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Am J Infect Control. 2016 Jul 1;44(7):815-9. doi: 10.1016/j.ajic.2016.01.017. Epub 2016 Mar 4.

Practical toolkit for monitoring endoscope reprocessing effectiveness: Identification of viable bacteria on gastroscopes, colonoscopes, and bronchoscopes.

Author information

1
Ofstead & Associates, Inc, St Paul, MN.
2
Department of Infection Prevention, University of Minnesota Health, Minneapolis, MN.
3
Department of Clinical Quality Improvement, University of Minnesota Health, Minneapolis, MN.
4
Division of Gastroenterology, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN.

Abstract

BACKGROUND:

Experts have recommended microbiologic surveillance by external reference laboratories for certain flexible endoscopes. There is currently insufficient evidence on the feasibility and utility of cultures. Researchers evaluated a preassembled toolkit for collecting and processing samples from endoscopes.

METHODS:

A pilot study was performed in a large academic medical center. A toolkit was used to aseptically sample biopsy ports and suction/biopsy channels of 5 gastroscopes, 5 colonoscopes, and 5 bronchoscopes after full reprocessing. Blinded specimens were packaged and transported on icepacks to a reference laboratory that used standard methodologies for microbial cultures.

RESULTS:

The laboratory detected bacteria in samples from 60% of patient-ready endoscopes, including gram-positive and gram-negative species. Viable microbes (<10 CFU) were recovered from 2 gastroscopes, 3 colonoscopes, and 4 bronchoscopes. Stenotrophomonas maltophilia and Delftia acidovorans were recovered from all 3 endoscope types. Subsequent environmental testing detected S maltophilia in the reprocessing rinse water.

CONCLUSIONS:

A preassembled toolkit facilitated the aseptic collection of samples for culturing by a reference laboratory that detected viable microbes on fully reprocessed endoscopes. Speciation allowed identification of potential pathogens and a possible common contamination source, demonstrating that microbial cultures may have value even when colony counts are low.

KEYWORDS:

High-level disinfection; Microbial cultures; Stenotrophomonas maltophilia

PMID:
26952038
DOI:
10.1016/j.ajic.2016.01.017
[Indexed for MEDLINE]

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