Wie steht es um die Hygiene beim Endoskopieren?

Heudorf, U.; Hofmann, H.; Kützke, G.; Otto, U.; Exner, Martin

doi:10.1007/s00103-005-1155-x

Cited by 7 publications

(1 citation statement)

References 26 publications

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“…Entsprechend dieser Richtlinie wurden in zwei aufeinander folgenden Untersuchungen in den Jahren 2003 und 2013 die Struktur-und Prozessqualität bei der Aufbereitung flexibler Endoskope in allen gastroenterologischen Kliniken und Praxen im Frankfurter Raum überprüft. Das Ergebniss zeigte, dass die Kliniken die Richtlinien bereits 2003 weitgehend einhielten und die Praxen ihr Hygienemanagement über den folgenden 10-Jahreszeitraum erheblich verbessert hatten (Bader et al 2002, Heudorf et al 2005, Jager et al 2014. Für die Tiermedizin fehlen derartige Standards und Kontrollmechanismen derzeit leider noch, auch wenn die Endoskopie verschiedener Organsysteme mittlerweile in die Routinediagnostik der meisten Kliniken und Praxen Einzug gehalten hat.…”

Section: Introductionunclassified

Influence of different cleaning, disinfection and drying methods on endoscope hygiene in equine medicine

Barton¹,

Roschanski²,

Merle³

et al. 2017

PHK

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Influence of different cleaning, disinfection and drying methods on endoscope hygiene in equine medicineIn times of increasing numbers of infections caused by multiresistant bacteria like MRSA (Methicillin-resistenter Staphylococcus aureus) or ESBL (Extended-Spectrum Beta-Lactamasen) producing bacteria, sufficient, but feasible cleaning and disinfection of veterinary endoscopes is of great importance. In the here described study, two cleaning-and disinfection methods (manual vs. automatized) as well as two different drying techniques (air-drying vs. pressurized air) were compared. Therefore, in 4 groups of 40 endoscopic examinations were investigated by sampling of working channel, endoscope tip and shaft at 3 time-points. Microbiologic swab results were evaluated for total bacteria numbers, successful cleaning and disinfection was defined as total bacteria of 0 or at least 4 log reduction. Overall, the percentage of successful cleaning, disinfection and drying over the different groups varied from 74 to 82 %. A significant influence of the method of drying and the examined organ system was found for the working channel, while no significant factors were found for tip and shaft. Disinfection was most successful after examinations of the lower airways (P = 0.003), while odds ratios for the gastrointestinal tract and upper airways were 0.073 and 0.115, respectively. There was also a trend towards a positive effect of pressurized air drying, but this remained insignificant (P = 0.095). Overall, modern methods of disinfection and drying were found to be superior for the localizations working channel and endoscope tip (P > 0.05), but not for the shaft. In conclusion, careful cleaning and disinfection is essential in particular after endoscopic examinations of the upper airways and the gastrointestinal tract. Pressurized air drying seems preferable.

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Section: Introductionunclassified

Influence of different cleaning, disinfection and drying methods on endoscope hygiene in equine medicine

Barton¹,

Roschanski²,

Merle³

et al. 2017

PHK

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Hygiene und Infektionsprävention in Zahnarztpraxen

Heudorf

Dehler

Klenner

et al. 2006

Bundesgesundheitsbl.

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Recommendations for prevention of infection in dentistry have been published in many countries and in Germany as well. In a pilot project in collaboration with the Public Health Service of the City of Frankfurt and the chamber of dentists in Hesse, compliance with these recommendations was studied in dental practices in Frankfurt/M in 2005. After being informed about the recommendations, more than 50% of the 560 Frankfurt dentists agreed to participate in this project, and 127 of these practitioners were visited by experts of the dentist chamber. Hygienic standards in the practices were examined using a checklist. A proper hygiene schedule was observed in 84% of the practices. Facilities for hand hygiene such as dispensers for soap, disinfectant and towels were available in 98, 93 and 92% of the practices, and personal protective equipment such as gloves, masks, eye wear and gowns was found in 98, 100, 98 and 88% of the practices, respectively. Reprocessing of dental instruments was done either manually (52%), manually in combination with ultrasonic cleaning (48%) or by using special reprocessing machines (32%). Steam sterilization was used in all practices; in some practices gravity displacement sterilizers were used (14%), whereas in most of the practices (61%) a high-speed prevacuum sterilizer was available -- especially in dental surgeon practices (77%). Monitoring and documentation of the sterilization process was done automatically (33%) or by hand (55%). In 80% of the practices, pressure, temperature, time and person responsible were documented. Documents of routine maintenance and regular biological testing of the sterilizers could be shown in 93 and 84% of the practices. The Frankfurt pilot project based on information and advice in combination with control has proven to be successful in the majority of practices enrolled. Encouraged by this experience, the chamber of dentists wants to implement this project all over the state of Hesse. The intention is to inform and to visit all 4,500 dental practices in agreement with the local public health services, which in turn could reduce their own control visits in dental practices. Thus, hygiene control visits of the public health services could focus on other practices such as ambulatory surgery or endoscopy.

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Reprocessing cystoscopes in urology . Guideline compliance in hospitals and private practices in Frankfurt/M, Germany in 2005/2006

Heudorf

Otto

2007

Bundesgesundheitsbl.

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After having been informed about current guidelines, all urologic units in hospitals and private practices in Frankfurt/Main were visited in 2005/6 by members of the public health department and assessed using a checklist based on the recommendations of the German Guidelines for reprocessing medical instruments including rigid and flexible cystoscopes. In 12 hospitals and 22 private practices cystoscopy was performed using rigid cystoscopes, whereas flexible cystoscopes were used in 7 hospitals and 8 private practices. Cystoscopy with flexible instruments was more common in ambulatory than in clinic settings (about 1150/year vs. 280/year). In hospitals, reprocessing of the rigid cystoscopes was performed in special units for reprocessing (disinfection, sterilisation) using validated automatic processes, whereas reprocessing of flexible cystoscopes often was performed in the urologic units themselves, and not always in a correct manner. In the private practices, mainly manual reprocessing procedures were in use for rigid cystoscopes, in 18 out of 22 practices correct. However, only in 50 % of the private practices, sterilisation equipment was available for reprocessing rigid cystoscopes and/or endoscopic accessories. Flexible cystoscopes were reprocessed using a washer-disinfector in one practice, in the other ones, manual reprocessing was performed. In two practices only, reprocessing according to the guidelines was seen. Infection control advice and repeated control of the public health department resulted in the correction of most processing faults within some months.

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Wie steht es um die Hygiene beim Endoskopieren?

Cited by 7 publications

References 26 publications

Influence of different cleaning, disinfection and drying methods on endoscope hygiene in equine medicine

Influence of different cleaning, disinfection and drying methods on endoscope hygiene in equine medicine

Hygiene und Infektionsprävention in Zahnarztpraxen

Reprocessing cystoscopes in urology . Guideline compliance in hospitals and private practices in Frankfurt/M, Germany in 2005/2006

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