Currently, flexible endoscopes, including gastrointestinal, urological, and respiratory endoscopes, are reused following cleaning and high-level disinfection. Current techniques used to clean endoscopes for reuse are not consistently effective, revealed a study published in the February issue of the American Journal of Infection Control, the official journal of the Association for Professionals in Infection Control and Epidemiology.
‘Even though top-notch reprocessing techniques were used, the endoscopes in this study had visible signs of damage and debris, and tests showed a high proportion were still contaminated.’
Tweet it Now
The findings of this study support the need for careful visual
inspection and cleaning verification tests to ensure that all endoscopes
are free of damage and debris before they are high-level disinfected or
sterilized and used on another patient."APIC is concerned about the risk of infections related to endoscopic procedures," said Linda Greene, 2017 APIC president. "This study reinforces the importance of having strong infection prevention and control programs at all types of facilities, led by highly trained infection preventionists, to ensure that facilities are following the latest evidenced-based guidance."
Results from the new study conducted by Ofstead & Associates, Inc., suggest that even more rigorous reprocessing techniques of endoscopes are not consistently effective, and organic residues often remain.
"Understanding issues with the effectiveness of reprocessing techniques is critically important as institutions seek to improve the quality of endoscope cleaning and disinfection," said lead study author Cori L. Ofstead, Ofstead & Associates, Inc. "Even though top-notch methods were used, the endoscopes in this study had visible signs of damage and debris, and tests showed a high proportion were still contaminated."
Using a longitudinal study design, Ofstead, et al. performed three assessments of 20 endoscopes over a seven-month period. The assessments involved visual inspections with a tiny camera, microbial cultures, and biochemical tests to detect protein and adenosine triphosphate (ATP) - a marker that identifies organic matter. These assessments were used to identify endoscopes that required further cleaning and maintenance.
Advertisement
Further results indicated that about 20% of endoscopes in each group exceeded post-cleaning benchmarks for ATP and protein residue. Moreover, ATP levels were higher for gastroscopes, which are used for upper GI procedures, than the endoscopes used for colonoscopy. "Since the same technicians used the same techniques to clean and disinfect these scopes, the findings and our visual observations suggest that something is happening to gastroscopes during procedures that changes the surfaces and causes reprocessing failures," says Ofstead.
Advertisement
"The finding of residual fluid in 95% of endoscopes tested was significant because moisture fosters microbial growth and the development of biofilm - which can be difficult or impossible to remove," said Ofstead. "This confirms the importance of cleaning, disinfecting, and drying to ensure patient safety."
Source-Eurekalert