The purpose of this article was to investigate bacterial biofilm formed on endoscopes and to explore the possible correlation between endoscope reprocessing procedures and bacterial biofilm growth on endoscope channels.
Sixty-six endoscope suction and biopsy channels and 13 water and air channels were collected from 66 hospitals throughout China. Scanning electron microscopy was used to observe biofilm growth on the internal surface of these channels. Questionnaires were mailed to 66 endoscopy centers to investigate reprocessing procedures for endoscopes.
Obvious biofilm growth was detected on 36 suction and biopsy channels (36/66, 54.6%) and 10 water and air channels (10/13, 76.9%). The percentage of manual cleaning in group B (n = 36, without detection of biofilms) was 92.3% (33/36), whereas it was 50.0% (15/30) in group A (n = 30, with detection of biofilms). Follow-up of group A (n = 30) showed that no biofilm was detected, whereas biofilm was detected in group B. The difference was statistically significant (P = .001). The proportion of detergent reuse in group B was 92.3% (33/36), and it was 61.5% in group A (18/30) (P = .005). The proportion of alcohol-air drying in group B was 38.9% (14/36), and it was 76.7% (23/30) in group A (P = .002).
The formation of endoscopic biofilm during clinical practice may be related to reuse of detergent, manual cleaning, and incomplete drying.
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- Multisociety guideline on reprocessing flexible gastrointestinal endoscopes: 2011.Gastrointest Endosc. 2011; 73: 1075-1084
- Nosocomial infection by endoscope: current situation issues and countermeasures.Chin J Nosocomiol. 2005; 15: 423-425
- Is biofilm accumulation on endoscope tubing a contributor to the failure of cleaning and decontamination?.J Hosp Infect. 2004; 58: 224-229
- Multidrug resistant organism (MRO) biofilm infection of equipment and surfaces in an intensive care unit - implications for infection transmission.Am J Infect Control. 2011; 39: E192-E193
- Bacterial biofilms: a common cause of persistent infections.Science. 1999; 284: 1318-1322
- Mechanisms of biofilm resistance to antimicrobial agents.Trends Microbiol. 2001; 9: 34-39
- The effect of multiple cycles of contamination, detergent washing, and disinfection on the development of biofilm in endoscope tubing.Am J Infect Control. 2009; 37: 470-475
- Evaluation of detergents and contact time on biofilm removal from flexible endoscopes.Am J Infect Control. 2013; 41: e89-e92
The operating technique standard of cleaning and disinfection for endoscope. 2004 ed. Chinese Ministry of Health;2004.
- Analysis of the air/water channels of gastrointestinal endoscopies as a risk factor for the transmission of microorganisms among patients.Am J Infect Control. 2012; 40: 913-916
- Endoscope reprocessing methods: a prospective study on the impact of human factors and automation.Gastroenterol Nurs. 2010; 33: 304-311
- A study of the efficacy of bacterial biofilm cleanout for gastrointestinal endoscopes.World J Gastroenterol. 2010; 16: 1019-1024
- Biofilm removal by medical device cleaners: comparison of two bioreactor detection assays.J Hosp Infect. 2010; 74: 160-167
- Standards of infection control in reprocessing of flexible gastrointestinal endoscopes.Gastroenterol Nurs. 2013; 36: 293-303
- Endoscope drying/storage cabinet: interest and efficacy.J Hosp Infect. 2008; 68: 59-65
Conflict of interest: None to report.
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