AIM:To conduct a bacterial culture study for monitoring decontamination of automated endoscope reprocessors(AERs) after high-level disinfection(HLD).METHODS:From February 2006 to January 2011,authors conducted randomi...AIM:To conduct a bacterial culture study for monitoring decontamination of automated endoscope reprocessors(AERs) after high-level disinfection(HLD).METHODS:From February 2006 to January 2011,authors conducted randomized consecutive sampling each month for 7 AERs.Authors collected a total of 420 swab cultures,including 300 cultures from 5 gastroscope AERs,and 120 cultures from 2 colonoscope AERs.Swab cultures were obtained from the residual water from the AERs after a full reprocessing cycle.Samples were cultured to test for aerobic bacteria,anaerobic bacteria,and mycobacterium tuberculosis.RESULTS:The positive culture rate of the AERs was 2.0%(6/300) for gastroscope AERs and 0.8%(1/120) for colonoscope AERs.All the positive cultures,including 6 from gastroscope and 1 from colonoscope AERs,showed monofloral colonization.Of the gastroscopeAER samples,50%(3/6) were colonized by aerobic bacterial and 50%(3/6) by fungal contaminations.CONCLUSION:A full reprocessing cycle of an AER with HLD is adequate for disinfection of the machine.Swab culture is a useful method for monitoring AER decontamination after each reprocessing cycle.Fungal contamination of AERs after reprocessing should also be kept in mind.展开更多
High level disinfection(HLD) of the gastrointestinal(GI)endoscope is not simply a slogan, but rather is a form of experimental monitoring-based medicine. By definition,GI endoscopy is a semicritical medical device. He...High level disinfection(HLD) of the gastrointestinal(GI)endoscope is not simply a slogan, but rather is a form of experimental monitoring-based medicine. By definition,GI endoscopy is a semicritical medical device. Hence,such medical devices require major quality assurance for disinfection. And because many of these items are temperature sensitive, low-temperature chemical methods, such as liquid chemical germicide, must be used rather than steam sterilization. In summarizing guidelines for infection prevention and control for GI endoscopy, there are three important steps that must be highlighted: manual washing, HLD with automated endoscope reprocessor, and drying. Strict adherence to current guidelines is required because compared to any other medical device, the GI endoscope is associated with more outbreaks linked to inadequate cleaning or disinfecting during HLD. Both experimental evaluation on the surveillance bacterial cultures and in-use clinical results have shown that, the monitoring of the stringent processes to prevent and control infection is an essential component of the broader strategy to ensure the delivery of safe endoscopy services, because endoscope reprocessing is a multistep procedure involving numerous factors that can interfere with its efficacy. Based on our years of experience in the surveillance of culture monitoring of endoscopic reprocessing, we aim in this study to carefully describe what details require attention in the GI endoscopy disinfection and to share our experience so that patients can be provided with high quality and safe medical practices. Quality management encompasses all aspects of pre- and postprocedural care including the efficiency of the endoscopy unit and reprocessing area, as well as the endoscopic procedure itself.展开更多
基金Supported by The Gastrointestinal Scope Unit of the Chang Gung Memorial Hospital(Kaohsiung)of Taiwan
文摘AIM:To conduct a bacterial culture study for monitoring decontamination of automated endoscope reprocessors(AERs) after high-level disinfection(HLD).METHODS:From February 2006 to January 2011,authors conducted randomized consecutive sampling each month for 7 AERs.Authors collected a total of 420 swab cultures,including 300 cultures from 5 gastroscope AERs,and 120 cultures from 2 colonoscope AERs.Swab cultures were obtained from the residual water from the AERs after a full reprocessing cycle.Samples were cultured to test for aerobic bacteria,anaerobic bacteria,and mycobacterium tuberculosis.RESULTS:The positive culture rate of the AERs was 2.0%(6/300) for gastroscope AERs and 0.8%(1/120) for colonoscope AERs.All the positive cultures,including 6 from gastroscope and 1 from colonoscope AERs,showed monofloral colonization.Of the gastroscopeAER samples,50%(3/6) were colonized by aerobic bacterial and 50%(3/6) by fungal contaminations.CONCLUSION:A full reprocessing cycle of an AER with HLD is adequate for disinfection of the machine.Swab culture is a useful method for monitoring AER decontamination after each reprocessing cycle.Fungal contamination of AERs after reprocessing should also be kept in mind.
基金The gastrointestinal endoscopy unit of Kaohsiung Chang Gung Memorial Hospital,Taiwan
文摘High level disinfection(HLD) of the gastrointestinal(GI)endoscope is not simply a slogan, but rather is a form of experimental monitoring-based medicine. By definition,GI endoscopy is a semicritical medical device. Hence,such medical devices require major quality assurance for disinfection. And because many of these items are temperature sensitive, low-temperature chemical methods, such as liquid chemical germicide, must be used rather than steam sterilization. In summarizing guidelines for infection prevention and control for GI endoscopy, there are three important steps that must be highlighted: manual washing, HLD with automated endoscope reprocessor, and drying. Strict adherence to current guidelines is required because compared to any other medical device, the GI endoscope is associated with more outbreaks linked to inadequate cleaning or disinfecting during HLD. Both experimental evaluation on the surveillance bacterial cultures and in-use clinical results have shown that, the monitoring of the stringent processes to prevent and control infection is an essential component of the broader strategy to ensure the delivery of safe endoscopy services, because endoscope reprocessing is a multistep procedure involving numerous factors that can interfere with its efficacy. Based on our years of experience in the surveillance of culture monitoring of endoscopic reprocessing, we aim in this study to carefully describe what details require attention in the GI endoscopy disinfection and to share our experience so that patients can be provided with high quality and safe medical practices. Quality management encompasses all aspects of pre- and postprocedural care including the efficiency of the endoscopy unit and reprocessing area, as well as the endoscopic procedure itself.
