Study Confirms 71% Scopes Contaminated: Need Sterilization!! American Journal of Infection Control
Available online 30 March 201 Major Article
Residual moisture and waterborne pathogens inside flexible endoscopes: Evidence from a multisite study of endoscope drying effectiveness
- Cori L. Ofstead, MSPH, , Otis L. Heymann, BA, Mariah R. Quick, MPH, John E. Eiland, RN, MS, Harry P. Wetzler, MD, MSPH
Highlights
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Moisture may foster microbial growth and biofilm development in endoscopes.
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Retained moisture was detected in 49% of endoscopes.
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Microbial growth was found in samples from 71% of endoscopes.
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Retained fluid was associated with higher ATP levels and microbial growth.
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Improvements in reprocessing and drying methods are needed to ensure patient safety.
"Results
Fluid was detected in 22 of 45 (49%) endoscopes. Prevalence of moisture varied significantly by site (5%; 83%; 85%; P < .001). High adenosine triphosphate levels were found in 22% of endoscopes, and microbial growth was detected in 71% of endoscopes. Stenotrophomonas maltophilia, Citrobacter freundii, and Lecanicillium lecanii/Verticillium dahliae were found. Retained fluid was associated with significantly higher adenosine triphosphate levels (P < .01). Reprocessing and drying practices conformed with guidelines at 1 site and were substandard at 2 sites. Damaged endoscopes were in use at all sites.
Conclusions
Inadequate reprocessing and insufficient drying contributed to retained fluid and contamination found during this multisite study. More effective methods of endoscope reprocessing, drying, and maintenance are needed to prevent the retention of fluid, organic material, and bioburden that could cause patient illness or injury."
"This bolsters the argument that HLD is not a sufficient reprocessing method given myriad challenges with reprocessing endoscopes and the surgical nature of most endoscopic procedures. Ultimately, to reduce patient risk, clinicians should move toward the use of sterilized endoscopes, as recently recommended. This would alleviate the observed problems related to inadequate drying and storage and provide a less hospitable environment for microbes that thrive in wet conditions."
"Researchers examined 45 patient-ready endoscopes (43 Olympus; 2 Karl Storz;). The study involved 13 colonoscopes, 12 gastroscopes, 5 duodenoscopes, 3 cystoscopes, 3 ureteroscopes, 3 endoscopic ultrasound endoscopes, 3 bronchoscopes, 2 intubation endoscopes, and 1 endobronchial ultrasound bronchoscope."
"All sites were using automated endoscope reprocessors (AERs) with peracetic acid HLD (A: Steris Reliance and Steris 1E [Steris Corporation, Mentor, Ohio]; B and C: Medivators Advantage [Medivators Inc., Minneapolis, Minnesota])."
My Note... 4 cystoscopes and ureteroscopes that were sterilized using H2O2 did not show bacterial contamination. Of the 4 duodenoscopes for which data was reported, all were contaminated with bacteria post-HLD reprocessing.
"In this study, 71% of endoscopes had microbial contamination—a proportion exceeding previous findings by our team and others in the field (8%-64%). Differences in microbial growth are likely due to the more stringent methods used to obtain and process samples in this study. We used the flush-brush-flush method, since flush-only methods are now considered inadequate. Multiple endoscope components were sampled because previous studies detected contamination on various endoscope surfaces. "
"Numerous studies have found that HLD is not effective at eliminating bioburden on flexible endoscopes, even when HLD is performed multiple times. Experts are calling for a shift to sterilization, and Olympus recently released new reprocessing instructions that recommend sterilization rather than HLD for endoscopes that come into contact with “sterile areas” of the body. "
TSO3'S VP4 REMAINS THE SOLUTION! WE CAN ONLY HOPE FDA, CDC, AAMI, AND OTHERS WILL RECOGNIZE THIS AND MOVE QUICKLY TO IMPLEMENT THIS TRANSITION TO STERILIZATION OF ENDOSCOPES FOR PATIENT SAFETY!!
THIS TOS SHARE PRICE IS RIDICULOUS!!!