Good Practices on Endoscope Reprocessing in Italy: Findings of a Nationwide Survey

Abstract

Background: Correct reprocessing and microbiological surveillance on endoscopes are fundamental for preventing the transmission of multi-drug resistant strains and device-related infections. Methods: A questionnaire with three domains was created: (1) centre characteristics; (2) endoscope reprocessing procedures; and (3) application of microbiological surveillance. Nurses working in endoscopic units across Italy were invited to anonymously fill out the questionnaire on the SurveyMonkey platform between November 2021 and February 2022. Results: A total of 82 out of 132 endoscopic centres participated in the survey, with at least one centre from each Italian region. Data found different concerns regarding the current practice of both reprocessing and microbiological surveillance. According to respondents, the training on reprocessing was performed through theoretical training and only in 10% of centres; the microbiological surveillance was regularly performed in 59% of centres; and sampled endoscopes were not excluded for use in 31% of centres performing the surveillance until the outcome was pending, and when positive, 72% maintained them in quarantine until a successive negative result. Conclusions: Reprocessing and microbiological surveillance currently present several criticisms along the endoscopic centres in Italy. Our survey highlights the need for the correct application of the national recommendations in each endoscopic centre to prevent the potential transmission of endoscope-related infections.

An insight into outbreak of atypical mycobacterial infection following percutaneous nephrolithotomy - Role of cleaning and sterilization techniques inspected

“…27 Further, workup revealed a disinfectant plastic tray responsible for infections. In our study, inadequate cleaning of small-sized facial dilators (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16), 18G initial puncture needle, and Amplatz sheath was probably the inciting factor for NTM outbreak. Author also recommended use of metal surface, autoclaving, or use of OPA over Glutaraldehyde to prevent infections.…”

“…12 Many guidelines, training, and assessment programs have been proposed to ensure adequacy at each level of reprocessing. [13][14][15] Despite these many outbreaks have been reported recently, especially in urology practice. [16][17][18] In our study, the occurrence of wound infection in group A only highlights the importance of proper cleaning of endoscopes and accessories.…”

How to implement adverse events as a quality indicator in gastrointestinal endoscopy

“…16,[55][56][57]59 National surveys to monitor quality in endoscopy led by scientific societies are characterized by poor response numbers and by unrepresentative data collection of only the best performers. [60][61][62][63] More efficient methods are eagerly needed to reliably capture endoscopy-related AEs (and incidents) in a continuous and complete way. Automated national databases containing all medical records of all civilians seem the only way to succeed to effectively capture endoscopyrelated AEs and incidents correctly.…”

“…This is why this mode of action only results in small‐scale initiatives of local endoscopy units for a limited time duration 16,55–57,59 . National surveys to monitor quality in endoscopy led by scientific societies are characterized by poor response numbers and by unrepresentative data collection of only the best performers 60–63 …”