High-quality endoscope reprocessing decreases endoscope contamination

Area of Science:

• Medical Microbiology
• Infection Control
• Gastroenterology

Background:

• Outbreaks of severe infections linked to contaminated gastrointestinal (GI) endoscopes, particularly duodenoscopes, have been reported globally.
• Microbial contamination rates of GI endoscopes vary significantly in existing literature.
• Evaluating endoscope hygiene is crucial for patient safety in endoscopy centers.

Purpose of the Study:

• To assess the hygiene quality of gastrointestinal endoscopes and automated endoscope reprocessors (AERs) in Tyrol, Austria.
• To determine the microbial contamination rates of endoscopes and AERs using routine and advanced sampling methods.
• To identify common microbial contaminants and potential sources of contamination in endoscopy reprocessing workflows.

Main Methods:

• A multicentre prospective study conducted in 2015-2016 analyzed 463 GI endoscopes and 105 AERs from 29 endoscopy centers.
• Both routine (R) and combined routine and advanced (CRA) sampling procedures were employed.
• Microbial contamination was investigated using culture-based and molecular-based analyses.

Main Results:

• The contamination rate of GI endoscopes ranged from 1.3% to 4.6% based on national guidelines.
• The CRA sampling method revealed higher failure rates (4.6% in phase I, 3.0% in phase II) compared to routine sampling (1.8% in phase I, 1.3% in phase II).
• Pseudomonas spp., primarily Pseudomonas oleovorans, was the most frequently identified indicator organism; no tested viruses were detected. AERs showed technical faults in phase I and microbial contamination in phase II.

Conclusions:

• The contamination rate of endoscopes in this Austrian study was notably low compared to other European countries.
• High-quality endoscope reprocessing, effective drying, and proper storage practices are suggested as key factors for maintaining low contamination levels.
• The findings underscore the importance of rigorous adherence to reprocessing protocols to prevent endoscope-related infections.