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High-quality endoscope reprocessing decreases endoscope contamination.

P Decristoforo1, J Kaltseis1, A Fritz1

  • 1Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|February 7, 2018
PubMed
Summary

Gastrointestinal endoscope contamination rates in Austria were low, with Pseudomonas species being the most common contaminant. High-quality reprocessing, drying, and storage likely contributed to these favorable hygiene results.

Keywords:
Automated endoscope reprocessorContaminationGastrointestinal endoscopeGuidelineHigh-level disinfectionMicrobiological surveillance

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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.