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Biofilm accumulation in new flexible gastroscope channels in clinical use

Published online by Cambridge University Press:  15 June 2021

Mariusa Gomes Borges Primo Open the ORCID record for Mariusa Gomes Borges Primo [Opens in a new window] ,
Anaclara Ferreira Veiga Tipple Open the ORCID record for Anaclara Ferreira Veiga Tipple [Opens in a new window] ,
Dayane de Melo Costa Open the ORCID record for Dayane de Melo Costa [Opens in a new window] ,
Simone Vieira Toledo Guadagnin Open the ORCID record for Simone Vieira Toledo Guadagnin [Opens in a new window] ,
Adriana Silva Azevedo Open the ORCID record for Adriana Silva Azevedo [Opens in a new window] ,
Lara Stefânia Netto de Oliveira Leão-Vasconcelos Open the ORCID record for Lara Stefânia Netto de Oliveira Leão-Vasconcelos [Opens in a new window] ,
Michelle Alfa Open the ORCID record for Michelle Alfa [Opens in a new window]  and
Karen Vickery Open the ORCID record for Karen Vickery [Opens in a new window]
Mariusa Gomes Borges Primo
Affiliation:
Clinics Hospital, Federal University of Goias, Goiânia, Goias, Brazil
Anaclara Ferreira Veiga Tipple*
Affiliation:
Faculty of Nursing, Federal University of Goias, Goiânia, Goias, Brazil
Dayane de Melo Costa
Affiliation:
Faculty of Nursing, Federal University of Goias, Goiânia, Goias, Brazil
Simone Vieira Toledo Guadagnin
Affiliation:
Clinics Hospital, Federal University of Goias, Goiânia, Goias, Brazil
Adriana Silva Azevedo
Affiliation:
Clinics Hospital, Federal University of Goias, Goiânia, Goias, Brazil
Lara Stefânia Netto de Oliveira Leão-Vasconcelos
Affiliation:
Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiânia, Goias, Brazil
Michelle Alfa
Affiliation:
Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
Karen Vickery
Affiliation:
Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
*
Author for correspondence: Anaclara Ferreira Veiga Tipple, E-mail: [email protected]
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Abstract

Objective:

Assess the accumulation of protein and biofilm on the inner surfaces of new flexible gastroscope (FG) channels after 30 and 60 days of patient use and full reprocessing.

Design:

Clinical use study of biofilm accumulation in FG channels.

Setting:

Endoscopy service of a public hospital.

Methods:

First, we tested an FG in clinical use before the implementation of a revised reprocessing protocol (phase 1 baseline; n = 1). After replacement of the channels by new ones and the implementation of the protocol, 3 FGs were tested after 30 days of clinical use (phase 2; n = 3) and 3 FGs were tested after 60 days of clinical use (phase 3; n = 3), and the same FGs were tested in phase 2 and 3. Their biopsy, air, water, and air/water junction channels were removed and subjected to protein testing (n = 21), bacteriological culture (n = 21), and scanning electron microscopy (SEM) (n = 28). Air–water junction channels fragments were subjected to SEM only.

Results:

For the FGs, the average number of uses and reprocessing cycles was 60 times. Extensive biofilm was detected in air, water, and air–water junction channels (n = 18 of 28). All channels (28 of 28) showed residual matter, and structural damage was identified in most of them (20 of 28). Residual protein was detected in the air and water channels of all FG evaluated (phases 1–3), except for 1 air channel from phase 2. Bacteria were recovered from 8 of 21 channels, most air or water channels.

Conclusions:

The short time before damage and biofilm accumulation in the channels was evident and suggests that improving the endoscope design is necessary. Better reprocessing methods and channel maintenance are needed.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 2 , February 2022 , pp. 174 - 180
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

PREVIOUS PRESENTATION: An abstract with partial results of this study was presented at the IDWEEK 2020 on October 21, conducted virtually.

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