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Endoscope sampling and culturing methods
1Medical Device Testing, Eurofins Biotech Germande, Aix-en-Provence, France.
Background:
Contamination rates reported in the literature for patient-ready flexible endoscopes vary from 0.4% to 49%. Unfortunately, the comparison and interpretation of these results is almost impossible since several factors including sampling and culturing methods, target levels for contamination, or definition of indicator micro-organisms vary widely from one study to the other.
Aim:
To compare the efficacy of six duodenoscope sampling and culturing methods by means of extraction efficacy comparison, while at the same time identifying key parameters that provide optimal microbial recovery.
Methods:
The duodenoscope sample extraction efficacy of each method was assessed using the repetitive recovery method described in ISO 11737-1: 2018.
Findings:
Mean overall bioburden extraction efficacy varied from 1% for the Australian method to 39% for the French one. The lowest endoscope sample extraction efficacy was associated with the absence of any neutralizer, friction, or tensioactive agent, and when only a small portion of the sampling solution collected was inoculated on to culture media. The efficacy of the sampling and culturing methods also varied according to the nature of micro-organisms present in the endoscope, and the time between sampling and culturing.
Conclusion:
This study supports the need for a harmonized and standardized sampling and culturing method for flexible endoscopes.
Insights
Standardizing flexible endoscope sampling and culturing is crucial due to wide contamination rate variations. This study found significant differences in microbial recovery efficacy among methods, highlighting the need for a unified approach.
Area of Science:
- Microbiology
- Infection Control
- Medical Device Reprocessing
Background:
- Patient-ready flexible endoscope contamination rates vary widely (0.4%-49%) in literature.
- Inconsistent sampling, culturing methods, and definitions hinder result interpretation.
- Lack of standardization complicates comparisons of endoscope contamination levels.
Purpose of the Study:
- To compare the efficacy of six duodenoscope sampling and culturing methods.
- To identify key parameters for optimal microbial recovery from endoscopes.
- To address the variability in flexible endoscope contamination assessment.
Main Methods:
- Assessed duodenoscope sample extraction efficacy using the repetitive recovery method (ISO 11737-1:2018).
- Evaluated six different sampling and culturing techniques.
- Focused on microbial recovery and extraction efficiency.
Main Results:
- Mean bioburden extraction efficacy ranged from 1% (Australian method) to 39% (French method).
- Lower efficacy was linked to the absence of neutralizers, friction, or tensioactive agents.
- Efficacy depended on microorganism type and time from sampling to culturing.
Conclusions:
- Significant variability exists in current flexible endoscope sampling and culturing methods.
- A harmonized and standardized method for flexible endoscope sampling and culturing is necessary.
- Standardization will improve the reliability and comparability of contamination data.
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