Abstract
Background: The use of a contaminated endoscope may lead to infections due to the transmission of potential pathogens from patient to patient. Methods: Post-reprocessing microbiological surveillance of four duodenoscopes was carried out over a three-year period in the Digestive Endoscopy Unit of an Italian hospital. Sampling of duodenoscopes was performed after the devices have been reprocessed. The initial phase of surveillance involved the contemporary evaluation of the four duodenoscopes; afterwards, microbiological surveillance proceeded at monthly intervals. Results: The initial phase of surveillance revealed that three duodenoscopes presented a high level of contamination with “high-concern” micro-organisms, some of which were multi-drug-resistant. The highest values of contamination regarded the species P. aeruginosa (2500 CFU/duodenoscope), K. pneumoniae (2580 CFU/duodenoscope), and A. baumannii (2600 CFU/duodenoscope). Since the cultures were repeatedly positive on three successive occasions, the contaminated devices were sent to the manufacturer for evaluation. Audits were carried out with the personnel responsible for reprocessing, which was aimed to optimize the procedures used, and subsequently, only one case of non-conformity was found. Conclusions: Our study highlighted both the potential risk of transmitting pathogens through the use of duodenoscopes and the importance of implementing a well-structured system of microbiological surveillance and training programs, in order to reduce the risk of spreading retrograde cholangiopancreatography (ERCP)-associated infections.
Highlights
The use of endoscopic procedures, for both diagnostic and therapeutic purposes, is consolidated and increasing in several specialties of modern medicine [1]
The use of a contaminated endoscope may lead to infections due to the transmission of potential pathogens from patient to patient [3,4]
Samples from the distal end displayed contamination by P. aeruginosa, K. pneumoniae, K. oxytoca, S. maltophilia, A. baumannii, E. coli, and C. freundii, while those taken from the instrument channel showed the presence of P. aeruginosa, K. pneumoniae, Enterobacter spp., S. maltophilia, and
Summary
The use of endoscopic procedures, for both diagnostic and therapeutic purposes, is consolidated and increasing in several specialties of modern medicine [1]. Such procedures involve the use of reusable devices (duodenoscopes, colonoscopes, etc.), which must be properly reprocessed in order to eliminate contamination through biological fluids. The use of a contaminated endoscope may lead to infections due to the transmission of potential pathogens from patient to patient. Methods: Post-reprocessing microbiological surveillance of four duodenoscopes was carried out over a three-year period in the Digestive Endoscopy Unit of an Italian hospital. The initial phase of surveillance involved the contemporary evaluation of the four duodenoscopes; afterwards, microbiological surveillance proceeded at monthly intervals
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