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. 2023 Jan:131:139-147.
doi: 10.1016/j.jhin.2022.09.024. Epub 2022 Oct 13.

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

B Casini  1 , A M Spagnolo  2 , M Sartini  3 , B Tuvo  1 , M Scarpaci  1 , M Barchitta  4 , A Pan  5 , A Agodi  4 , M L Cristina  6 ; Study Group
Collaborators, Affiliations
Free article

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

B Casini et al. J Hosp Infect. 2023 Jan.
Free article

Abstract

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.

Keywords: Duodenoscopes; Endoscope reprocessing; Microbiological surveillance; Survey.

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