Work

Adequacy of Duodenoscope Reprocessing Methods as Reported by Infectious Disease Physicians

Year: 2015

Type: article

Abstract: Background. Two recent outbreaks of multidrug-resistant organism (MDRO) bacterial transmission have been reported via duodenoscopes without reprocessing breaches or duodenoscope defects identified. In March 2015, the Centers for Disease Control and Prevention (CDC) released an interim surveillance protocol for duodenoscopes to guide use of surveillance cultures to assess endoscope reprocessing. Methods. The Infectious Diseases Society of America's Emerging Infections Network (EIN) surveyed its physician members later in March 2015 to determine institutional practices for endoscope decontamination and surveillance cultures. An email with a link to a 5-item electronic survey was sent to 699 EIN members with a recorded interest in hospital epidemiology. Results. Three hundred seventy-eight (54%) of 699 EIN members responded; 190 (50%) reported that their facilities used duodenoscopes. One hundred thirty-four of 190 (70%) reported a single method of decontamination: automated endoscope washers with high-level disinfection by 108 (57%), manual reprocessing using high-level disinfection by 20 (11%), and ethylene oxide gas sterilization by 6 (3%). Thirty-eight (20%) respondents reported 2 methods of decontamination, most often automated washers plus manual reprocessing by 26 (14%); 5 (3%) reported 3 methods. Respondents were asked to select all methods used to identify possible infections resulting from duodenoscopy in the last 12 months. The most common response was “None” by 59 (31%). A single method was reported by 71 (37%), most commonly surveillance cultures by 25 (13%). Other surveillance methods included clinical cultures, microbiologic patient screening, and follow-up patient contact post procedure. Two surveillance methods were reported by 30 (16%), and 3 or more methods were reported by 13 (7%). Finally, 79% of respondents reported reviewing duodenoscopy policies and procedures currently or in the past 3 months. Conclusion. Our study shows that a minority of infectious diseases physician respondents reported that their institutions were using multiple reprocessing steps as recommended. In addition, approximately one-third of respondents reported that their institutions had not used any methods within the last year to identify post-duodenoscopy MDRO transmission or infections. These findings suggest the possibility that endemic bacterial transmission associated with duodenoscopy may occur and may go unrecognized. Disclosures. All authors: No reported disclosures.

Source: Open Forum Infectious Diseases

DOI: 10.1093/ofid/ofv131.29

Authors: Susan E. Beekmann, Tara Palmore, Philip M. Polgreen, John E. Bennett

Institutions: University of Iowa, National Institutes of Health, National Institutes of Health Clinical Center, National Institute of Allergy and Infectious Diseases

Language: English

Topic: Medical Device Sterilization and Disinfection

Subfield: Microbiology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,053