Storage of gastrointestinal endoscopes: when is the safe time for re-use?

Naiara Bussolotti Garcia,Adriana Cristina De Oliveira

doi:10.1590/0034-7167-2021-0216

Naiara Bussolotti Garcia, Adriana Cristina De Oliveira

Open Access

https://doi.org/10.1590/0034-7167-2021-0216

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Abstract

to identify the safe storage time for the use of flexible gastrointestinal endoscopes after high-level disinfection, as well as the defining criteria for this time. an integrative literature review was carried out in the Virtual Health Library, PubMed, Scopus, and Web of Science, considering original articles published since 2000. eleven articles were selected, whose storage times ranged from 1 to 56 days, with a predominance of one to seven days (73%). Several criteria were used to define this time, predominantly the premise of efficient processing (100%), use of alcohol flush (64%), use of drying cabinets (18%), among others. the criteria for determining the storage time did not show a consensus for clinical practice. Expanding the discussion of this theme with the definition of the minimum necessary conditions is of fundamental importance for the reduction of risks and safety of the procedure and the patient.

Highlights

Gastrointestinal flexible endoscopes are equipment of complex structure and conformity, with channels of different angles, accesses, and lumens, which make friction difficult and, the removal of dirt and moisture
These consist of a complex structure, composed of microorganisms adhered to an abiotic and biotic surface, protected by extracellular polysaccharide substances or exopolysaccharide matrix (EPS), which favors protection by preventing the action of antimicrobial agents(1-5). Infections related to such procedures, as well as the transmission of resistant microorganisms, mainly associated with contaminated duodenoscopes, have been described since 2010 in several countries in Europe and the United States of America, alerting world authorities, associations and gastroenterology societies about the weaknesses in complying with endoscope processing guidelines(6-11)
The record of cross-transmission of microorganisms and outbreaks among patients undergoing endoscopic procedures occurs under adequate processing conditions, the predominance of cases has been reported in situations where failures or omissions in one or more of the steps have occurred; in addition, there is the challenge related to the design of endoscopes

Summary

Introduction

Gastrointestinal flexible endoscopes are equipment of complex structure and conformity, with channels of different angles, accesses, and lumens, which make friction difficult and, the removal of dirt and moisture In this context, the maintenance of residues, moisture and microorganisms can favor both cross-contamination between patients undergoing endoscopic procedures and the formation of biofilms. The maintenance of residues, moisture and microorganisms can favor both cross-contamination between patients undergoing endoscopic procedures and the formation of biofilms These consist of a complex structure, composed of microorganisms adhered to an abiotic and biotic surface, protected by extracellular polysaccharide substances or exopolysaccharide matrix (EPS), which favors protection by preventing the action of antimicrobial agents(1-5). As for the design, duodenoscopes increase cleaning challenges by the presence of an additional mechanism called “elevator channel”(12)

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