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Disposable Bronchoscope Model for Simulating Endoscopic Reprocessing and Surveillance Cultures

Published online by Cambridge University Press:  21 November 2016

Mohamed H. Yassin*
Affiliation:
Division of Infectious Diseases, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania Department of Infection Control, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
Rahman Hariri
Affiliation:
Clinical Microbiology Laboratory, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
Yasir Hamad
Affiliation:
Division of Infectious Diseases, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
Juliet Ferrelli
Affiliation:
Department of Infection Control, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
Leeanna McKibben
Affiliation:
University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
Yohei Doi
Affiliation:
Division of Infectious Diseases, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
*
Address correspondence to Mohamed H Yassin, MD, PhD, 1400 Locust Street, Pittsburgh, PA 15219, ([email protected]).

Abstract

BACKGROUND

Endoscope-associated infections are reported despite following proper reprocessing methods. Microbiological testing can confirm the adequacy of endoscope reprocessing. Multiple controversies related to the method and interpretation of microbiological testing cultures have arisen that make their routine performance a complex target.

OBJECTIVE

We conducted a pilot study using disposable bronchoscopes (DBs) to simulate different reprocessing times and soaking times and to compare high-level disinfection versus ethylene oxide sterilization. We also reviewed the time to reprocessing and duration of the procedures.

METHODS

Bronchoscopes were chosen because an alternative disposable scope is commercially available and because bronchoscopes are more prone to delays in processing. Disposable bronchoscopes were contaminated using a liquid bacterial suspension and were then incubated for 1–4 hours. Standard processing and high-level disinfection were performed on 36 endoscopes. Ethylene oxide sterilization was performed on 21 endoscopes. Endoscope cultures were performed using the standard “brush, flush, brush” technique.

RESULTS

After brushing was performed, a final water-flush culture procedure was the most effective method of detecting bacterial persistence on the disposable scopes. Klebsiella pneumoniae was the most commonly recovered organism after reprocessing. Ethylene oxide sterilization did not result in total elimination of viable bacteria.

CONCLUSION

Routine endoscopy cultures may be required to assess the adequacy of endoscopic processing.

Infect Control Hosp Epidemiol 2017;38:136–142

Type
Original Articles
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION. This study was presented as abstract number 110 at IDWeek 2015 in San Diego, California. The oral abstract session was held on October 8, 2015.

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