Michelle J. Alfa 1 , 2 , * , Harminder Singh 3 , Zoann Nugent 3 , Donald Duerksen 3 , Gale Schultz 4 , Carol Reidy 5 , Patricia DeGagne 1 , Nancy Olson 1
07 November 2017
lever cavity, biofilm, channel, PTFE-BBF model, endoscope sample collection, duodenoscope, flush-brush-flush extraction
Simulated-use buildup biofilm (BBF) model was used to assess various extraction fluids and friction methods to determine the optimal sample collection method for polytetrafluorethylene channels. In addition, simulated-use testing was performed for the channel and lever cavity of duodenoscopes.
BBF was formed in polytetrafluorethylene channels using Enterococcus faecalis, Escherichia coli, and Pseudomonas aeruginosa. Sterile reverse osmosis (RO) water, and phosphate-buffered saline with and without Tween80 as well as two neutralizing broths (Letheen and Dey–Engley) were each assessed with and without friction. Neutralizer was added immediately after sample collection and samples concentrated using centrifugation. Simulated-use testing was done using TJF-Q180V and JF-140F Olympus duodenoscopes.
Despite variability in the bacterial CFU in the BBF model, none of the extraction fluids tested were significantly better than RO. Borescope examination showed far less residual material when friction was part of the extraction protocol. The RO for flush-brush-flush (FBF) extraction provided significantly better recovery of E. coli ( p = 0.02) from duodenoscope lever cavities compared to the CDC flush method.
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