Background
Patient-ready endoscopes were monitored over an 80-week period to determine the efficacy
of decontamination procedures in a busy endoscopy center. Decontamination failure
was related to patient and procedural parameters.
Methods
Samples from patient-ready endoscopes were cultured aerobically and anaerobically
and subjected to polymerase chain reaction (PCR) to detect hepatitis B virus (HBV),
hepatitis C virus (HCV), and HIV. PCR to detect coliforms from 109 culture negative
washes was used as a surrogate marker for biofilm in endoscopes. PCR was used to detect
the presence of Helicobactor pylori in endoscopes used on infected patients. Procedural information such as biopsy retrieval,
endoscope number, diagnosis, attending personnel, and decontamination system procedures
was collected.
Results
Gastroscopes (n = 1376) and colonoscopes (n = 987) were equally contaminated (1.8%
vs 1.9%, respectively) with low numbers of organisms commonly isolated from the nasopharynx
and/or feces. Only 1 wash contained viral nucleic acid (HCV). There was a significant
correlation (P < .001) between the number of times a patient-ready endoscope was contaminated and
its frequency of use. Colonoscopes used on patients with gastrointestinal disease
were significantly more likely to remain contaminated through the decontamination
process (P < .05). All other patient, staff, and decontamination system parameters remained
not statistically significant. Coliform DNA was detected in 40% of culture-negative
washes collected from patient-ready endoscopes, suggesting the presence of biofilm.
No H pylori DNA was detected.
Conclusion
Recommended decontamination procedures do not entirely eliminate persistence of low
numbers of organisms on a few endoscopes, but this is unlikely to cause serious consequences
in patients. Bacterial biofilm is difficult to remove and may explain this low-level
persistence.
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Article Info
Publication History
Published online: January 23, 2006
Sydney, New South Wales, AustraliaFootnotes
Supported by NHMRC grant number 9937934 and a NHMRC Industry Fellowship (to K.V.).
Identification
Copyright
© 2006 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
