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Infection Control Practices in Gastrointestinal Endoscopy in the United States: A National Survey

Published online by Cambridge University Press:  21 June 2016

Geoffrey J. Gorse*
Affiliation:
Division of Infectious Diseases, St. Louis University School of Medicine, and St. Louis Veterans Affairs Medical Center, St. Louis, Missouri
Roberta L. Messner
Affiliation:
Quality Assurance, Nursing Service, Huntington Veterans' Affairs Medical Center, Huntington, West Virginia
*
Division of Infectious Diseases, Department of Internal Medicine, St. Louis University School of Medicine, 1402 South Grand Boulevard, St. Louis, MO 63104

Abstract

Objectives:

To ascertain current infection control practices, endoscope cleaning procedures, perceived risks of infection, and implementation of universal precautions in gastrointestinal endoscopy units in the United States.

Design:

National mailed survey of gastroenterology nurses and associates conducted anonymously in March 1988.

Setting:

Completed surveys were received from all 50 states and Puerto Rico and from all practice settings. The most common practice setting was private/community hospitals (66%).

Participants:

Of the 4,952 survey forms mailed to all members and to interested non-members of the Society of Gastrointestinal Nurses and Associates, 2,158 (44%) were returned and 2,030 (41%) were completed and evaluable. Of the respondents, 1,487 (73%) were registered nurses.

Results:

Sixty-seven percent (n = 1,358) of the respondents routinely used an enzymatic cleaner as a step in the instrument decontamination process; 93% (n = 1,879) chemically disinfected instruments after each case; and 88% (n = 1,779) disinfected endoscopes with an aqueous glutaraldehyde product. Respondents reported that they and a significantly smaller proportion of physicians (p<.001) employed barrier precautions for all endoscopic cases involving possible contact with blood/body fluids of patients known (66% versus 57%, respectively) and not known (12% versus 8%, respectively) to have a bloodborne infection. Endoscopy-related infections, usually bacterial, were reported to have occurred at their institutions by 6% (n = 116) of respondents.

Conclusions:

We conclude that cleaning, disinfection, and sterilization procedures for gastrointestinal endoscopic instruments vary, that appropriate protective apparel is not always worn, and that some practices may lead to preventable endoscopy-related infection in patients.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1991

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References

1.Shahmir, M, Schuman, BM. Complications of fiberoptic endoscopy. Gastrointest Endosc. 1980;26:8691.Google Scholar
2.Matteucci, DJ, Organ, CH, Dykstra, M, Zalasney, B, Jenkins, H. Efficacy of a simplified lower gastrointestinal flexible endoscope cleaning method. Dis Colon Rectum. 1985;28:653657.Google Scholar
3.Classen, DC. Jacobson, IA. Burke, JP. Iackson, JT, Evans, RS. Serious pseudomonas infections associated with endoscopic retrograde cholangiopancreatography. Am J Med. 1988;84:590596.Google Scholar
4.Wolf, D, Fleischer, D, Divak, MV. Incidence of bacteremia with elective upper gastrointestinal endoscopic laser therapy. Gastrointest Endosc. 1985;31:247250.Google Scholar
5.Spector, GJ. Cleansing of endoscopic instruments to prevent spread of infectious disease. Laryngoscope. 1987;97:887.Google Scholar
6.American Society for Gastrointestinal Endoscopy (ASGE). Infection control during gastrointestinal endoscopy: guidelines for clinical application. Gastrointest Endosc. 1988;34(suppl):S37S40.Google Scholar
7.Silvis, SE, Nebel, O, Rogers, G, Sugawa, C, Mandelstam, I? Endoscopic complications, results of the 1974 American Society for Gastrointestinal endoscopy survey. JAMA. 1976;235:928930.Google Scholar
8.Rutala, WA, Clontz, EP, Weber, DJ, Hoffmann, KK. Disinfection practices for endoscopes and other semicritical items. Third International Conference on Nosocomial Infections, Atlanta. Georgia; July 31-August 3, 1990. Abstract B/36.Google Scholar
9.Moore, RM Jr.. Kaczmarek, RG. McCrohan, J. Multi-state investigation of the actual disinfection/sterilization of gastrointestinal endoscopes. Third International Conference on Nosocomial Infections, Atlanta, Georgia; July 31-August 3, 1990. Abstract B/38.Google Scholar
10.Bond, WW. Disinfecting and sterilizing of flexible fiberoptic endoscopes (FFE) and accessories. Endosc Rev. 1987;4:5558.Google Scholar
11.Vennes, JA. Infectious complications of gastrointestinal endoscopy. Dig Dis Sci. 1981;26(suppl):605645.Google Scholar
12.Cryan, EMJ, Falkiner, FR, Mulvihill, TE, Keane, CT, Keeling, PWN. Pseudomonas aeruginosa cross infection following endoscopic retrograde cholangiopancreatography. J Hosp Infect. 1984;5:371376.Google Scholar
13.Earnshaw, JJ, Clark, AW, Thorn, BT. Outbreak of Pseudomonas aeruginosa following endoscopic retrograde cholangiopancreatography. J Hosp Infect. 1985;6:9597.Google Scholar
14.Lai, KH, Tsai, YT, Lee, SD. Spontaneous bacterial peritonitis after endoscopic variceal sclerotherapy. Gastrointest Endosc. 1986;32:303.Google Scholar
15.Bond, WW, Moncada, RE. Viral hepatitis B infection risk in flexible fiberoptic endoscopy, Gastrointest Endosc. 1978;24:225230.Google Scholar
16.Birnie, GG, Quigley, EM, Clements, GB, Follet, EAC, Watkinson, G. Endoscopic transmission of hepatitis B virus. Gut. 1983;24:171174.Google Scholar
17.Hawkey, PM, Davies, AJ, Viant, AC, Lush, CJ, Mortensen, NJ. Contamination of endoscopes by Salmonella species. J Hosp Infect. 1981;2:373376.Google Scholar
18.Chmel, H, Armstrong, D. Salmonella oslo, a focal outbreak in a hospital. Am J Med. 1976;60:203208.Google Scholar
19.Tuffnell, PG. Salmonella infections transmitted by a gastroscope. Can J Public Health. 1976;67:141142.Google Scholar
20.Centers for Disease Control. Salmonella gastroenteritis acquired from gastroduodenoscopy. MMWR. 1977;26:266.Google Scholar
21.Beecham, HJ IIICohen, ML, Parkin, WE. Salmonella typhimurium transmission by fiberoptic upper gastrointestinal endoscopy. JAMA. 1979;241:10131015.Google Scholar
22.Dwyer, DM, Klein, EG, Istre, GR, Robinson, MG, Neumann, DA, McCoy, GA. Salmonella newport infections transmitted by fiberoptic colonoscopy. Gastrointest Endosc. 1987;33:8487.Google Scholar
23.Favero, MS, Petersen, NJ, Bond, WW. Transmission and control of laboratory-acquired hepatitis infection, In: Gröschel, DHM, Richardson, JH, Vesley, D, Songer, JR, Housewright, RD, Barkley, WE, eds. Laboratory Safety: Principles and Practices Washington D.C.: American Society for Microbiology; 1986:4958.Google Scholar
24.Favero, MS. Sterilization, disinfection, and antisepsis in the hospital. In: Lennette, EH, Balows, A, Hausler, WJ Jr. Shadomy, HJ, eds. Manual of Clinical Microbiology. Washington, D.C.: American Society for Microbiology; 1985:129137.Google Scholar
25.Garner, JS, Favero, MS. Guideline for Handwashing and Hospital Environmental Control, 1985. Atlanta, Ga: US Dept of Health, Education and Welfare, Centers for Disease Control; 1985.Google Scholar
26.Castle, M, Ajemian, E. Cleaning, disinfection, and sterilization. In: Hospital Infection Control-Principles and Practice. 2nd ed. New York, NY, John Wiley and Sons, Inc.; 1987:266279.Google Scholar
27.Rutala, WA. Disinfection, sterilization, and waste disposal. In: Wenzel, RP, ed. Prevention and Control of Nosocomial Infection. Baltimore, MD: Williams and Wilkins; 1987:257282.Google Scholar
28.Society of Gastrointestinal Assistants. Recommended Guidelines for Infection Control in Gastrointestinal Endoscopy Settings. Rochester, NY: Society of Gastrointestinal Nurses and Associates, Inc.; 1990.Google Scholar
29.Bond, WW. Questions and answers. Virus transmission via fiberoptic endoscope: recommended disinfection. JAMA. 1987;257:843844.Google Scholar
30.Bond, WW, Favem, MS, Petersen, NJ, Ebert, JW. Inactivation of hepatitis B virus by intermediate-to-high-level disinfectant chemicals. J Clin Microbial. 1983;18:535538.Google Scholar
31.Ott, BJ, Nelson, B. Understanding the structure and function of endoscope channels: the inside story. Society of Gastrointestinal Assistants Journal. 1987;9:184187.Google Scholar
32.Gerding, DN, Peterson, LR, Vennes, JA. Cleaning and disinfection of fiberoptic endoscopes: evaluation of glutaraldehyde exposure time and forced-air drying. Gastroenterology. 1982;83:613618.Google Scholar
33
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