Abstract
BackgroundEndoscopic colorectal cancer (CRC) screening is currently implemented in many countries. Since endoscopes cannot be sterilised, the transmission of infectious agents through endoscopes has been a matter of concern. We report on a continuous quality control programme in a large-scale randomised controlled trial on flexible sigmoidoscopy screening of an average-risk population. Continuously, throughout a two-year screening period, series of microbiological samples were taken from cleaned ready-to-use endoscopes and cultured for bacterial growth.Results8573 endoscopies were performed during the trial period. Altogether, 178 microbiological samples (2%) were taken from the biopsy channels and surfaces from the endoscopes. One sample (0.5%) showed faecal contamination (Enterobacter cloacae), and 25 samples (14%) showed growth of environmental bacteria.ConclusionsGrowth of bacteria occurs in a clinical significant number of samples from ready-to-use endoscopes. Pathogenic bacteria, however, were found only in one sample. Improvement of equipment design and cleaning procedures are desirable and continuous microbiological surveillance of endoscopes used in CRC screening is recommended.
Highlights
Endoscopic colorectal cancer (CRC) screening is currently implemented in many countries
One sample showed growth of Enterobacter cloacae, indicating faecal contamination. This endoscope was re-tested after two weeks without any findings of contamination
After cleaning and disinfection adhering to current guidelines [2], a considerable number of microbiological samples taken from cleaned ready-to-use endoscopes showed bacterial growth
Summary
Endoscopic colorectal cancer (CRC) screening is currently implemented in many countries. Since endoscopes cannot be sterilised, the transmission of infectious agents through endoscopes has been a matter of concern. We report on a continuous quality control programme in a large-scale randomised controlled trial on flexible sigmoidoscopy screening of an average-risk population. Screening for CRC by gastrointestinal endoscopy (flexible sigmoidoscopy or colonoscopy) has been recommended for the average-risk population [1], and is currently implemented in many Western countries. Cleaning and disinfection of the devices has been a subject of concern, as transmission of infectious material cannot be entirely dismissed [3]. In 2002, the New York Times reported on the possible transmission of Pseudomonas infection to 400 patients after examination with bronchoscopes that were not (page number not for citation purposes)
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