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      Comparative Study of Microbiological Monitoring Results from Three Types of Sampling Methods after Gastrointestinal Endoscope Reprocessing

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          Abstract

          Objective

          Compare the effects of three sampling methods on the microbiological monitoring results after reprocessing of gastrointestinal endoscopes, providing scientific basis for improving the monitoring quality of gastrointestinal endoscope cleaning and disinfection.

          Method

          Gastrointestinal endoscopes after reprocessing were selected randomly at the gastrointestinal endoscopy center of a tertiary hospital in Shanghai from October 2018 to February 2019. The endoscopes selected were all sampled in three different methods under continuous sampling and intermittent sampling respectively. Methods used includes, the biopsy channel group (Group A), the entire channel group (Group B), and the disc brush group (Group C). Then the colony forming units (CFU/piece) were counted in the laboratory.

          Results

          A total of 12 endoscopes were sampled by using continuous sampling approach, in which the detection rate of bacteria in disc brush group (33.3%) and entire channel group (33.3%) was higher than biopsy channel group (8.3%). Among the 12 endoscopes sampled with intermittent approach, the detection rate of bacteria from high to low was the disc brush group (50%), the entire channel group (41.7%), and the biopsy channel group (8.3%).

          Conclusion

          Different sampling methods will lead to the difference of microbiological culture results after reprocessing of gastrointestinal endoscope, indicating that the improved sampling method is beneficial to objectively reflect the endoscope cleaning and disinfection effect, and improve the monitoring quality of endoscope disinfection.

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          Most cited references17

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          Transmission of infection by flexible gastrointestinal endoscopy and bronchoscopy.

          Flexible endoscopy is a widely used diagnostic and therapeutic procedure. Contaminated endoscopes are the medical devices frequently associated with outbreaks of health care-associated infections. Accurate reprocessing of flexible endoscopes involves cleaning and high-level disinfection followed by rinsing and drying before storage. Most contemporary flexible endoscopes cannot be heat sterilized and are designed with multiple channels, which are difficult to clean and disinfect. The ability of bacteria to form biofilms on the inner channel surfaces can contribute to failure of the decontamination process. Implementation of microbiological surveillance of endoscope reprocessing is appropriate to detect early colonization and biofilm formation in the endoscope and to prevent contamination and infection in patients after endoscopic procedures. This review presents an overview of the infections and cross-contaminations related to flexible gastrointestinal endoscopy and bronchoscopy and illustrates the impact of biofilm on endoscope reprocessing and postendoscopic infection.
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            Withdrawal of a novel-design duodenoscope ends outbreak of a VIM-2-producing Pseudomonas aeruginosa.

            Infections are a recognized risk of endoscopic retrograde cholangiopancreatography (ERCP). This paper reports on a large outbreak of VIM-2-producing Pseudomonas aeruginosa that was linked to the use of a recently introduced duodenoscope with a specific modified design (Olympus TJF-Q180V).
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              • Record: found
              • Abstract: found
              • Article: not found

              A quarantine process for the resolution of duodenoscope-associated transmission of multidrug-resistant Escherichia coli.

              Because of their complex design, duodenoscopes have been long recognized to be difficult to fully disinfect and may play a role in transmission of bacteria between patients. Recent reports of duodenoscope-associated carbapenem-resistant enterobacteriaceae transmission have confirmed these suspicions. An outbreak of a multidrug resistant strain of Escherichia coli was recently reported at our institution. Herein we report the results of our investigation and the process improvements that we deployed in an effort to contain the outbreak.
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                Author and article information

                Contributors
                Journal
                Biomed Res Int
                Biomed Res Int
                BMRI
                BioMed Research International
                Hindawi
                2314-6133
                2314-6141
                2019
                3 December 2019
                : 2019
                : 7940468
                Affiliations
                1Gastrointestinal Endoscopy Center, Changhai Hospital, Shanghai, China
                2Department of Anesthesiology, Changhai Hospital, Shanghai, China
                3School of Nursing, The Navy Military Medical University, Shanghai, China
                4Department of Nursing, Changhai Hospital, Shanghai, China
                5Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
                Author notes

                Guest Editor: Yatao Liu

                Author information
                https://orcid.org/0000-0003-1559-3921
                https://orcid.org/0000-0002-6760-3813
                https://orcid.org/0000-0002-4081-4776
                https://orcid.org/0000-0003-2521-8105
                https://orcid.org/0000-0003-2862-685X
                https://orcid.org/0000-0002-5284-8033
                https://orcid.org/0000-0002-7129-6959
                https://orcid.org/0000-0002-2450-2094
                https://orcid.org/0000-0002-4346-0475
                https://orcid.org/0000-0003-2019-7317
                https://orcid.org/0000-0001-8358-3384
                https://orcid.org/0000-0002-3184-9336
                Article
                10.1155/2019/7940468
                6914964
                31886251
                bdca5f3c-3425-402d-b77e-cc0b256b987e
                Copyright © 2019 Su Ma et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 April 2019
                : 20 August 2019
                Funding
                Funded by: Chinese Geriatrics Society
                Award ID: GRYJ-YK2018045
                Funded by: Changhai hospital
                Award ID: 2018HLZD08
                Categories
                Research Article

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