Potential testing of reprocessing procedures by real-time polymerase chain reaction: A multicenter study of colonoscopy devices

Autor: Valeriani, Federica, Agodi, Antonella, Casini, Beatrice, Cristina, Maria Luisa, D'Errico, Marcello Mario, Gianfranceschi, Gianluca, Liguori, Giorgio, Liguori, Renato, Mucci, Nicolina, Mura, Ida, Pasquarella, Cesira, Piana, Andrea, Sotgiu, Giovanni, Privitera, Gaetano, Protano, Carmela, Quattrocchi, Annalisa, Ripabelli, Giancarlo, Rossini, Angelo, Spagnolo, Anna Maria, Tamburro, Manuela, Tardivo, Stefano, Veronesi, Licia, Vitali, Matteo, Romano Spica, Vincenzo, GISIO Working Group of the Italian Society of Hygiene, Preventive Medicine and Public Health.
Jazyk: angličtina
Rok vydání: 2017
Předmět:
0301 basic medicine
DNA
Bacterial

medicine.medical_specialty
Quality Assurance
Health Care

Epidemiology
030106 microbiology
Colonoscopy
Flocked swab sampling
Health care-associated infections
MfDNA
Sanitation
Surveillance
Epidemiology
Health Policy
Public Health
Environmental and Occupational Health
Infectious Diseases

Real-Time Polymerase Chain Reaction
law.invention
03 medical and health sciences
0302 clinical medicine
law
Medicine
Humans
Multiplex
Medical physics
Sanitation
Polymerase chain reaction
Protocol (science)
Flocked swab sampling
Surveillance
medicine.diagnostic_test
Colonoscopes
business.industry
Health Policy
Environmental and Occupational Health
Public Health
Environmental and Occupational Health

Microbiology Test
Health care-associated infections
MfDNA
Infectious Diseases
mfDNA
DNA extraction
Surgery
Disinfection
Real-time polymerase chain reaction
Multicenter study
flocked swab sampling
health care-associated infections
mfdna
sanitation
surveillance
epidemiology
health policy
public health
environmental and occupational health
infectious diseases
Equipment Contamination
030211 gastroenterology & hepatology
Public Health
business
Popis: Background Reprocessing of endoscopes is key to preventing cross-infection after colonoscopy. Culture-based methods are recommended for monitoring, but alternative and rapid approaches are needed to improve surveillance and reduce turnover times. A molecular strategy based on detection of residual traces from gut microbiota was developed and tested using a multicenter survey. Methods A simplified sampling and DNA extraction protocol using nylon-tipped flocked swabs was optimized. A multiplex real-time polymerase chain reaction (PCR) test was developed that targeted 6 bacteria genes that were amplified in 3 mixes. The method was validated by interlaboratory tests involving 5 reference laboratories. Colonoscopy devices (n = 111) were sampled in 10 Italian hospitals. Culture-based microbiology and metagenomic tests were performed to verify PCR data. Results The sampling method was easily applied in all 10 endoscopy units and the optimized DNA extraction and amplification protocol was successfully performed by all of the involved laboratories. This PCR-based method allowed identification of both contaminated (n = 59) and fully reprocessed endoscopes (n = 52) with high sensibility (98%) and specificity (98%), within 3-4 hours, in contrast to the 24-72 hours needed for a classic microbiology test. Results were confirmed by next-generation sequencing and classic microbiology. Conclusions A novel approach for monitoring reprocessing of colonoscopy devices was developed and successfully applied in a multicenter survey. The general principle of tracing biological fluids through microflora DNA amplification was successfully applied and may represent a promising approach for hospital hygiene.
Databáze: OpenAIRE