This article is more than 5 years old. Information may no longer be current.
Endoscopes contaminated despite guideline-adherent reprocessing
Despite reprocessing in accordance with U.S. multisociety guidelines, endoscopes were still found to be contaminated with viable microbes and biologic debris in a recent study, which suggests guidelines may be insufficient.
Researchers observed that all 15 endoscopes during 60 encounters assessed in the study period from November 4 to 8, 2013, were reprocessed according to guidelines in an endoscopy unit at Mayo Clinic in Rochester, Minn. Then they assessed contamination immediately after bedside cleaning, manual cleaning, high-level disinfection and overnight storage by performing visual inspection, microbial cultures and rapid indicator tests for adenosine triphosphate (ATP), protein, hemoglobin and carbohydrate residue. Samples were also collected from two new endoscopes as controls.
The rapid indicator tests showed contamination with protein, carbohydrate, hemoglobin or ATP exceeded benchmarks in 100% of scopes after bedside cleaning, 92% after manual cleaning, 73% after high-level disinfection and 82% after overnight storage. The researchers observed visible residue on sampling materials but never on the endoscopes, and the control endoscope channels were not contaminated.
“This study demonstrates that colonoscopes and gastroscopes can harbor residual organic material, including viable microbes, even when adherence with recommended reprocessing guidelines is verified,” the study authors said in a press release. “More research is needed to identify processes that can ensure all flexible endoscopes are free of residual contamination and viable microbes prior to patient use, including the potential use of routine monitoring with rapid indicators and microbiologic cultures. Results from this study suggest that current standards and practices may not be sufficient for detecting and removing residual contamination.” – by Adam Leitenberger
Disclosure: Ofstead and three other researchers report they are employees of Ofstead & Associates, which has received research funding and speaking honoraria related to endoscopic procedures from 3M, Advanced Sterilization Products, Medivators, Invendo Medical, Boston Scientific and Steris. All other researchers report no relevant financial disclosures.