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Endoscope Reprocessing: Update on Controversial Issues

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Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy

Reprocessing, Endoscopy, Disinfection

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      Abstract

      Several issues concerning endoscope reprocessing remain unresolved based on currently available data. Thus, further studies are required to confirm standard practices including safe endoscope shelf life, proper frequency of replacement of some accessories including water bottles and connecting tubes, and microbiological surveillance testing of endoscopes after reprocessing. The efficacy and cost-effectiveness of newer technology that allows automated cleaning and disinfection is one such controversial issue. In addition, there are no guidelines on whether delayed reprocessing and extended soaking may harm endoscope integrity or increase the bioburden on the external or internal device surfaces. In this review, we discuss the unresolved and controversial issues regarding endoscope reprocessing.

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      Most cited references 37

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      Multisociety guideline on reprocessing flexible gastrointestinal endoscopes: 2011.

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        Is biofilm accumulation on endoscope tubing a contributor to the failure of cleaning and decontamination?

        We predicted that biofilm would form on surfaces of endoscope tubing in contact with fluids, and may be difficult to remove by current washing procedures. Its presence may protect micro-organisms from disinfectant action and contribute to failure of decontamination prior to re-use. Tubing samples removed from 13 endoscopes that had been sent to an endoscope-servicing centre were examined for the presence of biofilm and bacteria by scanning electron microscopy. Biological deposits were present on all samples tested. Biofilm (bacteria plus exopolysaccharides matrix) was present on the suction/biopsy channels of five of 13 instruments, and was very extensive on one of these. Bacteria and microcolonies were often but not necessarily associated with surface defects on the tubing. All 12 air/water channels examined showed biofilm, and this was extensive on nine samples. Routine cleaning procedures do not remove biofilm reliably from endoscope channels, and this may explain the unexpected failure of decontamination encountered in practice despite good adherence to infection control guidelines.
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          ESGE-ESGENA Guideline: cleaning and disinfection in gastrointestinal endoscopy.

           H Biering,  ,  M Cimbro (2008)
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            Author and article information

            Affiliations
            Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
            Author notes
            Correspondence: Young-Seok Cho. Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea. Tel: +82-2-2258-6021, Fax: +82-2-2258-2038, yscho@ 123456catholic.ac.kr
            Journal
            Clin Endosc
            Clin Endosc
            CE
            Clinical Endoscopy
            The Korean Society of Gastrointestinal Endoscopy
            2234-2400
            2234-2443
            September 2015
            30 September 2015
            : 48
            : 5
            : 356-360
            4604270
            10.5946/ce.2015.48.5.356
            Copyright © 2015 Korean Society of Gastrointestinal Endoscopy

            This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

            Categories
            Focused Review Series: Endoscopic Disinfection in the Era of MERS

            Radiology & Imaging

            disinfection, endoscopy, reprocessing

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