Literature DB >> 28918989

Improper positioning of the elevator lever of duodenoscopes may lead to sequestered bacteria that survive disinfection by automated endoscope reprocessors.

Michelle J Alfa1, Harminder Singh2, Donald R Duerksen2, Gale Schultz3, Carol Reidy4, Pat DeGagne5, Nancy Olson5.   

Abstract

BACKGROUND: Some outbreaks associated with contaminated duodenoscopes have been attributed to biofilm formation. The objective of this study was to determine whether bacteria within an organic matrix could survive if the elevator lever was improperly positioned in the automated endoscope reprocessor (AER) after 1 round of reprocessing.
METHODS: Duodenoscope lever cavities with an open or sealed elevator wire channel were inoculated with 6-7 Log10 of both Escherichia coli and Enterococcus faecalis in ATS2015 (Healthmark Industries, Fraser, MI) and dried for 2 hours. The duodenoscopes with the lever in the horizontal position were processed through 2 makes of AERs. The cavity was sampled using a flush-brush-flush method to determine the quantity of surviving bacteria.
RESULTS: E faecalis (range, 21-6 Log10 CFU) and E coli (range, 0-3 Log10 CFU) survived disinfection of sealed or unsealed elevator wire channel duodenoscopes in 2 different AERs with and without cleaning cycles.
CONCLUSION: If bacteria in organic residue are under the improperly positioned lever, then just 1 round of use is sufficient for bacteria to survive both liquid chemical sterilization and liquid chemical HLD regardless of whether or not the AER had a cleaning cycle.
Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Bacteria survival; High-level-disinfection; Sterilization

Mesh:

Year:  2017        PMID: 28918989     DOI: 10.1016/j.ajic.2017.07.021

Source DB:  PubMed          Journal:  Am J Infect Control        ISSN: 0196-6553            Impact factor:   2.918


  5 in total

Review 1.  Duodenoscope-Associated Infections: Update on an Emerging Problem.

Authors:  M Rubayat Rahman; Abhilash Perisetti; Roxana Coman; Pardeep Bansal; Rajiv Chhabra; Hemant Goyal
Journal:  Dig Dis Sci       Date:  2018-12-19       Impact factor: 3.199

2.  Sterile Reverse Osmosis Water Combined with Friction Are Optimal for Channel and Lever Cavity Sample Collection of Flexible Duodenoscopes.

Authors:  Michelle J Alfa; Harminder Singh; Zoann Nugent; Donald Duerksen; Gale Schultz; Carol Reidy; Patricia DeGagne; Nancy Olson
Journal:  Front Med (Lausanne)       Date:  2017-11-07

Review 3.  Recent advances in understanding the epidemiology of healthcare-associated infections.

Authors:  Pranavi Sreeramoju
Journal:  F1000Res       Date:  2019-01-25

4.  Duodenoscope-Associated Infections beyond the Elevator Channel: Alternative Causes for Difficult Reprocessing.

Authors:  Gheorghe G Balan; Irina Rosca; Elena-Laura Ursu; Adrian Fifere; Cristian-Dragos Varganici; Florica Doroftei; Ioana-Andreea Turin-Moleavin; Vasile Sandru; Gabriel Constantinescu; Daniel Timofte; Gabriela Stefanescu; Anca Trifan; Catalin Victor Sfarti
Journal:  Molecules       Date:  2019-06-25       Impact factor: 4.411

Review 5.  A narrative review on current duodenoscope reprocessing techniques and novel developments.

Authors:  Maarten Heuvelmans; Herman F Wunderink; Henny C van der Mei; Jan F Monkelbaan
Journal:  Antimicrob Resist Infect Control       Date:  2021-12-23       Impact factor: 4.887

  5 in total

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