Optimizing endoscope surveillance: how sampling methods and time points affect microbiological surveillance.

Area of Science:

• Infection Control
• Microbiology
• Medical Device Reprocessing

Background:

• Endoscope-associated infections persist despite reprocessing guidelines.
• Effective microbial surveillance is crucial for quality control in endoscopy units.
• Sampling timing and technique influence surveillance effectiveness.

Purpose of the Study:

• To evaluate the impact of sampling timing (immediately after high-level disinfection vs. overnight drying) and technique (conventional flushing sampling method vs. flush-brush-flush sampling method) on microbial recovery from reprocessed endoscopes.

Main Methods:

• Prospective multi-centre study in three gastrointestinal endoscopy units.
• Sampling performed immediately post-high-level disinfection (HLD) or after overnight dry cabinet storage.
• Comparison of conventional flushing sampling method (CFSM) and flush-brush-flush sampling method (FBFSM).

Main Results:

• Overall pass rate for disinfected endoscopes was 83.4%.
• Flush-brush-flush sampling method (FBFSM) showed significantly lower pass rates, indicating better microbial recovery than CFSM.
• Endoscopes sampled after overnight drying had higher pass rates and lower detection of key organisms compared to immediate post-HLD sampling.

Conclusions:

• The drying phase is critical for reducing residual microbial contamination on endoscopes.
• Flush-brush-flush sampling method (FBFSM) is a more sensitive technique for post-reprocessing surveillance.
• Optimizing drying and sampling methods enhances the effectiveness of microbial surveillance in preventing endoscope-associated infections.