Microbiological surveillance – where do we stand?

Microbiological surveillance is an important quality assurance tool in endoscopy and have been established in many countries for more than 20 years [1]. The aim of microbiological surveillance is to check the quality of endoscope reprocessing, to confirm the reprocessing quality or to identify possible weak points at an early stage and to provide information about possible risks. Microbiological surveillance can also give indications of possible defects in endoscopes and washer-disinfectors, so that you can react at an early stage.

In outbreak management, microbiological surveillance is a helpful tool to better understand the situation and find the actual cause that may have led to the transmission of pathogens. Publications on outbreaks in GI endoscopy usually describe the situation in one institution and can only be a snapshot.

In reviews the data evaluation from published outbreaks is a challenge because the reprocessing methods are subject to national differences and have changed over the years. The comparison of microbiological surveillance programmes is very difficult because methods of sampling, the time of sampling, the number of channels checked, the type of sampling solution used, the cultivation methods (filtration vs centrifugation) and the interpretation of the results show extreme variations [1] [2]. More homogeneous data are available when the outbreaks are evaluated at national level [3].

When microbiological surveillance programmes are developed and tested, this is usually done in one institute with a limited range of endoscopes and over a limited period of time.

The present work by Pineau is a multi-centre evaluation in France over the impressive period of 17 years. The evaluation is based on the recommendations of the French guidelines [4], which were adapted over the course of the study to the new established methods for duodenoscope sampling [5]. The study of Pineau reflects the situation across France by including all endoscopy departments in private and public clinics [6]. Due to the national character, endoscopes from different disciplines could be evaluated, which differed in endoscope types, manufacturers, design and channel geography. Due to the large number of clinics involved and the wide range of variations of endoscopes involved, a really complete picture of the reprocessing situation in France was created. The sampling performance was the responsibility of one institute that operates nationwide and used uniformly trained personnel with a uniform method protocol. As a result, there are no institute-related variations here either. Due to the impressive number of 90311 samples and the uniform sampling in 490 private and public clinics in France, extensive homogeneous data is available. In this way, trends and critical points can be derived. What do we learn from the publication?

Publication History

Article published online:
28 April 2023

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