Endoscopy 2020; 52(S 01): S148
DOI: 10.1055/s-0040-1704456
ESGE Days 2020 ePoster Podium presentations
Thursday, April 23, 2020 11:30 – 12:00 Periendoscopic management: From appropriateness to sedation ePoster Podium 4
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DOES DOUBLE HIGH LEVEL DISINFECTION FOR DUODENOSCOPES ADD ANY VALUE? A SYSTEMATIC REVIEW AND META ANALYSIS

O Elbahr
1   National Liver Institute, Hepatology and Gastroenterology, Shebin Alkawm, Egypt
,
A Saleh
2   Menoufia university, Infection Control, Shebin Alkawm, Egypt
,
AA Aziz
3   National Liver Institute, Medical Microbiology and Immunology, Shebin Alkawm, Egypt
,
S Awad
3   National Liver Institute, Medical Microbiology and Immunology, Shebin Alkawm, Egypt
,
F Khalil
3   National Liver Institute, Medical Microbiology and Immunology, Shebin Alkawm, Egypt
,
S Afiffy
1   National Liver Institute, Hepatology and Gastroenterology, Shebin Alkawm, Egypt
,
A Kamal
1   National Liver Institute, Hepatology and Gastroenterology, Shebin Alkawm, Egypt
,
A Alsebaey
1   National Liver Institute, Hepatology and Gastroenterology, Shebin Alkawm, Egypt
,
G Badra
1   National Liver Institute, Hepatology and Gastroenterology, Shebin Alkawm, Egypt
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Duodenoscopes emerging infection especially drug resistant bacteria considered a major concern nowadays. Different approaches were tried to overcome this problem, like double high level disinfection procedure.Our aim was to perform a systematic review and meta analysis to evaluate risk difference for positive cultures from duodenoscopes between double high level disinfection (dHLD) and single high level disinfection (sHLD).

Tab. 1

Data from selected studies

studies

sHLD (Cultures) +ve/all

dHLD (cultures) +ve/all

Bartles 2018

108/2798

127/3052

Rex 2018

200/1524

Snyder 2017

32/174

34/169

Bang 2016

30/329

Methods A thorough literature search (in October and November 2019) for studies comparing between dHLD and sHLD for duodenoscopes was performed by 3 researchers in web of science, Scopus, PubMed and Cochran databases. the search terms were “duodenoscope, “ERCP endoscope”, “disinfection”, “ sterilization” and “reprocessing” with only randomized clinical trials with English language were accepted.

Results 4 trials were identified studying dHLD and only 2 clinical trials comparing dHLD with standard sHLD were found reporting 6193 duodenoscopes´ cultures. Overall sHLD cultures were 2972 and dHLD cultures were 3221 overall positive cultures in sHLD were 140 and 161 in dHLD.

The results of meta analysis using the random effect model showed no significant risk difference (RD) between the 2 procedures for duodenoscopes positive cultures (p = 0.53, RD 0.003 CI 95 % “- 0.007 - 0.013”).

Conclusions Double HLD offered no difference over single HLD for duodenoscope disinfection. an alternative strategy to overcome duodenoscopes transmitted infection is a big issue to be resolved.