Microbiologic assessment of flexible gastrointestinal endoscope reprocessing using a pump-assisted sampling technique: an investigation involving all endoscopy units in Tianjin, China.
BACKGROUND
Microbiologic surveillance of flexible gastrointestinal endoscopes is recommended in several guidelines as the primary means of identifying reprocessing failures. This study aimed to evaluate the contamination level and prevalence of bacteria of post-reprocessing endoscopes and to access whether using a pump-assisted sampling method (PASM) improves the sensitivity of culture.


METHODS
All 59 endoscopy units in Tianjin, China, were investigated. The PASM and the conventional flushing sampling method (CFSM) were used to compare the results of the microbial culture. Logistic regression analysis was used to identify the influencing factors.


RESULTS
One hundred four (56.52%) flushing channel samples of gastrointestinal endoscopes were positive for culture, and the maximum bacterial concentration was 14,100 colony-forming units (CFU)/channel. One hundred fifty-one (82.07%) flushing samples were qualified according to the national standard of China (≤ 20 CFU/channel). The qualified rate of the samples collected by PASM was significantly lower than the qualified rate by CFSM (65.52% vs 89.68%). Using PASM (odds ratio [OR]: 4.257; 95% confidence interval [CI]: 1.870-9.690) would increase the sensitivity of culture. The use of purified water (OR: 0.288; 95% CI: 0.102-0.814) could reduce the risk of endoscope reprocessing failure.


CONCLUSION
Many endoscopes fail to meet the national standard for microbial culture after reprocessing. Our results suggest that using a pump-assisted method could increase the sensitivity of the test.
['Ji|Xue-Yue|XY|', 'Ning|Pei-Yong|PY|', 'Zhang|Wei|W|', 'Yang|Dong-Jing|DJ|', 'Liu|He|H|', 'Liu|Jun|J|', 'Song|Jia|J|', 'Fei|Chun-Nan|CN|']
D001419:Bacteria D002681:China D003428:Cross Infection D004203:Disinfection D020776:Endoscopes, Gastrointestinal D004866:Equipment Contamination D006801:Humans D017053:Infection Control
Endoscope Reprocessing Contamination Pump-assisted sampling method Rinse water