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Am J Infect Control. 2015 Aug;43(8):794-801. doi: 10.1016/j.ajic.2015.03.003.

Persistent contamination on colonoscopes and gastroscopes detected by biologic cultures and rapid indicators despite reprocessing performed in accordance with guidelines.

Author information

1
Ofstead & Associates, Saint Paul, MN; Division of Infectious Diseases, Mayo Clinic, Rochester, MN. Electronic address: cori@ofsteadinsights.com.
2
Ofstead & Associates, Saint Paul, MN.
3
Division of Internal Medicine, Mayo Clinic, Rochester, MN.
4
Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC.
5
Division of Infectious Diseases, Mayo Clinic, Rochester, MN.

Abstract

BACKGROUND:

Pathogens have been transmitted via flexible endoscopes that were reportedly reprocessed in accordance with guidelines.

METHODS:

Researchers observed reprocessing activities to ensure guideline compliance in a large gastrointestinal endoscopy unit. Contamination was assessed immediately after bedside cleaning, manual cleaning, high-level disinfection, and overnight storage via visual inspection, aerobic cultures, and tests for adenosine triphosphate (ATP), protein, carbohydrate, and hemoglobin.

RESULTS:

All colonoscopes and gastroscopes were reprocessed in accordance with guidelines during the study. Researchers collected and tested samples during 60 encounters with 15 endoscopes. Viable microbes were recovered from bedside-cleaned (92%), manually cleaned (46%), high-level disinfected (64%), and stored (9%) endoscopes. Rapid indicator tests detected contamination (protein, carbohydrate, hemoglobin, or ATP) above benchmarks on bedside-cleaned (100%), manually cleaned (92%), high-level disinfected (73%), and stored (82%) endoscopes. Visible residue was never observed on endoscopes, but it was often seen on materials used to sample endoscopes. Seven endoscopes underwent additional reprocessing in response to positive rapid indicators. Control endoscope channels were free of biologic residue and viable microbes.

CONCLUSION:

Despite reprocessing in accordance with US guidelines, viable microbes and biologic debris persisted on clinically used gastrointestinal endoscopes, suggesting current reprocessing guidelines are not sufficient to ensure successful decontamination.

KEYWORDS:

Colonoscope; Endoscope reprocessing; Epidemiology; Gastrointestinal endoscopy; High-level disinfection; Reprocessing medical devices

PMID:
26234219
DOI:
10.1016/j.ajic.2015.03.003
[Indexed for MEDLINE]

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