Analysis of high-level disinfection effect of flexible endoscopes in an endoscope center_West China Medical Journal

Authors：

ZHANG Ju ¹ , LI Xiaojing ¹ , LU Wei ¹ , LI Gang ² , HUANG Yanchun ³ , YE Xiaoqin ⁴ , YANG Junhua ¹ ,  MA Li ⁵ , ZHANG Yanhua ⁶

1. Department of Nosocomial Infection Management, the First People’s Hospital of Longquanyi District of Chengdu, West China Longquan Hospital Sichuan University, Chengdu, Sichuan 610100, P. R. China;
2. Department of Proctology, the First People’s Hospital of Longquanyi District of Chengdu, West China Longquan Hospital Sichuan University, Chengdu, Sichuan 610100, P. R. China;
3. Department of Clinical Laboratory, the First People’s Hospital of Longquanyi District of Chengdu, West China Longquan Hospital Sichuan University, Chengdu, Sichuan 610100, P. R. China;
4. Endoscopy Center, the First People’s Hospital of Longquanyi District of Chengdu, West China Longquan Hospital Sichuan University, Chengdu, Sichuan 610100, P. R. China;
5. Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
6. Nosocomial Infection Management Department, Chongzhou People’s Hospital, Chengdu, Sichuan 611230, P. R. China;

Corresponding author：

MA Li, Email: 1004500237@qq.com

Keywords：

Endoscopy Center; Flexible endoscopy; High-level disinfection; Surveillance

DOI：

10.7507/1002-0179.202101270

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the high-level disinfection effect of flexible endoscopes in the Endoscopy Center of the First People’s Hospital of Longquanyi District of Chengdu, explore the key links of flexible endoscope cleaning and disinfection, and provide theoretical guarantee and technical support for the next step of the endoscope center work.Methods We sampled and monitored the lumens, water and air injection ports and biopsy ports of 19 flexible endoscopes after high-level disinfection in the Endoscopy Center of the First People’s Hospital of Longquanyi District of Chengdu. A total of 307 specimens were collected from 108 flexible endoscopes. We compared the disinfection effects of different flexible endoscopes and different sampling sites, and compared the microbial detection status of different flexible endoscopes.Results The qualified rates of disinfection of gastroscopes, colonoscope and duodenoscopy were 79.22%, 86.21% and 100.00%, respectively, and the difference was not statistically significant (P=0.721). The qualified rates of disinfection of the endoscopic lumen, water and air injection port and biopsy port were 87.04%, 93.00% and 94.95%, respectively, and the difference was not statistically significant (χ²=4.585, P=0.101). The qualified rates of the lumen, water and air injection port and biopsy port of gastroscope, colonoscope and duodenoscope were 84.42%, 93.10%, 100.00%, 92.96%, 92.59%, 100.00%, 94.29%, 96.30%, 100.00%, respectively. There was no statistically significant difference in the disinfection effect of various parts of different flexible endoscopes (P>0.05). Bacteriological identification showed that of the 28 specimens with excess bacteriological standards, 16 gram-positive bacteria (57.1%), and 12 gram-negative bacteria (42.9%) were found.Conclusion The cleaning and disinfection effect of flexible endoscopes has certain defect. Endoscope should be treated in strict accordance with the technical specifications for cleaning and disinfection of the flexible endoscope to further improve the disinfection effect of the flexible endoscope.

Citation： ZHANG Ju, LI Xiaojing, LU Wei, LI Gang, HUANG Yanchun, YE Xiaoqin, YANG Junhua, MA Li, ZHANG Yanhua. Analysis of high-level disinfection effect of flexible endoscopes in an endoscope center. West China Medical Journal, 2021, 36(3): 353-357. doi: 10.7507/1002-0179.202101270 Copy

1.	周闻博, 李天庆, 焉丹, 等. 基于数据的软式内镜故障循证管理实践. 华西医学, 2019, 34(6): 618-624.
2.	夏婷婷, 施施, 杨金燕, 等. 国内外软式内镜清洗消毒技术最新进展. 中华医院感染学杂志, 2019, 29(8): 1271-1276.
3.	Rutala WA, Weber DJ. Gastrointestinal endoscopes: a need to shift from disinfection to sterilization?. JAMA, 2014, 312(14): 1405-1406.
4.	秦瑾, 闻海丰, 李筱轶, 等. 软式内镜清洗消毒持续质量改进的效果. 中国消毒学杂志, 2015, 32(10): 1034-1035.
5.	邵春梅, 柴西英, 韩亚颖, 等. 消毒供应中心集中管理模式对软式腔镜消毒及灭菌质量的影响. 中华现代护理杂志, 2019, 25(20): 2578-2581.
6.	任群慧, 冯望, 肖红. 软式内镜的处置流程及清洗效果监测研究进展. 中国消毒学杂志, 2018, 35(7): 534-537.
7.	李阳, 姜亦虹. 医疗机构消化内镜清洗消毒历史和现状调查. 中国感染控制杂志, 2017, 16(10): 960-962, 965.
8.	中华人民共和国国家卫生和计划生育委员会. 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.
9.	Reprocessing Guideline Task Force, Petersen BT, Cohen J, et al. Multisociety guideline on reprocessing flexible GI endoscopes: 2016 update. Gastrointest Endosc, 2017, 85(2): 282-294.
10.	胡国庆. 新标准对医疗机构消毒灭菌的新要求. 华西医学, 2018, 33(3): 253-258.
11.	中华人民共和国国家质量监督检验检疫总局, 中国国家标准化管理委员会. 医院消毒卫生标准. (2012-06-29)[2021-01-27]. http://www.nhc.gov.cn/ewebeditor/uploadfile/2014/10/20141029163321351.pdf.
12.	Ofstead CL, Wetzler HP, Doyle EM, et al. Persistent contamination on colonoscopes and gastroscopes detected by biologic cultures and rapid indicators despite reprocessing performed in accordance with guidelines. Am J Infect Control, 2015, 43(8): 794-801.
13.	凌琳, 胡成文, 胡敏. 某省120所医疗机构内镜清洗消毒现状问卷调查结果分析. 中国感染控制杂志, 2020, 19(4): 353-359.
14.	谢静, 陈敏, 罗薛峰. 软式内镜消毒液过氧乙酸和戊二醛消毒效果对比Meta分析. 华西医学, 2018, 33(3): 302-306.
15.	Beilenhoff U, Biering H, Blum R, et al. Reprocessing of flexible endoscopes and endoscopic accessories used in gastrointestinal endoscopy: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology Nurses and Associates (ESGENA) - update 2018. Endoscopy, 2018, 50(12): 1205-1234.
16.	ASGE Quality Assurance in Endoscopy Committee, Calderwood AH, Day LW, et al. ASGE guideline for infection control during GI endoscopy. Gastrointest Endosc, 2018, 87(5): 1167-1179.
17.	Dirlam Langlay AM, Ofstead CL, Mueller NJ, et al. Reported gastrointestinal endoscope reprocessing lapses: the tip of the iceberg. Am J Infect Control, 2013, 41(12): 1188-1194.
18.	雷毅, 蒋丽娟, 董小峰, 等. 陕西省省属医院软式内镜消毒质量监测与分析. 中国消毒学杂志, 2018, 35(2): 150-151.
19.	张燕华, 周英顺, 陈建美, 等. 常规高水平消毒软式内镜细菌监测结果. 中华医院感染学杂志, 2020, 30(24): 3832-3836.
20.	Ofstead CL, Heymann OL, Quick MR, et al. Residual moisture and waterborne pathogens inside flexible endoscopes: evidence froma multisite study of endoscope drying effectiveness. Am J Infect Control, 2018, 46(6): 689-696.
21.	McCafferty CE, Aghajani MJ, Abi-Hanna D, et al. An update on gastrointestinal endoscopy-associated infections and their contributing factors. Ann Clin Microbiol Antimicrob, 2018, 17(1): 36.
22.	王广芬, 朱梦捷, 廖丹, 等. 十二指肠镜清洗消毒及监测研究新进展. 中华医院感染学杂志, 2017, 27(24): 5751-5755.
23.	马慧, 张婕, 李涛, 等. 十二指肠镜消毒后微生物污染调查. 中华医院感染学杂志, 2017, 27(12): 2853-2856.
24.	葛冬梅. 邻苯二甲醛和酸性氧化电位水消毒软式内镜效果比较. 中国消毒学杂志, 2017, 34(10): 922-924.
25.	刘卫平, 何欢, 张凯, 等. 不同处理方法清除软式内镜生物膜的效果研究. 中国消毒学杂志, 2020, 37(4): 257-259.
26.	Roberts CG. The role of biofilms in reprocessing medical devices. Am J Infect Control, 2013, 41(5 Suppl): S77-S80.
27.	Smith ZL, Oh YS, Saeian K, et al. Transmission of carbapenem-resistant Enterobacteriaceae during ERCP: time to revisit the current reprocessing guidelines. Gastrointest Endosc, 2015, 81(4): 1041-1045.
28.	Kim S, Russell D, Mohamadnejad M, et al. Risk factors associated with the transmission of carbapenem-resistant Enterobacteriaceae via contaminated duodenoscopes. Gastrointest Endosc, 2016, 83(6): 1121-1129.

1. 周闻博, 李天庆, 焉丹, 等. 基于数据的软式内镜故障循证管理实践. 华西医学, 2019, 34(6): 618-624.
2. 夏婷婷, 施施, 杨金燕, 等. 国内外软式内镜清洗消毒技术最新进展. 中华医院感染学杂志, 2019, 29(8): 1271-1276.
3. Rutala WA, Weber DJ. Gastrointestinal endoscopes: a need to shift from disinfection to sterilization?. JAMA, 2014, 312(14): 1405-1406.
4. 秦瑾, 闻海丰, 李筱轶, 等. 软式内镜清洗消毒持续质量改进的效果. 中国消毒学杂志, 2015, 32(10): 1034-1035.
5. 邵春梅, 柴西英, 韩亚颖, 等. 消毒供应中心集中管理模式对软式腔镜消毒及灭菌质量的影响. 中华现代护理杂志, 2019, 25(20): 2578-2581.
6. 任群慧, 冯望, 肖红. 软式内镜的处置流程及清洗效果监测研究进展. 中国消毒学杂志, 2018, 35(7): 534-537.
7. 李阳, 姜亦虹. 医疗机构消化内镜清洗消毒历史和现状调查. 中国感染控制杂志, 2017, 16(10): 960-962, 965.
8. 中华人民共和国国家卫生和计划生育委员会. 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.
9. Reprocessing Guideline Task Force, Petersen BT, Cohen J, et al. Multisociety guideline on reprocessing flexible GI endoscopes: 2016 update. Gastrointest Endosc, 2017, 85(2): 282-294.
10. 胡国庆. 新标准对医疗机构消毒灭菌的新要求. 华西医学, 2018, 33(3): 253-258.
11. 中华人民共和国国家质量监督检验检疫总局, 中国国家标准化管理委员会. 医院消毒卫生标准. (2012-06-29)[2021-01-27]. http://www.nhc.gov.cn/ewebeditor/uploadfile/2014/10/20141029163321351.pdf.
12. Ofstead CL, Wetzler HP, Doyle EM, et al. Persistent contamination on colonoscopes and gastroscopes detected by biologic cultures and rapid indicators despite reprocessing performed in accordance with guidelines. Am J Infect Control, 2015, 43(8): 794-801.
13. 凌琳, 胡成文, 胡敏. 某省120所医疗机构内镜清洗消毒现状问卷调查结果分析. 中国感染控制杂志, 2020, 19(4): 353-359.
14. 谢静, 陈敏, 罗薛峰. 软式内镜消毒液过氧乙酸和戊二醛消毒效果对比Meta分析. 华西医学, 2018, 33(3): 302-306.
15. Beilenhoff U, Biering H, Blum R, et al. Reprocessing of flexible endoscopes and endoscopic accessories used in gastrointestinal endoscopy: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology Nurses and Associates (ESGENA) - update 2018. Endoscopy, 2018, 50(12): 1205-1234.
16. ASGE Quality Assurance in Endoscopy Committee, Calderwood AH, Day LW, et al. ASGE guideline for infection control during GI endoscopy. Gastrointest Endosc, 2018, 87(5): 1167-1179.
17. Dirlam Langlay AM, Ofstead CL, Mueller NJ, et al. Reported gastrointestinal endoscope reprocessing lapses: the tip of the iceberg. Am J Infect Control, 2013, 41(12): 1188-1194.
18. 雷毅, 蒋丽娟, 董小峰, 等. 陕西省省属医院软式内镜消毒质量监测与分析. 中国消毒学杂志, 2018, 35(2): 150-151.
19. 张燕华, 周英顺, 陈建美, 等. 常规高水平消毒软式内镜细菌监测结果. 中华医院感染学杂志, 2020, 30(24): 3832-3836.
20. Ofstead CL, Heymann OL, Quick MR, et al. Residual moisture and waterborne pathogens inside flexible endoscopes: evidence froma multisite study of endoscope drying effectiveness. Am J Infect Control, 2018, 46(6): 689-696.
21. McCafferty CE, Aghajani MJ, Abi-Hanna D, et al. An update on gastrointestinal endoscopy-associated infections and their contributing factors. Ann Clin Microbiol Antimicrob, 2018, 17(1): 36.
22. 王广芬, 朱梦捷, 廖丹, 等. 十二指肠镜清洗消毒及监测研究新进展. 中华医院感染学杂志, 2017, 27(24): 5751-5755.
23. 马慧, 张婕, 李涛, 等. 十二指肠镜消毒后微生物污染调查. 中华医院感染学杂志, 2017, 27(12): 2853-2856.
24. 葛冬梅. 邻苯二甲醛和酸性氧化电位水消毒软式内镜效果比较. 中国消毒学杂志, 2017, 34(10): 922-924.
25. 刘卫平, 何欢, 张凯, 等. 不同处理方法清除软式内镜生物膜的效果研究. 中国消毒学杂志, 2020, 37(4): 257-259.
26. Roberts CG. The role of biofilms in reprocessing medical devices. Am J Infect Control, 2013, 41(5 Suppl): S77-S80.
27. Smith ZL, Oh YS, Saeian K, et al. Transmission of carbapenem-resistant Enterobacteriaceae during ERCP: time to revisit the current reprocessing guidelines. Gastrointest Endosc, 2015, 81(4): 1041-1045.
28. Kim S, Russell D, Mohamadnejad M, et al. Risk factors associated with the transmission of carbapenem-resistant Enterobacteriaceae via contaminated duodenoscopes. Gastrointest Endosc, 2016, 83(6): 1121-1129.

West China Medical Journal

Analysis of high-level disinfection effect of flexible endoscopes in an endoscope center

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content