Significant increased bacterial contamination with endoscope overnight and weekend storage times
Simone Vieira Toledo Guadagnin1, Dayane de Melo Costa2,3, Mariusa Gomes Borges Primo1
1Clinics Hospital, Federal University of Goias, Goiânia, Goias, Brazil.
Background And Aim:
Forced-air drying (FAD) cabinets are recommended for storage of reprocessed endoscopes, but financial constraints prevent their universal application. The study aimed to determine bacterial contamination in flexible gastroscopes (FG) channels after storage, in a cabinet with filtered air and UV lights, but without FAD.
Methods:
Eight FG in clinical use in an endoscopy service of a large Brazilian hospital were sampled: immediately "Time zero" (N = 50), 12 h "Time 1" (N = 25), and 60 h "Time 2" (N = 25) after reprocessing. Following a flush-brush-flush of channels, 40-mL sterile water and 3 cm of the brush were collected. Each sample was divided, filtered onto two 0.22-μm membranes, and incubated in media without or with disinfectant neutralizer. Automated method was used for identification and antibiotic resistance test of isolated bacteria.
Results:
Bacterial contamination in times "1" and "2" was 5.9 and 16.1 times greater than that of "Time zero," respectively. Number of positive cultures in media with and without neutralizer was similar at times "1" and "2," while media with neutralizer produced more positive cultures at "Time zero." Most bacteria isolated at "Time 2" were Gram-negative rods (52.3%) and showed resistance to one or more antibiotics (65%).
Conclusion:
Bacterial contamination was detected on reprocessed FG stored in non-FAD cabinets overnight (12 h) and increased with longer storage time (60 h). The contamination source is likely to be bacteria in biofilm which multiply in the absence of FAD. Evidence-based criteria should be available for storage time according to the cabinet available.
Insights
Bacterial contamination increased in flexible gastroscopes stored without forced-air drying (FAD) cabinets. Longer storage times in non-FAD cabinets led to higher contamination, suggesting biofilm multiplication.
Area of Science:
- Infection Control
- Microbiology
- Medical Device Reprocessing
Background:
- Forced-air drying (FAD) cabinets are recommended for reprocessed endoscopes.
- Financial constraints limit FAD cabinet use in many healthcare settings.
- Alternative storage methods require evaluation for bacterial contamination risks.
Purpose of the Study:
- To assess bacterial contamination in flexible gastroscopes (FG) after storage.
- To evaluate storage in a cabinet with filtered air and UV light, but without FAD.
- To determine the impact of storage duration on contamination levels.
Main Methods:
- Eight flexible gastroscopes were sampled at 0, 12, and 60 hours post-reprocessing.
- Channel samples were collected using a flush-brush-flush method.
- Bacterial identification and antibiotic resistance testing were performed using automated methods.
Main Results:
- Bacterial contamination was significantly higher at 12 and 60 hours compared to time zero.
- Gram-negative rods constituted the majority of bacteria at 60 hours (52.3%).
- 65% of bacteria isolated at 60 hours exhibited antibiotic resistance.
Conclusions:
- Reprocessed flexible gastroscopes stored in non-FAD cabinets show increased bacterial contamination.
- Prolonged storage (60 hours) exacerbates contamination, likely due to biofilm growth.
- Evidence-based guidelines for storage duration based on available cabinet technology are needed.
