COVID-19 Emergency Management: From the Reorganization of the Endoscopy Service to the Verification of the Reprocessing Efficacy

Beatrice Casini, Benedetta Tuvo, Fabrizio Maggi, Giuliana Del Magro, Alessandro Ribechini, Anna Laura Costa, Michele Totaro, Angelo Baggiani, Giulia Gemignani and Gaetano Privitera
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Beatrice Casini: Department of Translational Research, N.T.M.S., University of Pisa, 56126 Pisa, Italy
Benedetta Tuvo: Department of Translational Research, N.T.M.S., University of Pisa, 56126 Pisa, Italy
Fabrizio Maggi: Department of Translational Research, N.T.M.S., University of Pisa, 56126 Pisa, Italy
Giuliana Del Magro: Endoscopy Service Division, University Hospital of Pisa, 56126 Pisa, Italy
Alessandro Ribechini: Thoracic Endoscopy Division, University Hospital of Pisa, 56126 Pisa, Italy
Anna Laura Costa: Department of Translational Research, N.T.M.S., University of Pisa, 56126 Pisa, Italy
Michele Totaro: Department of Translational Research, N.T.M.S., University of Pisa, 56126 Pisa, Italy
Angelo Baggiani: Department of Translational Research, N.T.M.S., University of Pisa, 56126 Pisa, Italy
Giulia Gemignani: Medical Direction, University Hospital of Pisa, 56126 Pisa, Italy
Gaetano Privitera: Department of Translational Research, N.T.M.S., University of Pisa, 56126 Pisa, Italy

IJERPH, 2020, vol. 17, issue 21, 1-13

Abstract: Microbiological surveillance carried out in order to verify the effectiveness of endoscope reprocessing does not include the research of viruses, although endoscopes may be associated with the transmission of viral infections. This paper reports the experience of the University Hospital of Pisa in managing the risk from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during an endoscopy. A review of the reprocessing procedure was conducted to assess whether improvement actions were needed. To verify the reprocessing efficacy, a virological analysis was conducted both before and after the procedure. Five bronchoscopes and 11 digestive endoscopes (6 gastroscopes and 5 colonoscopes) were sampled. The liquid samples were subjected to concentration through the use of the Macrosep Advance Centrifugal Devices (PALL Life Sciences, Port Washington, NY, USA) and subsequently analyzed using the cobas ® SARS-CoV-2 Test (Roche Diagnostics, Basel, Switzerland), together with eSwab 490 CE COPAN swabs (COPAN, Brescia, Italy), which were used to sample surfaces. In accordance with the first ordinance regarding the coronavirus disease 2019 (COVID-19) emergency issued by the Tuscany Region in March 2020, a procedure dedicated to the management of the COVID-19 emergency in endoscopic practices was prepared, including the reprocessing of endoscopes. The virological analysis carried out on samples collected from endoscopes after reprocessing gave negative results, as well as on samples collected on the endoscopy column surfaces and the two washer-disinfectors that were dedicated to COVID-19 patients. The improvement in endoscope reprocessing implemented during the COVID-19 emergency was effective in ensuring the absence of SARS-CoV-2, thus reducing the risk of infections after an endoscopy on COVID-19 patients.

Keywords: SARS-CoV-2; endoscopy; reprocessing; virological investigation; COVID-19 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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