Processamento endoscópico: quais são os gaps na prática clínica?

Kinetic analysis of hemoglobin detergency by probability density functional method

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