GASTROINTESTINAL ENDOSCOPY IN HEALTH 4.0: HOW SAFE ARE WE?

Aims:

Several outbreaks of severe infections due to contamination of gastrointestinal (GI) endoscopes have been described previously. However, the true rate of microbial contamination during endoscopy is unknown. Thus, the aim of this study was to evaluate the hygiene quality of endoscopy units in Tyrol/Austria in a two point prevalence study.

Methods:

In 2015 and 2016, a total of 463 GI endoscopes and 105 automated endoscope reprocessors (AER) from 36 endoscopy centres were analysed by a routine and an advanced routine sampling method and investigated for microbial contamination by culture- and molecular-based analyses.

Results:

The contamination rate of GI endoscopes was 1.3 – 4.6% according to national and European guidelines, suggesting that 1.3 – 4.6 patients out of 100 had contacts with hygiene relevant microorganisms through an endoscopic intervention. The most commonly identified indicator organism was Pseudomonas spp., mainly P. oleovorans. None of the tested viruses were detected. The impact of the advanced study procedure, compared to routine sampling, on microbial recovery revealed only a very minor advantage. While AERs in phase I failed (n = 9) mainly due to technical faults, phase II revealed lapses (n = 6) only on account to microbial contamination of the last rinsing water, mainly with Pseudomonas spp.

Conclusions:

In the present study the contamination rate of endoscopes was low compared to results from other European countries, probably due to a high quality of endoscope reprocessing, drying and storage. Furthermore, this study demonstrates the need for harmonization of guidelines for endoscope reprocessing, microbial monitoring and reporting.