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. 2023 Mar 17;11(3):E247-E257.
doi: 10.1055/a-1991-1391. eCollection 2023 Mar.

Endoscope reprocessing: Retrospective analysis of 90,311 samples

Lionel Pineau  1
Affiliations

Endoscope reprocessing: Retrospective analysis of 90,311 samples

Lionel Pineau. Endosc Int Open. .

Abstract

Background and study aims The contamination level of ready-to-use endoscopes published in the literature varies from 0.4 % to 49.0 %. Unfortunately, the comparison and the interpretation of these results are quite impossible, given the limited number of samples and sites included and the differences observed between sampling, culturing methods, and interpretation criteria. Methods The objective of this retrospective study was to analyze the results of 90,311 endoscope samples collected between 2004 and 2021 in 490 private or public hospitals in France. Results Through the full test period, the mean ratio of endoscopes at the action level was 12.6 % (19.5 % including alert level). Of the endoscopy units, 23.0 % had a ratio of compliant endoscopes ≤ 70.0 %. The overall microbial quality of gastroscopes, duodenoscopes, and colonoscopes is improving year by year, whereas an opposite trend is observed for ultrasound endoscopes and bronchoscopes. In 2021, following French guidelines, 13.0 % of the endoscopes should have been quarantined and 8.1 % were at the alert level, meaning that the contamination level of 21.1 % of the endoscopes exceeded what was defined as a maximum acceptable value. Conclusions This study demonstrates that additional efforts, including implementation of microbial surveillance strategies using a standardized sampling method and periodic observational audits, must be made to improve the overall microbiological quality of endoscopes and reduce the risk associated with their use.

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Conflict of interest statement

Competing interests L Pineau is an employee of Eurofins Biotech Germande which reports having been consulted and having received financial support from medical device manufacturers to performed studies on the efficacy of medical devices.

Figures

Fig. 1
Fig. 1
Distribution of healthcare centers included in the study between 2004 and 2021 according to their ratio of compliant endoscopes (X = percentage of endoscopes at the target level).
Fig. 2
Fig. 2
Evolution of the ratio of endoscopes at the action and alert levels and number of endoscopes sampled between 2004 and 2021.
Fig. 3
Fig. 3
Evolution of the ratio of colonoscopes at the action and alert levels and number of endoscopes sampled between 2004 and 2021.
Fig. 4
Fig. 4
Evolution of the ratio of gastroscopes at the action and alert levels and number of endoscopes sampled between 2004 and 2021.
Fig. 5
Fig. 5
Evolution of the ratio of duodenoscopes at the action and alert levels and number of endoscopes sampled between 2004 and 2021.
Fig. 6
Fig. 6
Evolution of the ratio of ultrasound endoscopes at the action and alert levels and number of endoscopes sampled between 2004 and 2021.
Fig. 7
Fig. 7
Evolution of the ratio of bronchoscopes at the action and alert levels and number of endoscopes sampled between 2004 and 2021.
Fig. 8
Fig. 8
Evolution of the ratio of high-risk endoscopes at the action and alert levels and number of endoscopes sampled between 2004 and 2021.
Fig. 9
Fig. 9
Evolution of the ratio of other endoscopes at the action and alert levels and number of endoscopes sampled between 2004 and 2021.
Fig. 10
Fig. 10
Variation in the mean ratio of non-compliant endoscopes according to the endoscope model for each endoscope type (each point represents a specific endoscope model). Quartile representation, 2021 results.
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References

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