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Bacterial contamination of endoscopist and assistant face visors during gastrointestinal endoscopy: a pilot study
David Nylander1, John Leeds1,2, John Perry3
1Department of Gastroenterology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
Background And Aim:
During the COVID-19 pandemic, health workers' facial exposure to pathogens has been brought into focus. In this study, we aimed to determine the occurrence and degree of facial contamination to both endoscopists and their assistants during endoscopic procedures to help inform future safety measures.
Methods:
Non-sterile visors worn by endoscopist, assistant and room control visors from 50 procedures were swabbed post procedure for culture. Procedure type, therapy, duration and evidence of visible visor contamination were recorded. After 48-hour incubation, all bacterial colonies were identified using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry. Organisms were classified into skin/environmental, oronasal and enteric.
Results:
A total of 104 visors were available for assessment (93 staff; 11 control). In worn visors, skin/environmental flora were isolated from 70, oronasal flora from 8, and enteric flora from 3 with an average colony count of >9.5. Notably, bacteria of enteric origin (Escherichia coli and Enterobacter cloacae) were isolated from three worn visors. In room control, skin/environmental flora were isolated from seven and oronasal flora from one with average colony count of five. No room control visors grew enteric flora. Overall, 9.1% room control and 10.8% worn visors were contaminated with organisms that could possibly have originated from patients. However, enteric flora were only obtained from worn visors. No visors were visibly contaminated.
Conclusion:
This pilot study demonstrates risk of contamination to faces of endoscopists and assistants. Larger studies are required to determine degree of risk and to give guidance on facial protection during gastrointestinal endoscopy.
Insights
Endoscopic procedures can contaminate healthcare workers' faces with patient pathogens, even without visible visor contamination. This pilot study highlights the risk of facial contamination for endoscopists and assistants.
Area of Science:
- Microbiology
- Infectious Disease Control
- Gastroenterology
Background:
- Facial exposure of healthcare workers to pathogens gained attention during the COVID-19 pandemic.
- Endoscopic procedures involve close patient contact, raising concerns about pathogen transmission.
Purpose of the Study:
- To assess the occurrence and extent of facial contamination in endoscopists and assistants during endoscopic procedures.
- To inform the development of enhanced safety measures for gastrointestinal endoscopy.
Main Methods:
- Non-sterile visors worn by staff and room control visors were collected from 50 procedures.
- Swabs were cultured, and bacterial colonies identified using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry.
- Organisms were categorized as skin/environmental, oronasal, or enteric.
Main Results:
- Enteric bacteria (e.g., *Escherichia coli*) were isolated from three worn visors, indicating potential patient-to-staff transmission.
- While 10.8% of worn visors and 9.1% of control visors showed contamination, enteric flora was exclusively found on worn visors.
- No visors exhibited visible contamination, underscoring the need for objective assessment.
Conclusions:
- This pilot study indicates a risk of facial contamination for healthcare professionals performing endoscopy.
- Further research is necessary to quantify this risk and establish guidelines for appropriate facial protection during endoscopic procedures.
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