Experimental Study to Develop a Method for Improving Sample Collection to Monitor Laryngoscopes after Reprocessing

Abstract

Background/AimsThe microbiological surveillance of endoscopes and automated flexible endoscope reprocessing have been proven to be two of the most difficult and controversial areas of infection control in endoscopy. The purpose of this study was to standardize a sampling method for assessing the effectiveness of standard reprocessing operating procedures for flexible fiberoptic laryngoscopes (FFLs). MethodsFirst, the sampling devices were directly inoculated with Bacillus atrophaeus spores; second, tissue non tissue (TNT) wipes were tested on artificially contaminated surfaces and on FFLs.ResultsComparison of the sponges, cellulose, and TNT wipes indicated that the TNT wipes were more effective in releasing spores (93%) than the sponges (49%) and cellulose wipes (52%). The developed protocol provides a high efficiency for both collection and extraction from the stainless steel surface (87% of the spores were removed and released) and from the FFL (85% of the spores were removed and released), with relatively low standard deviations for recovery efficiency, particularly for the analysis of the FFL. ConclusionsTNT wipes are more efficient for sampling surface areas, thereby aiding in the accuracy and reproducibility of environmental surveillance.

Using Microbiological Sampling to Evaluate the Efficacy of Nasofibroscope Disinfection: The Tristel Trio Wipes System in Ear–Nose–Throat (ENT) Endoscopy

“…In our study, we adopted TNT wipes, a more efficient device for sampling surfaces that could improve the accuracy and reproducibility of environmental surveillance as discussed in a previous study [12].…”

“…We developed a surface sampling method (by TNT wipes) to detect low levels of bacteria on a FFNs as discussed in a recent publication [12].…”

“…The second sample was collected using the wipe procedure [12]. We sampled the whole insertion shaft of the FFL with a sterile TNT wipe pre-moistened with 0.5 mL of sterile water by wiping the surface from top to bottom of the insertion tube, folding the exposed side of the wipe to the interior, and wiping once again (Figure 2).…”

What is the Best Sampling Method to Monitor the Effect of Endoscopy Reprocessing?

“…The sampling method needs to be further defined and clarified. In this issue of Clinical Endoscopy , Ditommaso et al published a study on the efficacy of a surface sampling device for surveillance culture after flexible fiberoptic laryngoscopes [ 7 ]. In this study, the extraction efficiency of three different sampling devices (tissue non tissue [TNT] wipes, cellulose wipes, and hydrated sponge) inoculated with Bacillus atrophaeus spores were compared and TNT wipes showed the highest extraction efficiency (93% vs. 52% and 49%, respectively).…”

“…Surveillance sampling and culturing of endoscopes are a major concern to prevent iatrogenic infection in patients during endoscopic procedures. Surface sample culture of endoscopes was not demonstrated to be much better than channel flushing/brushing or endoscope tip swabbing, but an experimental study by Ditommaso et al called attention to surface sample culture and showed the superiority of the TNT wipes in terms of extraction rate [ 7 ]. More research studies are needed, and appropriate standards should be prepared to apply this study results in clinical practice.…”