A double-reprocessing high-level disinfection protocol does not eliminate positive cultures from the elevators of duodenoscopes.
Endoscopy
; 50(6): 588-596, 2018 06.
Article
em En
| MEDLINE
| ID: mdl-29237202
ABSTRACT
BACKGROUND AND STUDY AIM:
Duodenoscopes have been the source of serious infection, despite correct performance of high-level disinfection (HLD). This study aimed to observe the impact of performing HLD twice on the rate of positive cultures from duodenoscope elevators.METHODS:
We performed double HLD (DHLD; i.âe. complete manual cleaning followed by automated reprocessing, with the entire process repeated) and then randomly cultured the elevators of our duodenoscopes on about 30â% of occasions.RESULTS:
DHLD was associated with positive elevator cultures for any microorganism in 9.4â% of cases, with a 0.8â% rate of known pathogens (627 cultures) between May 2015 and February 2016. After February 2016, and in association with changing the precleaning fluid, as well as use of a new FDA-recommended cleaning brush, the rate of positive cultures for any microorganism after DHLD was 4.8â% and 0.2â% for known pathogens (420 cultures). In a third phase, characterized by a change in personnel performing DHLD and retirement of a duodenoscope with a high rate of positive cultures, the rate of positive cultures for any microorganism was 4.9â% (783 cultures) and the rate of positive culture for known pathogens was 0.3â%. To our knowledge, no duodenoscope transmission of infection occurred during the study interval.CONCLUSIONS:
DHLD resulted in a low rate of positive cultures for known pathogens and for organisms of low pathogenic potential, but did not eliminate these, from duodenoscope elevators. Additional improvements in HLD protocols and/or duodenoscope design are needed.
Texto completo:
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Desinfecção
/
Contaminação de Equipamentos
/
Duodenoscópios
/
Desinfetantes
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Estados Unidos