Microbiologic assessment of flexible gastrointestinal endoscope reprocessing using a pump-assisted sampling technique: an investigation involving all endoscopy units in Tianjin, China

Ji, Xue-Yue; Ning, Pei-Yong; Wei, Zhang; Yang, Dawei; Li, He; Liu, Jun; Song, Jia; Fei, Chun-Nan

doi:10.1016/j.ajic.2018.04.216

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…Our research results showed that of the 316 reprocessed endoscopes examined, 279 (88.3%) met Chinese national standards (≤20 CFU/channel). Compared with our previous research reports, the qualified reprocessing rate has increased (82.07% reported in 2018,[ 1 ]84.64% reported in 2020[ 27 ]). In the past few years, on-site routine surveillance has played a vital role in publicizing national standards and promoting hospitals to implement the standard reprocessing protocol.…”

Section: Discussioncontrasting

confidence: 53%

“…In the past few decades, the increase in endoscopes' functions and pathogenic microorganisms' evolution has made reprocessing endoscopes more difficult. [ 1 ] In particular, some modern and complicated endoscopic interventions such as endoscopic retrograde cholangiopancreatography (ERCP), break through the mucosal barrier and increase the risk of infection caused by endoscopy. [ 2 ] Gastrointestinal endoscopy has been confirmed to be an essential risk factor for the spread of carbapenem-resistant Enterobacteriaceae (CRE) and its related superbugs.…”

Section: Introductionmentioning

confidence: 99%

“…However, the small sample size collected each year and the significant differences in the endoscopes' background characteristics may lead to a particular selection bias and insufficient evidence for the sampling techniques' estimated effects. Although our previous research reported that FBFSM or PASM had been associated with the impact of endoscope microbial recovery,[ 1 27 ] it remains unclear if associations were attributable to selection bias.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of channel sampling methods and brush heads in surveillance culture of endoscope reprocessing: A propensity score matching and paired study

Ning

Fei

et al. 2022

Saudi J Gastroenterol

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Background: Endoscopy-related infections have caused multiple outbreaks. The importance of surveillance culture is gradually recognized, but sampling techniques are not consistent in many guidelines. It is unclear whether the Flush-Brush-Flush sampling method (FBFSM) is more sensitive than the conventional flush sampling method (CFSM) and whether different sampling brushes have different effects. Methods: The propensity score matching method was done with two matching ways, 1:1 nearest neighbor propensity score matching and full matching was used to analyze the surveillance culture data collected by FBFSM and CFSM. We fit a confounder-adjusted multiple generalized linear logistic regression model to estimate the marginal odds ratio (OR). A paired study was applied to compare the sampling effect of polyurethane foam (PU) head brush and polyamide (PA) head brush. Result: From 2016 to 2020, 316 reprocessed endoscope samples were collected from all 59 endoscopy centers in Tianjin. About 279 (88.3%) reprocessed endoscopes met the threshold of Chinese national standards (<20 CFU/Channel). The qualified rate of reprocessed endoscopes sampling by CFSM (91.8%) and FBFSM (81.6%) was statistically different (p < 0.05). The adjusted OR by full matching for FBFSM was 7.98 (95% confidence interval: 3.35-21.78). Forty one pairs of colonoscopes, after reprocessing from 27 centers, were tested by PA and PU brushes, and no difference was found in microbial recovery. Conclusion: FBFSM was confirmed to be a more sensitive sampling technique. PU and PA brushes had no significant difference in sampling effect.

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Section: Discussioncontrasting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of channel sampling methods and brush heads in surveillance culture of endoscope reprocessing: A propensity score matching and paired study

Ning

Fei

et al. 2022

Saudi J Gastroenterol

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The importance of sampling technique and rinse water for assessing flexible gastrointestinal endoscope reprocessing: A 3-year study covering 59 centers

Ning

Fei

et al. 2020

American Journal of Infection Control

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Turbulent fluid flow is a novel closed-system sample extraction method for flexible endoscope channels of various inner diameters

Sohn

Alfa

Lai

et al. 2020

Journal of Microbiological Methods

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Overview:Effective sample extraction from endoscope channels is crucial for monitoring manual cleaning adequacy as well as for ensuring optimal sensitivity for culture after disinfection. The objective of this study was to compare the efficacy of Turbulent Fluid Flow (TFF) to Flush (F) or Flush-Brush-Flush (FBF) methods.Materials & Methods: Pseudomonas aeruginosa and Enterococcus faecalis in artificial test soil-2015 (ATS2015) were used as bacterial markers while protein and carbohydrate were the organic markers for biofilm formed inside 3.2-mm and 1.37-mm polytetrafluoroethylene (PTFE) channels. TFF was generated using compressed air and sterile water to provide friction for sample extraction. Extraction for biofilm coated PTFE channels as well as for colonoscope channels perfused with ATS2015 containing 10 8 CFU/mL P. aeruginosa, E. faecalis and Candida albicans was determined using TFF compared to FBF and F. Results:The extraction ratio for P. aeruginosa and E. faecalis from biofilm extracted by TFF compared to the positive control was significantly better than F for 1.37-mm channels (≥ 0.94 for both bacteria by TFF versus 0.69 to 0.72 by F for P. aeruginosa and E. faecalis, respectively) but not significantly different between TFF and FBF for 3.2-mm channels. F was also ineffective for extraction of protein and carbohydrate from 1.37-mm channels. Extraction efficacy by TFF from inoculated colonoscope channels was >98% for all test markers. Conclusions:The novel TFF method for extraction of samples from colonoscope channels is a more effective method than the existing FBF and F methods.

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Microbiologic assessment of flexible gastrointestinal endoscope reprocessing using a pump-assisted sampling technique: an investigation involving all endoscopy units in Tianjin, China

Abstract: Many endoscopes fail to meet the national standard for microbial culture after reprocessing. Our results suggest that using a pump-assisted method could increase the sensitivity of the test.

Cited by 4 publications

References 19 publications

Comparison of channel sampling methods and brush heads in surveillance culture of endoscope reprocessing: A propensity score matching and paired study

Comparison of channel sampling methods and brush heads in surveillance culture of endoscope reprocessing: A propensity score matching and paired study

The importance of sampling technique and rinse water for assessing flexible gastrointestinal endoscope reprocessing: A 3-year study covering 59 centers

Turbulent fluid flow is a novel closed-system sample extraction method for flexible endoscope channels of various inner diameters

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