Adoption of Improved Reprocessing Decreased Microbiological Non-Compliance for Bronchoscopes

Benedetta Tuvo, Michela Scarpaci, Tommaso Cosci, Alessandro Ribechini, Silvia Briani, Grazia Luchini, Michele Totaro, Angelo Baggiani, Maria Luisa Cristina, Simona Barnini, Simone Leonetti and Beatrice Casini ()
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Benedetta Tuvo: Department of Translational Research and the New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
Michela Scarpaci: Department of Translational Research and the New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
Tommaso Cosci: Department of Translational Research and the New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
Alessandro Ribechini: Thoracic Endoscopy Division, University Hospital of Pisa, 56126 Pisa, Italy
Silvia Briani: Hospital Management, University Hospital of Pisa, 56126 Pisa, Italy
Grazia Luchini: Hospital Management, University Hospital of Pisa, 56126 Pisa, Italy
Michele Totaro: Department of Translational Research and the New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
Angelo Baggiani: Department of Translational Research and the New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
Maria Luisa Cristina: Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genova, Italy
Simona Barnini: Microbiology Unit, University Hospital of Pisa, 56126 Pisa, Italy
Simone Leonetti: Department of Life Science, School of Advanced Studies Sant’Anna, 56124 Pisa, Italy
Beatrice Casini: Department of Translational Research and the New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy

IJERPH, 2022, vol. 19, issue 21, 1-13

Abstract: Background: In the past few decades, the inadequate reprocessing of bronchoscopes has been associated with several serious outbreaks caused by multidrug-resistant microorganisms. In this study we evaluated the improvement in the quality of reprocessing in a Bronchoscopy Unit (BU), after the introduction of a new procedure. Methods: In 2019, observational and clinical audits were conducted in the BU. After the introduction of an improved procedure in 2020, a microbiological surveillance plan was implemented in 2021. Results: In 2019, 13 of 22 bronchoscopes (59%) resulted as non-compliant, 18% as high concern organisms (HCO) and 36.4% as high microbial count (≥100 CFU/all channels) and HCO. The most frequent microorganisms were Staphylococcus aureus (38.5%) and NDM-producing Klebsiella pneumoniae (15.4%). The bronchoscopes were stored inside their transport cases, which in some cases were found to be contaminated by the same strains isolated on the bronchoscopes ( Enterobacter gergoviae and Vibrio alginolyticus ). In 2021, all 31 bronchoscopes were sampled at least three times and 13/99 (13.1%) resulted as non-compliant, mostly K. pneumoniae (4.04%). Contamination level increases weakly in bronchoscopes in use for more than 14 years (R = 0.32). Conclusions: The adoption of an improved reprocessing procedure decreased the non-compliance of bronchoscopes, increasing the quality of the process and patient safety.

Keywords: endoscope reprocessing; bronchoscopes; microbiological surveillance; NDM-producing Klebsiella pneumoniae (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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