Is Post-Reprocessing Microbiological Surveillance of Duodenoscopes Effective in Reducing the Potential Risk in Transmitting Pathogens?

Maria Luisa Cristina, Marina Sartini, Elisa Schinca, Gianluca Ottria, Chiara Dupont, Palmira Bova, Gianni Coccia, Beatrice Casini and Anna Maria Spagnolo
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Maria Luisa Cristina: Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genova, Italy
Marina Sartini: Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genova, Italy
Elisa Schinca: Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genova, Italy
Gianluca Ottria: Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genova, Italy
Chiara Dupont: Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genova, Italy
Palmira Bova: S.C. Gastroenterology, E.O. Ospedali Galliera, 16128 Genova, Italy
Gianni Coccia: S.C. Gastroenterology, E.O. Ospedali Galliera, 16128 Genova, Italy
Beatrice Casini: Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
Anna Maria Spagnolo: Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genova, Italy

IJERPH, 2019, vol. 17, issue 1, 1-10

Abstract: Background: The use of a contaminated endoscope may lead to infections due to the transmission of potential pathogens from patient to patient. Methods: Post-reprocessing microbiological surveillance of four duodenoscopes was carried out over a three-year period in the Digestive Endoscopy Unit of an Italian hospital. Sampling of duodenoscopes was performed after the devices have been reprocessed. The initial phase of surveillance involved the contemporary evaluation of the four duodenoscopes; afterwards, microbiological surveillance proceeded at monthly intervals. Results: The initial phase of surveillance revealed that three duodenoscopes presented a high level of contamination with “high-concern” micro-organisms, some of which were multi-drug-resistant. The highest values of contamination regarded the species P. aeruginosa (2500 CFU/duodenoscope), K. pneumoniae (2580 CFU/duodenoscope), and A. baumannii (2600 CFU/duodenoscope). Since the cultures were repeatedly positive on three successive occasions, the contaminated devices were sent to the manufacturer for evaluation. Audits were carried out with the personnel responsible for reprocessing, which was aimed to optimize the procedures used, and subsequently, only one case of non-conformity was found. Conclusions: Our study highlighted both the potential risk of transmitting pathogens through the use of duodenoscopes and the importance of implementing a well-structured system of microbiological surveillance and training programs, in order to reduce the risk of spreading retrograde cholangiopancreatography (ERCP)-associated infections.

Keywords: duodenoscopes; infection control; post-reprocessing; microbiological surveillance (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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