A Prospective, Randomized Comparison of Duodenoscope Reprocessing Surveillance Methods.

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.