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A Novel Flocked Swab Protocol Proves to Be an Effective Method for Culturing Elevator-Containing Endoscopes
Jennifer Y Lui1, Christopher G Chapman2, Irving Waxman2
1Center for Endoscopic Research and Therapeutics, UChicago Medicine, Chicago, IL, USA. Jennifer.Lui@uchospitals.edu.
Digestive Diseases and Sciences
|March 13, 2021
Summary
A new swab protocol for culturing duodenoscopes and linear echoendoscopes is more accurate and efficient than the brush method. This improved bacterial surveillance saves significant nursing hours and costs, enhancing patient safety.
Area of Science:
- Gastroenterology
- Infectious Disease Control
- Medical Device Reprocessing
Background:
- Elevator mechanisms on duodenoscopes and linear echoendoscopes pose disinfection challenges, leading to significant bacterial transmission.
- Current guidelines for bacterial culturing of these devices are insufficient.
- This study addresses the need for improved surveillance protocols.
Purpose of the Study:
- To compare the accuracy, efficiency, and cost-effectiveness of two bacterial surveillance protocols for elevator-containing endoscopes.
- To identify the optimal method for detecting residual bacteria after reprocessing.
Main Methods:
- Reprocessed duodenoscopes and linear echoendoscopes were sampled using sequential brush and swab protocols.
- Samples were cultured to detect bacterial presence.
- Data on accuracy, time, and cost were collected for each protocol.
Main Results:
- The swab protocol yielded three positive cultures (1.1%) for Enterobacter cloacae and Klebsiella pneumoniae from 532 samples.
- The brush protocol resulted in no positive cultures.
- The swab protocol is estimated to save over $26,500 and 478 nursing hours annually compared to the brush protocol.
Conclusions:
- The swab protocol is superior to the brush protocol for detecting residual bacteria on elevator-containing endoscopes.
- The swab protocol offers significant cost and nursing hour savings.
- This method enhances patient safety by improving endoscope disinfection surveillance.
