Recent Update on Microbiological Monitoring of Gastrointestinal Endoscopes after High-Level Disinfection

Shin, Suk Pyo; Kim, Wonhee

doi:10.5946/ce.2015.48.5.369

Cited by 22 publications

(17 citation statements)

References 23 publications

(30 reference statements)

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“…It is quick (<1 minute) and simple, but it fails to detect small quantities of microorganisms, 21 so it could be considered an indicator of endoscope cleanliness, notably to audit manual cleaning adequacy. 19 , 20 Recommended maximum RLU values for samples taken at the end of reprocessing (during storage or just before reuse) are not available.…”

Section: Discussionmentioning

confidence: 99%

Surveillance of Endoscopes: Comparison of Different Sampling Techniques

Cattoir

Vanzieleghem

Florin

et al. 2017

Infect. Control Hosp. Epidemiol.

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OBJECTIVETo compare different techniques of endoscope sampling to assess residual bacterial contamination.DESIGNDiagnostic study.SETTINGThe endoscopy unit of an 1,100-bed university hospital performing ~13,000 endoscopic procedures annually.METHODSIn total, 4 sampling techniques, combining flushing fluid with or without a commercial endoscope brush, were compared in an endoscope model. Based on these results, sterile physiological saline flushing with or without PULL THRU brush was selected for evaluation on 40 flexible endoscopes by adenosine triphosphate (ATP) measurement and bacterial culture. Acceptance criteria from the French National guideline (<25 colony-forming units [CFU] per endoscope and absence of indicator microorganisms) were used as part of the evaluation.RESULTSOn biofilm-coated PTFE tubes, physiological saline in combination with a PULL THRU brush generated higher mean ATP values (2,579 relative light units [RLU]) compared with saline alone (1,436 RLU; P=.047). In the endoscope samples, culture yield using saline plus the PULL THRU (mean, 43 CFU; range, 1–400 CFU) was significantly higher than that of saline alone (mean, 17 CFU; range, 0–500 CFU; P<.001). In samples obtained using the saline+PULL THRU brush method, ATP values of samples classified as unacceptable were significantly higher than those of samples classified as acceptable (P=.001).CONCLUSIONPhysiological saline flushing combined with PULL THRU brush to sample endoscopes generated higher ATP values and increased the yield of microbial surveillance culture. Consequently, the acceptance rate of endoscopes based on a defined CFU limit was significantly lower when the saline+PULL THRU method was used instead of saline alone.Infect Control Hosp Epidemiol 2017;38:1062–1069

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Section: Discussionmentioning

confidence: 99%

Surveillance of Endoscopes: Comparison of Different Sampling Techniques

Cattoir

Vanzieleghem

Florin

et al. 2017

Infect. Control Hosp. Epidemiol.

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“…One aspect of endoscope sample collection that is often overlooked when culturing endoscopes ( 3 , 4 , 7 , 11 , 17 , 19 , 23 ) is the need to use a “neutralizer” to ensure that trace residuals of antimicrobial agents (e.g., HLDs) are inactivated ( 9 , 13 , 15 , 24 ). In addition, the use of a neutralizing agent ensures that organisms with sub-lethal injury are protected and stimulated to grow on culture thereby reducing VBNC issues when culture is used to determine if endoscopes are contaminated ( 9 , 25 ).…”

Section: Discussionmentioning

confidence: 99%

Sterile Reverse Osmosis Water Combined with Friction Are Optimal for Channel and Lever Cavity Sample Collection of Flexible Duodenoscopes

et al. 2017

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IntroductionSimulated-use buildup biofilm (BBF) model was used to assess various extraction fluids and friction methods to determine the optimal sample collection method for polytetrafluorethylene channels. In addition, simulated-use testing was performed for the channel and lever cavity of duodenoscopes.Materials and methodsBBF was formed in polytetrafluorethylene channels using Enterococcus faecalis, Escherichia coli, and Pseudomonas aeruginosa. Sterile reverse osmosis (RO) water, and phosphate-buffered saline with and without Tween80 as well as two neutralizing broths (Letheen and Dey–Engley) were each assessed with and without friction. Neutralizer was added immediately after sample collection and samples concentrated using centrifugation. Simulated-use testing was done using TJF-Q180V and JF-140F Olympus duodenoscopes.ResultsDespite variability in the bacterial CFU in the BBF model, none of the extraction fluids tested were significantly better than RO. Borescope examination showed far less residual material when friction was part of the extraction protocol. The RO for flush-brush-flush (FBF) extraction provided significantly better recovery of E. coli (p = 0.02) from duodenoscope lever cavities compared to the CDC flush method.Discussion and conclusionWe recommend RO with friction for FBF extraction of the channel and lever cavity of duodenoscopes. Neutralizer and sample concentration optimize recovery of viable bacteria on culture.

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“…Reprocessing of endoscopic accessory equipment is also mandatory. It is recommended that all endoscopists should not only understand and comply with the endoscope cleaning and disinfection guidelines, but also actively participate in the endoscopic quality improvement program [ 38 ].…”

Section: Endoscopic Quality Control and Reprocessing (Essential)mentioning

confidence: 99%

Education and Training Guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy

et al. 2017

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The Korean Society of Gastrointestinal Endoscopy (KSGE) developed a gastrointestinal (GI) endoscopy board in 1995 and related regulations. Although the KSGE has acquired many specialists since then, the education and training aims and guidelines were insufficient. During GI fellowship training, obtaining sufficient exposure to some types of endoscopic procedures is difficult. Fellows should acquire endoscopic skills through supervised endoscopic procedures during GI fellowship training. Thus, the KSGE requires training guidelines for fellowships that allow fellows to perform independent endoscopic procedures without supervision. This document is intended to provide principles that the Committee of Education and Training of the KSGE can use to develop practical guidelines for granting privileges to perform accurate GI endoscopy safely. The KSGE will improve the quality of GI endoscopy by providing guidelines for fellowships and supervisors.

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Recent Update on Microbiological Monitoring of Gastrointestinal Endoscopes after High-Level Disinfection

Cited by 22 publications

References 23 publications

Surveillance of Endoscopes: Comparison of Different Sampling Techniques

Surveillance of Endoscopes: Comparison of Different Sampling Techniques

Sterile Reverse Osmosis Water Combined with Friction Are Optimal for Channel and Lever Cavity Sample Collection of Flexible Duodenoscopes

Education and Training Guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy

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