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Association Between Storage Interval and Contamination of Reprocessed Flexible Endoscopes in a Pediatric Gastrointestinal Procedural Unit

Published online by Cambridge University Press:  07 November 2016

Patricia Scanlon ,
Kathleen Flaherty ,
Erik A. Reilly ,
Ellen G. Barth ,
Gail Potter-Bynoe ,
Jeff Cardini ,
Ann Marie Riley ,
Alexander J. McAdam  and
Thomas J. Sandora
Patricia Scanlon
Affiliation:
Infection Prevention and Control, Boston Children’s Hospital, Boston, Massachusetts
Kathleen Flaherty
Affiliation:
Infection Prevention and Control, Boston Children’s Hospital, Boston, Massachusetts
Erik A. Reilly
Affiliation:
Department of Nursing, Boston Children’s Hospital, Boston, Massachusetts
Ellen G. Barth
Affiliation:
Department of Nursing, Boston Children’s Hospital, Boston, Massachusetts
Gail Potter-Bynoe
Affiliation:
Infection Prevention and Control, Boston Children’s Hospital, Boston, Massachusetts
Jeff Cardini
Affiliation:
Department of Nursing, Boston Children’s Hospital, Boston, Massachusetts
Ann Marie Riley
Affiliation:
Department of Laboratory Medicine, Boston Children’s Hospital, Boston, Massachusetts
Alexander J. McAdam
Affiliation:
Department of Laboratory Medicine, Boston Children’s Hospital, Boston, Massachusetts
Thomas J. Sandora*
Affiliation:
Infection Prevention and Control, Boston Children’s Hospital, Boston, Massachusetts Division of Infectious Diseases, Boston Children’s Hospital, Boston, Massachusetts
*
Address correspondence to Thomas J. Sandora, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115 (thomas.sandora@childrens.harvard.edu).
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Abstract

OBJECTIVE

The maximum safe storage interval after endoscope reprocessing remains unknown. We assessed the association between storage interval and endoscope contamination to evaluate the need for scope reprocessing prior to use.

METHODS

We conducted a study in 2 phases. In phase 1, we cultured 9 gastrointestinal (GI) endoscopes that had been stored for at least 7 days since reprocessing. Each scope was cultured in 3 places: external surfaces of hand piece, insertion tube, and internal channels. In phase 2, after reprocessing these scopes, we hung and cultured them prospectively in a similar fashion at 1-, 2-, 4-, 6-, and 8-week intervals without patient use. We defined clinically relevant contamination as >100 colony-forming units per milliliter (CFU/mL).

RESULTS

In phase 1, median hang time was 69 days (range, 8–555 days). Considering the 27 total cultures, 3 of 27 GI endoscopes (11.1%) had positive cultures, all with nonpathogenic skin flora at ≤100 CFU/mL. Median hang time was not statistically different between scopes with positive and negative cultures (P=.82). In phase 2, 7 of 131 prospective cultures (5.3%) from 6 of 9 GI endoscopes at varying storage intervals were positive, all at ≤100 CFU/mL. At 56 days after reprocessing (the longest storage interval studied), 1 of 24 cultures (4.2%) was positive (100 CFU/mL of Bacillus species from external biopsy/suction ports).

CONCLUSIONS

No endoscopes demonstrated clinically relevant contamination at hang times ranging from 7 to 555 days, and most scopes remained uncontaminated up to 56 days after reprocessing. Our data suggest that properly cleaned and disinfected GI endoscopes could be stored safely for longer intervals than currently recommended.

Infect. Control Hosp. Epidemiol. 2017;38:131–135

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 2 , February 2017 , pp. 131 - 135
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION. These data were presented in part as an abstract at IDWeek 2014, October 11, 2014, Philadelphia, Pennsylvania.

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