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Endoscopy 2007; 39(8): 737-739
DOI: 10.1055/s-2007-966644
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Reprocessing flexible gastrointestinal endoscopes after a period of disuse: is it necessary?

A.  S.  Vergis1, 2 , D.  Thomson1 , P.  Pieroni1 , S.  Dhalla1
  • 1Brandon Regional Health Centre, Brandon, Manitoba, Canada
  • 2Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
Further Information

Publication History

eingereicht 9 January 2007

akzeptiert 25 April 2007

Publication Date:
30 July 2007 (online)

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Commentaire de travail de A. S. Vergis et al., pp. 737Endoscopy 2007; 39(08): 847-847
DOI: 10.1055/s-0032-1308863

Background: Gastrointestinal endoscopy is an integral tool in the evaluation and management of many gastrointestinal and hepatobiliary conditions. Although rare, media reports of infectious complications following gastrointestinal endoscopy persist in this new millennium. With only limited data available, society guidelines continue to suggest that endoscopes undergo a reprocessing cycle before the first patient of the day. This preliminary study aimed to assess the microbiological stability of gastrointestinal endoscopes after high-level disinfection.

Methods: In this multiphase study, four endoscopic retrograde cholangiopancreatography (ERCP) scopes and three colonoscopes were evaluated. In phase 1, endoscopes were assayed after initial high-level disinfection and daily for a period of 2 weeks. In phase 2, this procedure was repeated to confirm phase 1 results. In phase 3, endoscopes were assayed after high-level disinfection and again following a 7-day storage period.

Results: In phase 1, 6 of 70 (8.6 %) assays were positive. This involved 4 of 7 (57 %) endoscopes (2 colonoscopes and 2 ERCP scopes) and was limited to the first 5 days of the study. No cultures were positive in phase 2. In phase 3, one endoscope had a positive culture. Positive cultures grew only Staphylococcus epidermidis, a low-virulence skin organism.

Discussion: With proper disinfection and storage, it appears that reprocessing of gastrointestinal endoscopes is unnecessary after periods of disuse of at least 7 days and possibly up to 2 weeks. Despite recent media reports of infectious complications, society guidelines that recommend more frequent reprocessing seem to lack scientific merit and need to be revisited.

References

  • 1 King W. 600 UW patients told of cleaning lapse. Seattle Times 20 March 2004
    Google Scholar
  • 2 Torassa U. Endoscope hygiene a growing problem but experts say it’s unlikely a patient would get hepatitis. San Francisco Chronicle 10 September 2004
    Google Scholar
  • 3 Nelson D B. Infection control during gastrointestinal endoscopy.  J Lab Clin Med. 2003;  141 159-167
    CrossrefPubMedGoogle Scholar
  • 4 American Society for Gastrointestinal Endoscopy . Reprocessing of flexible gastrointestinal endoscopes.  Gastrointest Endosc. 1996;  43 540-545
    PubMedGoogle Scholar
  • 5 Nelson D B, Jarvis W R, Rutala W A. et al . Multi-society guideline for reprocessing flexible gastrointestinal endoscopes. Society for Healthcare Epidemiology of America.  Infect Control Hosp Epidemiol. 2003;  24 532-537
    CrossrefPubMedGoogle Scholar
  • 6 . Cleaning and disinfection of equipment for gastrointestinal endoscopy. Report of a Working Party of the British Society of Gastroenterology Endoscopy Committee.  Gut. 1998;  42 585-593
    PubMedGoogle Scholar
  • 7 The European Society of Gastrointestinal Endoscopy . Guidelines on cleaning and disinfection in gastrointestinal endoscopy. Update 1999.  Endoscopy. 2000;  32 77-80
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Association of perioperative Registered Nurses . Recommended practices for cleaning and processing endoscopes and endoscopic accessories.  AORN J. 2003;  77 434-442
    CrossrefPubMedGoogle Scholar
  • 9 Nelson D B. Recent advances in epidemiology and prevention of gastrointestinal endoscopy related infections.  Curr Opin Infect Dis. 2005;  18 326-330
    CrossrefPubMedGoogle Scholar
  • 10 Rejchrt S, Cermak P, Pavlatova L. et al . Bacteriologic testing of endoscopes after high-level disinfection.  Gastrointest Endosc. 2004;  60 76-78
    CrossrefPubMedGoogle Scholar
  • 11 Riley R, Beanland C, Bos H. Establishing the shelf life of flexible colonoscopes.  Gastroenterol Nurs. 2002;  25 114-119
    CrossrefPubMedGoogle Scholar
  • 12 Principles of reprocessing of endoscopes and accessories [Czech]. The Ministry of Health decree: HEM no. 370-199/3953. Prague; Ministry of Health 1999
    Google Scholar

A. Vergis

Health Sciences Centre, University of Manitoba

GH604 - 820 Sherbrook Street

Winnipeg

Manitoba

Canada R3A 1R9

Fax: +1-204-787-4837

Email: ashleyvergis@hotmail.com

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