Microbiological surveillance post-reprocessing of flexible endoscopes used in digestive endoscopy: a national study.

Autor: Casini B; Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy., Spagnolo AM; Department of Health Sciences, University of Genova, Genova, Italy; Operating Unit Hospital Hygiene, Galliera Hospital, Genoa, Italy. Electronic address: am.spagnolo@unige.it., Sartini M; Department of Health Sciences, University of Genova, Genova, Italy; Operating Unit Hospital Hygiene, Galliera Hospital, Genoa, Italy. Electronic address: sartini@unige.it., Tuvo B; Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy., Scarpaci M; Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy., Barchitta M; Department of Medical, Surgical and Advanced Technology Sciences 'G.F. Ingrassia', University of Catania, Catania, Italy., Pan A; Operating Unit of Infectious Diseases, ASST Cremona, Cremona, Italy., Agodi A; Department of Medical, Surgical and Advanced Technology Sciences 'G.F. Ingrassia', University of Catania, Catania, Italy., Cristina ML; Department of Health Sciences, University of Genova, Genova, Italy; Operating Unit Hospital Hygiene, Galliera Hospital, Genoa, Italy.
Jazyk: angličtina
Zdroj: The Journal of hospital infection [J Hosp Infect] 2023 Jan; Vol. 131, pp. 139-147. Date of Electronic Publication: 2022 Oct 13.
DOI: 10.1016/j.jhin.2022.09.024
Abstrakt: Introduction: Microbiological surveillance of endoscopes is a safety measure for verifying the quality of reprocessing procedures and identifying contaminated devices, but duodenoscope-related outbreaks are still reported.
Aim: To assess the effectiveness of duodenoscope reprocessing procedures in Italy.
Methods: Between December 2019 and April 2020, data obtained from microbiological surveillance post-reprocessing in 15 Italian endoscopy units were collected. Sampling was carried out after reprocessing or during storage in a cabinet. In keeping with international guidelines and the Italian position paper, the micro-organisms were classified as high-concern organisms (HCOs) and low-concern organisms (LCOs).
Findings: In total, 144 samples were collected from 51 duodenoscopes. Of these, 36.81% were contaminated: 22.92% were contaminated with HCOs and 13.89% were contaminated with LCOs [2.08% with an LCO load of 11-100 colony-forming units (CFU)/device and 0.69% with an LCO load of >100 CFU/device]. The contamination rate was 27.5% in samples collected after reprocessing, 40% in samples collected during storage in a cabinet that was compliant with EN 16442:2015 (C-I), and 100% in samples collected during storage in a cabinet that was not compliant with EN 16442:2015 (NC-I). The respective HCO rates were 15.00%, 27.27% and 66.67%. Correlation between LCO contamination and storage time was demonstrated (Spearman's rho=0.3701; P=0.0026). The Olympus duodenoscope TJFQ180V demonstrated the lowest rate of contamination (29.82%), although the contamination rate was 100% for duodenoscopes stored in an NC-I cabinet.
Conclusion: Microbiological surveillance, along with strict adherence to reprocessing protocols, may help to detect endoscope contamination at an early stage, and reduce the risk of duodenoscope-associated infections.
(Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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