Hospital infection prevention and control quality supervision for flexible endoscope in Shanghai from 2018 to 2022_West China Medical Journal

Authors：

FU Lu ¹ , GAO Xiaodong ² , CUI Yixin ² , SUN Wei ² , SHI Qingfeng ² ,  SHEN Yan ²

1. Department of Infection Control, Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong, Jiangsu 226000, P. R. China;
2. Department of Infection Control, Zhongshan Hospital of Fudan University / Shanghai Infection Control and Prevention Center, Shanghai 200136, P. R. China;

Corresponding author：

SHEN Yan, Email: annieshenyan@sohu.com

Keywords：

Flexible endoscope; nosocomial infection; quality supervision

DOI：

10.7507/1002-0179.202401160

Video：

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Objective To describe the current state of hospital infection prevention and control for flexible endoscope in Shanghai, and analyze the trend of infection prevention and control quality from 2018 to 2022. Methods According to Regulation for Cleaning and Disinfection Technique of Flexible Endoscope (WS 507－2016), the quality of infection prevention and control for flexible endoscope was divided into seven parts: organizational management, layout, cleaning and disinfection (sterilization) process, environmental disinfection and sterilization, final rinse water, recording and monitoring, and occupational protection. Each quality control item was judged according to the on-site score and the correction opinion, and the item with correction opinion was judged as “unqualified”, otherwise it was “qualified”. The results of the infection prevention and control quality supervision for flexible endoscope from 2018 to 2022 were reviewed and analyzed, and the qualification rates of quality control items for hospitals at different levels and in different years were calculated. Results From 2018 to 2022, the total qualification rates of organization management, final rinse water, environmental disinfection and sterilization, and occupational protection were over 90%, and the total qualification rates of cleaning and disinfection (sterilization) process, and records and monitoring were over 80%. There was no statistically significant difference in the annual qualification rate (P>0.05). The total qualification rate of the layout was 78.19%, which was significantly higher before the outbreak of COVID-19 (2018-2019) than after the outbreak of COVID-19 (2020-2022) (P<0.001). There was no significant difference in the qualification rate of different levels of hospitals in terms of organizational management, layout, cleaning and disinfection (sterilization) process, records and monitoring, or occupational protection item (P>0.05). There were statistical differences in the qualification rates of different levels of hospitals in terms of final rinse water and environmental disinfection and sterilization (P<0.05). Conclusions The infection prevention and control qualification rate of flexible endoscope in Shanghai is high. However, the layout qualification rate after the COVID-19 pandemic is lower than before. There has been no significant trend in the quality of other items in the past five years. Weaknesses in the cleaning and disinfection (sterilization) process, as well as in recording and monitoring, are identified as key areas in management. Targeted training and supervision are recommended to address these weaknesses.

Citation： FU Lu, GAO Xiaodong, CUI Yixin, SUN Wei, SHI Qingfeng, SHEN Yan. Hospital infection prevention and control quality supervision for flexible endoscope in Shanghai from 2018 to 2022. West China Medical Journal, 2024, 39(3): 423-427. doi: 10.7507/1002-0179.202401160 Copy

1.	Benowitz I, Moulton-Meissner HA, Epstein L, et al. Gastrointestinal flexible endoscopes: infection control risks, lessons learned from outbreaks, and centers for disease control and prevention guidance. Gastrointest Endosc Clin N Am, 2020, 30(4): 723-733.
2.	Snyder GM. Introduction to transmission of infection: potential agents transmitted by endoscopy. Gastrointest Endosc Clin N Am, 2020, 30(4): 611-618.
3.	廖想, 李依倪. 消化内镜医院感染现状及其预防措施研究进展. 中国消毒学杂志, 2021, 38(2): 140-143.
4.	Rauwers AW, Kwakman JA, Vos MC, et al. Endoscope-associated infections: a brief summary of the current state and views toward the future. Tech Gastrointest Endosc, 2019, 21(4): 150608.
5.	Kumarage J, Khonyongwa K, Khan A, et al. Transmission of multi-drug resistant Pseudomonas aeruginosa between two flexible ureteroscopes and an outbreak of urinary tract infection: the fragility of endoscope decontamination. J Hosp Infect, 2019, 102(1): 89-94.
6.	Wang P, Xu T, Ngamruengphong S, et al. Rates of infection after colonoscopy and osophagogastroduodenoscopy in ambulatory surgery centres in the USA. Gut, 2018, 67(9): 1626-1636.
7.	张琳, 营建华, 李远菁, 等. 消化内镜相关医院感染现状及其影响因素. 中华医院感染学杂志, 2023, 33(15): 2391-2395.
8.	莫海亚, 张道权. 胃动力内镜检查发生医院感染危险因素及管理措施分析. 中国医药导报, 2022, 19(24): 65-68.
9.	刘运喜, 邢玉斌, 巩玉秀. 软式内镜清洗消毒技术规范 WS 507-2016. 中国感染控制杂志, 2017, 16(6): 587-592.
10.	孙振球, 徐勇勇. 医学统计学. 4 版. 北京: 人民卫生出版社, 2014: 107-108.
11.	Pereira ML, Bergamo RT, da Silva FM, et al. Risks of infection associated with aerosol generation during medical procedures in an endoscopy unit. J Hazard Mater Adv, 2022, 8: 100174.
12.	Shimpi RA, Spaete JP. Quality assurance in endoscopic infection control, disposable duodenoscopes, and the environmental impact of endoscopy. Tech Innov Gastrointest Endosc, 2022, 24(3): 290-299.
13.	孔懿, 黄英, 张亚英, 等. 南京市 10 家中医院的软式内镜清洗消毒现状调查. 中国消毒学杂志, 2020, 37(12): 934-937.
14.	申良荣, 李倩, 李宝珍. 陕西省 170 所医疗机构消化内镜清洗消毒现状调查. 中国消毒学杂志, 2017, 34(12): 1129-1131.
15.	Suresh S, Pande M, Patel K, et al. Education, training, and knowledge of infection control among endoscopy technicians and nurses. Am J Infect Control, 2021, 49(6): 836-839.
16.	Suresh S, Mahometano LD, Romero LG, et al. Tu1105 survey of education, training, and knowledge of endoscopy nurses and techs on infection control in the endoscopy unit. Gastrointest Endosc, 2020, 91(6S): AB547-AB548.
17.	冯翠兰. 消化内镜消毒效果监测研究新进展. 中国医学工程, 2017, 25(8): 28-31.
18.	黄茜莎, 刘波, 张翔, 等. 滤膜法与涂抹法检测内镜清洗消毒效果及成本比较. 中国感染控制杂志, 2019, 18(6): 571-576.
19.	朱炫瑞, 庄宜锦, 刘文龙, 等. 吉林省 72 所医疗机构软式内镜终末漂洗用水管理现状调查. 中国感染控制杂志, 2022, 21(7): 642-650.
20.	史庆丰, 胡必杰, 崔扬文, 等. 上海市 30 所三级医疗机构软式内镜终末漂洗水现状调查. 中华医院感染学杂志, 2020, 30(6): 923-926.
21.	王伟民, 马久红. 67 所医疗机构内镜终末漂洗水使用调查及相关因素分析. 中华医院感染学杂志, 2019, 29(10): 1587-1590.
22.	王萍, 鲍容, 史庆丰, 等. 某综合医院消化内镜生物膜形成现状及影响因素分析. 华西医学, 2021, 36(3): 348-352.
23.	Walker JT, Bak A, Marsden G, et al. Final rinse water quality for flexible endoscopy to minimize the risk of post-endoscopic infection. Report from Healthcare Infection Society Working Party. J Hosp Infect, 2022, 124: 79-96.

1. Benowitz I, Moulton-Meissner HA, Epstein L, et al. Gastrointestinal flexible endoscopes: infection control risks, lessons learned from outbreaks, and centers for disease control and prevention guidance. Gastrointest Endosc Clin N Am, 2020, 30(4): 723-733.
2. Snyder GM. Introduction to transmission of infection: potential agents transmitted by endoscopy. Gastrointest Endosc Clin N Am, 2020, 30(4): 611-618.
3. 廖想, 李依倪. 消化内镜医院感染现状及其预防措施研究进展. 中国消毒学杂志, 2021, 38(2): 140-143.
4. Rauwers AW, Kwakman JA, Vos MC, et al. Endoscope-associated infections: a brief summary of the current state and views toward the future. Tech Gastrointest Endosc, 2019, 21(4): 150608.
5. Kumarage J, Khonyongwa K, Khan A, et al. Transmission of multi-drug resistant Pseudomonas aeruginosa between two flexible ureteroscopes and an outbreak of urinary tract infection: the fragility of endoscope decontamination. J Hosp Infect, 2019, 102(1): 89-94.
6. Wang P, Xu T, Ngamruengphong S, et al. Rates of infection after colonoscopy and osophagogastroduodenoscopy in ambulatory surgery centres in the USA. Gut, 2018, 67(9): 1626-1636.
7. 张琳, 营建华, 李远菁, 等. 消化内镜相关医院感染现状及其影响因素. 中华医院感染学杂志, 2023, 33(15): 2391-2395.
8. 莫海亚, 张道权. 胃动力内镜检查发生医院感染危险因素及管理措施分析. 中国医药导报, 2022, 19(24): 65-68.
9. 刘运喜, 邢玉斌, 巩玉秀. 软式内镜清洗消毒技术规范 WS 507-2016. 中国感染控制杂志, 2017, 16(6): 587-592.
10. 孙振球, 徐勇勇. 医学统计学. 4 版. 北京: 人民卫生出版社, 2014: 107-108.
11. Pereira ML, Bergamo RT, da Silva FM, et al. Risks of infection associated with aerosol generation during medical procedures in an endoscopy unit. J Hazard Mater Adv, 2022, 8: 100174.
12. Shimpi RA, Spaete JP. Quality assurance in endoscopic infection control, disposable duodenoscopes, and the environmental impact of endoscopy. Tech Innov Gastrointest Endosc, 2022, 24(3): 290-299.
13. 孔懿, 黄英, 张亚英, 等. 南京市 10 家中医院的软式内镜清洗消毒现状调查. 中国消毒学杂志, 2020, 37(12): 934-937.
14. 申良荣, 李倩, 李宝珍. 陕西省 170 所医疗机构消化内镜清洗消毒现状调查. 中国消毒学杂志, 2017, 34(12): 1129-1131.
15. Suresh S, Pande M, Patel K, et al. Education, training, and knowledge of infection control among endoscopy technicians and nurses. Am J Infect Control, 2021, 49(6): 836-839.
16. Suresh S, Mahometano LD, Romero LG, et al. Tu1105 survey of education, training, and knowledge of endoscopy nurses and techs on infection control in the endoscopy unit. Gastrointest Endosc, 2020, 91(6S): AB547-AB548.
17. 冯翠兰. 消化内镜消毒效果监测研究新进展. 中国医学工程, 2017, 25(8): 28-31.
18. 黄茜莎, 刘波, 张翔, 等. 滤膜法与涂抹法检测内镜清洗消毒效果及成本比较. 中国感染控制杂志, 2019, 18(6): 571-576.
19. 朱炫瑞, 庄宜锦, 刘文龙, 等. 吉林省 72 所医疗机构软式内镜终末漂洗用水管理现状调查. 中国感染控制杂志, 2022, 21(7): 642-650.
20. 史庆丰, 胡必杰, 崔扬文, 等. 上海市 30 所三级医疗机构软式内镜终末漂洗水现状调查. 中华医院感染学杂志, 2020, 30(6): 923-926.
21. 王伟民, 马久红. 67 所医疗机构内镜终末漂洗水使用调查及相关因素分析. 中华医院感染学杂志, 2019, 29(10): 1587-1590.
22. 王萍, 鲍容, 史庆丰, 等. 某综合医院消化内镜生物膜形成现状及影响因素分析. 华西医学, 2021, 36(3): 348-352.
23. Walker JT, Bak A, Marsden G, et al. Final rinse water quality for flexible endoscopy to minimize the risk of post-endoscopic infection. Report from Healthcare Infection Society Working Party. J Hosp Infect, 2022, 124: 79-96.

West China Medical Journal

Hospital infection prevention and control quality supervision for flexible endoscope in Shanghai from 2018 to 2022

Abstract Full text Figures/Tables Video References Cited by

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