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A Prospective, Randomized Comparison of Duodenoscope Reprocessing Surveillance Methods.

Travis J De Wolfe^1,2, Nasia Safdar^2,3,4, Megan Meller²

¹Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh 15219, PA, USA.

Canadian Journal of Gastroenterology & Hepatology

|December 13, 2019

Summary

This summary is machine-generated.

The University of Wisconsin Hospitals and Clinics (UWHC) protocol for duodenoscope reprocessing surveillance detected similar bacterial contamination rates as the Centers for Disease Control and Prevention (CDC) protocol. The UWHC method offers a faster and more cost-effective alternative for healthcare facilities.

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Area of Science:

Healthcare-associated infections
Microbiology
Infection control

Background:

Duodenoscope use is linked to multidrug-resistant pathogen transmission between patients.
The Centers for Disease Control and Prevention (CDC) developed voluntary surveillance protocols in 2015 to monitor duodenoscope reprocessing quality.
Individual institutions have developed alternative surveillance protocols to the CDC's interim methods.

Purpose of the Study:

To compare the effectiveness of the 2015 CDC interim duodenoscope sampling protocol with an alternative protocol developed by the University of Wisconsin Hospitals and Clinics (UWHC).
To evaluate bacterial contamination detection rates, processing time, and cost-effectiveness of both protocols.

Main Methods:

A total of 248 sampling events were conducted at UWHC.
The CDC protocol involved culturing samples from brushed terminal ends and flushed lumens (n=129).
The UWHC protocol involved swabbing the elevator, immersing the terminal end in broth, and flushing with saline (n=119).

Main Results:

The CDC method yielded 8.53% positive cultures (11/129), while the UWHC method yielded 15.13% positive cultures (18/119).
The relative risk of detecting a contaminated duodenoscope was not significantly different between the two methods.
The UWHC method demonstrated significantly shorter mean processing time (5.11 minutes vs. 27.35 minutes) and lower cost per sample event ($15.04 vs. $17.87).

Conclusions:

The UWHC protocol provides comparable bacterial contamination detection rates to the CDC protocol.
The UWHC protocol is a viable alternative due to its significantly reduced processing time and lower cost.
Implementing the UWHC protocol can help healthcare facilities improve duodenoscope reprocessing surveillance efficiency and reduce patient infection risk.