Abstract
Objective:to evaluate the potential contamination of enzymatic detergent from its reuse and to identify the microbiological profile in the solution used to clean gastrointestinal endoscopic devices.Method:cross-sectional study based on microbiological analysis of 76 aliquots of 19 different enzymatic detergent solutions used to clean endoscopic devices. The aliquots were homogenized, subjected to Millipore® 0.45 µm membrane filtration and the presumptive identification of microorganisms was performed by biochemical-physiological methods according to previously established specific bacterial groups that are of clinical and epidemiological relevance.Results:the mean values, as well as the standard deviation and the median, of the enzymatic detergent microbial load increased as the solution was reused. There was a significant difference between the means of after first use and after fifth reuse. A total of 97 microorganisms were identified, with predominance of the coagulase-negative Staphylococcus, Pseudomonas spp., Klebsiella spp., Enterobacter spp. genus, and Escherichia coli species.Conclusion:the reuse of the enzymatic detergent solution is a risk to the safe processing of endoscopic devices, evidenced by its contamination with pathogenic potential microorganisms, since the enzymatic detergent has no bactericidal property and can contribute as an important source for outbreaks in patients under such procedures.
Highlights
Gastrointestinal endoscopic devices are equipment that cause great concern about processing
Used during the digestive endoscopy examination, these devices have external and internal surfaces exposed to high microbial load from their contact with the gastrointestinal tract, which makes proper decontamination necessary after each procedure to avoid cross contamination, to protect the team that reprocesses it against transmission of microorganisms and to prevent misdiagnosis, since biopsy fragments may remain inside the equipment and may be confused with those of another patient[1,2,3]
In the digestive endoscopy clinic, reusing the enzymatic detergent solution is usual, according to an internal protocol for its preparation and use per work shift, with an average duration of six hours, regardless of the number of times the equipment would be immersed in this period
Summary
Gastrointestinal endoscopic devices are equipment that cause great concern about processing. Used during the digestive endoscopy examination, these devices have external and internal surfaces exposed to high microbial load from their contact with the gastrointestinal tract, which makes proper decontamination necessary after each procedure to avoid cross contamination, to protect the team that reprocesses it against transmission of microorganisms and to prevent misdiagnosis, since biopsy fragments may remain inside the equipment and may be confused with those of another patient[1,2,3]. It is possible that this data underestimates the actual incidence of contamination since there are few estimates of infections resulting from these tests[3,6]. When these infections occur, they can cause serious harm to the patient’s health, as they include serious diseases such as sepsis, bacteremia, pneumonia, gastroenteritis, and hepatitis B and C(6-7). Patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) were affected and during the period more than 18 deaths were reported[8,9,10,11]
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