Supplement DGKH - Hygiene und Medizin - Aufbereitung von Medizinprodukten

Aufbereitung von Medizinprodukten

High-quality endoscope reprocessing decreases endoscope contamination

Background
Several outbreaks of severe infections due to contamination of gastrointestinal (GI) endoscopes, mainly duodenoscopes have been described previously. The rate of microbial endoscope contamination is varying dramatically in literature. Thus, the aim of this multicentre prospective study was to evaluate the hygiene quality of endoscopes and automated endoscope reprocessors (AERs) in Tyrol/Austria.

Methods
In 2015 and 2016, a total of 463 GI endoscopes and 105 AERs from 29 endoscopy centres were analysed by a routine (R) and a combined routine and advanced (CRA) sampling procedure and investigated for microbial contamination by culture- and molecular-based analyses.

Results
The contamination rate of GI endoscopes was 1.3–4.6 % according to national guideline, suggesting that 1.3–4.6 patients out of 100 could have had contacts with hygiene relevant microorganisms through an endoscopic intervention. Comparison of R and CRA sampling showed 1.8 % of R versus 4.6 % of CRA failing the acceptance criteria in phase I and 1.3 % of R versus 3.0 % of CRA samples in phase II. The most commonly identified indicator organism was Pseudomonas spp., mainly P. oleovorans. None of the tested viruses were detected in 40 samples. While AERs in phase I failed (n=9, 17.6 %) mainly due to technical faults, phase II revealed lapses (n=6, 11.5 %) only on account to microbial contamination of the last rinsing water, mainly with Pseudomonas spp.

Conclusions
In the present study the contamination rate of endoscopes was low compared to results from other European countries, possibly due to high quality of endoscope reprocessing, drying and storage.


Authors
P. Decristoforo1, J. Kaltseis1, A. Fritz1, Michael Edlinger2, Wilfried Posch1, Doris Wilflingseder1, Cornelia Lass-Flörl1, Dorothea Orth-Höller1, TEHS study group
(1 Medical University of Innsbruck, Division of Hygiene and Medical Microbiology
2 Medical University of Innsbruck, Department of Medical Statistics, Informatics)

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