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Evaluation of the Quality of Reprocessing of Gastrointestinal Endoscopes

Published online by Cambridge University Press:  29 May 2015

Philippe Saviuc ,
Romain Picot-Guéraud ,
Jacqueline Shum Cheong Sing ,
Pierre Batailler ,
Isabelle Pelloux ,
Marie-Pierre Brenier-Pinchart ,
Valérie Dobremez  and
Marie-Reine Mallaret
Philippe Saviuc
Affiliation:
CHU Grenoble, Pôle Santé Publique, Unité d’Hygiène Hospitalière, F-38000 Grenoble, France
Romain Picot-Guéraud*
Affiliation:
CHU Grenoble, Pôle Santé Publique, Unité d’Hygiène Hospitalière, F-38000 Grenoble, France
Jacqueline Shum Cheong Sing
Affiliation:
CHU Grenoble, Pôle Santé Publique, Unité d’Hygiène Hospitalière, F-38000 Grenoble, France
Pierre Batailler
Affiliation:
CHU Grenoble, Pôle Santé Publique, Unité d’Hygiène Hospitalière, F-38000 Grenoble, France
Isabelle Pelloux
Affiliation:
CHU Grenoble, Pôle Biologie et Pathologie, F-38000 Grenoble, France
Marie-Pierre Brenier-Pinchart
Affiliation:
CHU Grenoble, Pôle Biologie et Pathologie, F-38000 Grenoble, France Univ. Grenoble Alpes, Laboratoire Adaptation et Pathogénie des Microorganismes (LAPM), Centre National de la Recherche Scientifique (CNRS), F-38000 Grenoble, France
Valérie Dobremez
Affiliation:
CHU Grenoble, Pôle Santé Publique, Unité d’Hygiène Hospitalière, F-38000 Grenoble, France
Marie-Reine Mallaret
Affiliation:
CHU Grenoble, Pôle Santé Publique, Unité d’Hygiène Hospitalière, F-38000 Grenoble, France Univ. Grenoble Alpes, Laboratoire de Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Application, Grenoble (TIMC-IMAG), Centre National de la Recherche Scientifique (CNRS), F-38000 Grenoble, France
*
Address correspondence to Romain Picot-Guéraud, PharmD, Unité d’Hygiène Hospitalière, CHU de Grenoble, CS 10217 - 38043 Grenoble CEDEX 9 (rpicotgueraud@chu-grenoble.fr).
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Abstract

OBJECTIVES

To evaluate the quality of gastrointestinal endoscope reprocessing and discuss the advantages of microbiological surveillance testing of these endoscopes.

METHODS

Retrospective analysis of the results of endoscope sampling performed from October 1, 2006, through December 31, 2014, in a gastrointestinal endoscopy unit of a teaching hospital equipped with 89 endoscopes and 3 automated endoscope reprocessors, with an endoscopy quality assurance program in place. The compliance rate was defined as the proportion of the results classified at target or alert levels according to the French guidelines. A multivariate analysis (logistic regression) was used to identify the parameters influencing compliance.

RESULTS

A total of 846 samples were taken. The overall compliance rate was 86% and differed significantly depending on the sampling context (scheduled or not scheduled), the type of endoscope, and the season. No other parameter was associated with compliance. A total of 118 samples carried indicator microorganisms such as Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Enterobacteriaceae, and Candida sp.

CONCLUSION

The systematic use of an automated endoscope reprocessor does not provide totally satisfactory compliance. Microbiological surveillance is indispensable to monitor reprocessing, reinforce good practices (endoscopes, reprocessing units), and detect endoscopes requiring early technical maintenance.

Infect. Control Hosp. Epidemiol. 2015;36(9):1017–1023

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 9 , September 2015 , pp. 1017 - 1023
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

1. Ministère de la santé, de la famille et des personnes handicapées. Circulaire DHOS/E2/DGS/SD5C n°2003-591 du 17 décembre 2003 relative aux modalités de traitement manuel pour la désinfection des endoscopes non autoclavables dans les lieux de soins. http://www.sante.gouv.fr/fichiers/bo/2004/04-01/a0010011.htm. Published 2004. Accessed January 31, 2015.Google Scholar
2. Ministère de la santé et des protections sociales CTIN/DGS/DHOS. Bonnes pratiques de désinfection des dispositifs médicaux: guide pour l’entretien manuel des dispositifs médicaux en endoscopie digestive. Juin 2004. http://www.sante-sports.gouv.fr/IMG/pdf/Guide_pour_l_entretien_manuel_des_dispositifs_medicaux_en_endoscopie_digestive.pdf. Published 2004. Accessed January 31, 2015.Google Scholar
3. European Society of Gastrointestinal Endoscopy. Guidelines: cleaning and disinfection in GI endoscopy. Endoscopy 2008;40:939–947.Google Scholar
4. Gastroenterological Society of Australia. Infection control in endoscopy: microbiological testing of gastrointestinal and respiratory endoscopes and automated flexible reprocessors. http://www.gesa.org.au/files/editor_upload/File/Professional/Endoscopy_Microbiological_Testing.pdf. Published 2008. Updated February 2008. Accessed January 31, 2015.Google Scholar
5. American Society for Gastrointestinal Endoscopy and Society for Healthcare Epidemiology of America. Multisociety guideline on reprocessing flexible gastrointestinal endoscopes: 2011. Gastrointest Endosc 2011;73:1075–1084.CrossRefGoogle Scholar
6. Nelson, DB. Infectious disease complications of GI endoscopy: part II, exogenous infections. Gastrointest Endosc 2003;57:695–711.CrossRefGoogle ScholarPubMed
7. Nelson, DB, Muscarella, LF. Current issues in endoscope reprocessing and infection control during gastrointestinal endoscopy. World J Gastroenterol 2006;12:3953–3964.Google Scholar
8. Aumeran, C, Poincloux, L, Souweine, B, et al. Multidrug-resistant Klebsiella pneumoniae outbreak after endoscopic retrograde cholangiopancreatography. Endoscopy 2010;42:895–899.Google Scholar
9. Carbonne, A, Thiolet, JM, Fournier, S, et al. Control of a multi-hospital outbreak of KPC-producing Klebsiella pneumoniae type 2 in France, September to October 2009. Euro Surveill 2010;15: pii=19734. http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19734. Published 2010. Accessed January 31, 2015.CrossRefGoogle ScholarPubMed
10. Epstein, L, Hunter, JC, Arwady, MA, et al. New Delhi metallo-beta-lactamase–producing carbapenem-resistant Escherichia coli associated with exposure to duodenoscopes. JAMA 2014;312:1447–1455.Google Scholar
11. Wendorf, KA, Kay, M, Baliga, C, et al. Endoscopic retrograde cholangiopancreatography-associated AmpC Escherichia coli outbreak [published online March 30, 2015]. Infect Control Hosp Epidemiol 2015. doi:10.1017/ice.2015.66.Google Scholar
12. Méan, M, Mallaret, MR, Bichard, P, Shum, J, Zarski, JP. Gastrointestinal endoscopes cleaned without detergent substance following an automated endoscope washer/disinfector dysfunction. Gastroenterol Clin Biol 2006;30:665–668.Google Scholar
13. Moses, FM, Lee, J. Surveillance cultures to monitor quality of gastrointestinal endoscope reprocessing. Am J Gastroenterol 2003;98:77–81.Google Scholar
14. Beilenhoff, U, Neumann, CS, Rey, JF, et al; European Society of Gastrointestinal Endoscopy. A guideline for quality assurance in reprocessing: microbiological surveillance testing in endoscopy. Endoscopy 2007;39:175–181.Google Scholar
15. Comité techniques des infections nosocomiales et des infections liées aux soins, Conseil supérieur d’hygiène publique en France. Eléments d’assurance qualité en hygiène relatifs au contrôle microbiologique des endoscopes et à la traçabilité en endoscopie. http://www.sante.gouv.fr/IMG/pdf/microbio_endoscopes-2.pdf. Published 2007. Accessed January 31, 2015.Google Scholar
16. Ministère de la santé, des familles et des personnes handicapées. Guide des bonnes pratiques de désinfection des dispositifs médicaux: guide pour l’utilisation des laveurs-désinfecteurs d’endoscopes. CTIN/DGS/DHOS, novembre 2003. http://www.sante.gouv.fr/IMG/pdf/Guide_pour_l_utilisation_des_laveurs_desinfecteurs_d_endoscopes.pdf. Published 2003. Accessed January 31, 2015.Google Scholar
17. Gillespie, EE, Kotsanas, D, Stuart, RL. Microbiological monitoring of endoscopes: 5-year review. J Gastroenterol Hepatol 2008;23:1069–1074.Google Scholar
18. Saliou, P, Garlantézec, R, Baron, R, et al. Contrôles microbiologiques des endoscopes au centre hospitalier régional de Brest du 1er janvier 2007 au 31 décembre 2009. Pathol Biol (Paris) 2011;59:88–93.Google Scholar
19. Rutala, WA, Weber, DJ. Gastrointestinal endoscopes: a need to shift from disinfection to sterilization? JAMA 2014;312:1405–1406.CrossRefGoogle ScholarPubMed
20. Muscarella, LF. Inconsistencies in endoscope-reprocessing and infection-control guidelines: the importance of endoscope drying. Am J Gastroenterol 2006;101:2147–2154.Google Scholar