Partial interpretation of multisociety guideline on reprocessing flexible gastrointestinal endoscopes and accessories issued by ASGE in 2020_Chinese Journal of Evidence-Based Medicine

Authors：

GUO Shengli ¹ , ZHU Ting ¹ , LIN Weina ¹ , CHEN Xiaorong ² ,  YUAN Wei ¹

1. Department of Gastrointestinal Endoscopy, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, P.R.China;
2. Department of Gastroenterology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu 610072, P.R.China;

Corresponding author：

YUAN Wei, Email: 404563429@qq.com

Keywords：

Flexible gastrointestinal endoscopes; Accessories; Reprocessing; Guideline interpretation

DOI：

10.7507/1672-2531.202109045

Video：

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Due to the special structure and material of the flexible gastrointestinal (GI) endoscopes, it is difficult to reprocess endoscopes. Infections caused by endoscope reprocessing failure often occur. Strict implementation of the guidelines/relevant national standards and manufacturer's instructions is essential to prevent the occurrence of endoscopy-related infections and ensure patient safety. In 2020, ASGE (American Society for Gastrointestinal Endoscopy) released the "multisociety guideline on reprocessing flexible GI endoscopes and accessories". This paper aimed to promote the understanding of the reprocessing process of flexible GI endoscopes by the endoscope decontamination staff, and to provide references for clinical practice.

Citation： GUO Shengli, ZHU Ting, LIN Weina, CHEN Xiaorong, YUAN Wei. Partial interpretation of multisociety guideline on reprocessing flexible gastrointestinal endoscopes and accessories issued by ASGE in 2020. Chinese Journal of Evidence-Based Medicine, 2022, 22(1): 26-30. doi: 10.7507/1672-2531.202109045 Copy

1.	Epstein L, Hunter JC, Arwady MA, et al. New Delhi metallo-β-lactamase-producing carbapenem-resistant Escherichia coli associated with exposure to duodenoscopes. JAMA, 2014, 312(14): 1447-1455.
2.	Robertson P, Smith A, Anderson M, et al. Transmission of Salmonella enteritidis after endoscopic retrograde cholangiopancreatography because of inadequate endoscope decontamination. Am J Infect Control, 2017, 45(4): 440-442.
3.	Kovaleva J. Infectious complications in gastrointestinal endoscopy and their prevention. Best Pract Res Clin Gastroenterol, 2016, 30(5): 689-704.
4.	Ofstead CL, Heymann OL, Quick MR, et al. Residual moisture and waterborne pathogens inside flexible endoscopes: evidence from a multisite study of endoscope drying effectiveness. Am J Infect Control, 2018, 46(6): 689-696.
5.	刘卫平, 何欢, 杨永芳, 等. 内蒙古自治区24家医院软式内镜生物膜现状研究. 中国消毒学杂志, 2020, 37(7): 502-504.
6.	付喜梅, 俞秋华, 刘莉莉, 等. 四川省部分医院软式内镜清洗消毒现状调查及效果监测. 预防医学情报杂志, 2021, 37(8): 1100-1104.
7.	孔懿, 林泓怡, 黄英, 等. 南京市35家医疗机构的软式内镜清洗消毒现状调查. 中国消毒学杂志, 2021, 38(7): 518-521.
8.	张晓玲, 雷毅, 陈宝宝, 等. 陕西省属医院软式内镜消毒现状及影响因素分析. 中国消毒学杂志, 2021, 38(4): 275-278.
9.	Day LW, Muthusamy VR, Collins J, et al. Multisociety guideline on reprocessing flexible GI endoscopes and accessories. Gastrointest Endosc, 2021, 93(1): 11-33.
10.	鞠春晓, 张瑶, 刘晓林, 等. 慢性心力衰竭防治指南和共识的方法学质量评价. 中国循证医学杂志, 2021, 21(9): 1091-1097.
11.	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.
12.	李晔, 胡国庆. 临床使用软式内镜生物膜污染研究进展. 中国消毒学杂志, 2021, 38(7): 542-545.
13.	徐东平, 潘勤勤, 肖玲. 软式内镜消毒灭菌方法进展. 中华医院感染学杂志, 2021, 31(6): 957-960.
14.	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.
15.	Alfa MJ, Singh H. Impact of wet storage and other factors on biofilm formation and contamination of patient-ready endoscopes: a narrative review. Gastrointest Endosc, 2020, 91(2): 236-247.
16.	Alfa MJ, Ribeiro MM, da Costa Luciano C, et al. A novel polytetrafluoroethylene-channel model, which simulates low levels of culturable bacteria in buildup biofilm after repeated endoscope reprocessing. Gastrointest Endosc, 2017, 86(3): 442-451.
17.	ASGE Technology Committee, Parsi MA, Sullivan SA, et al. Automated endoscope reprocessors. Gastrointest Endosc, 2016, 84(6): 885-892.
18.	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.
19.	Wendorf KA, Kay M, Baliga C, et al. Endoscopic retrograde cholangiopancreatography-associated AmpC Escherichia coli outbreak. Infect Control Hosp Epidemiol, 2015, 36(6): 634-642.
20.	Marsh JW, Krauland MG, Nelson JS, et al. Genomic epidemiology of an endoscope-associated outbreak of klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae. PLoS One, 2015, 10(12): e0144310.
21.	Thaker AM, Muthusamy VR, Sedarat A, et al. Duodenoscope reprocessing practice patterns in U. S. endoscopy centers:a survey study. Gastrointest Endosc, 2018, 88(2): 316-322.
22.	Snyder GM, Wright SB, Smithey A, et al. Randomized comparison of 3 high-level disinfection and sterilization procedures for duodenoscopes. Gastroenterology, 2017, 153(4): 1018-1025.
23.	Bartles RL, Leggett JE, Hove S, et al. A randomized trial of single versus double high-level disinfection of duodenoscopes and linear echoendoscopes using standard automated reprocessing. Gastrointest Endosc, 2018, 88(2): 306-313.
24.	Muscarella LF. Use of ethylene-oxide gas sterilisation to terminate multidrug-resistant bacterial outbreaks linked to duodenoscopes. BMJ Open Gastroenterol, 2019, 6(1): e000282.
25.	Kovaleva J. Endoscope drying and its pitfalls. J Hosp Infect, 2017, 97(4): 319-328.
26.	Barakat MT, Huang RJ, Banerjee S. Comparison of automated and manual drying in the elimination of residual endoscope working channel fluid after reprocessing (with video). Gastrointest Endosc, 2019, 89(1): 124-132.
27.	Perumpail RB, Marya NB, McGinty BL, et al. Endoscope reprocessing: Comparison of drying effectiveness and microbial levels with an automated drying and storage cabinet with forced filtered air and a standard storage cabinet. Am J Infect Control, 2019, 47(9): 1083-1089.
28.	Allen JI, Allen MO, Olson MM, et al. Pseudomonas infection of the biliary system resulting from use of a contaminated endoscope. Gastroenterology, 1987, 92(3): 759-763.
29.	Brock AS, Steed LL, Freeman J, et al. Endoscope storage time: assessment of microbial colonization up to 21 days after reprocessing. Gastrointest Endosc, 2015, 81(5): 1150-1154.
30.	Scanlon P, Flaherty K, Reilly EA, et al. Association between storage interval and contamination of reprocessed flexible endoscopes in a pediatric gastrointestinal procedural unit. Infect Control Hosp Epidemiol, 2017, 38(2): 131-135.
31.	Sethi S, Huang RJ, Barakat MT, et al. Adenosine triphosphate bioluminescence for bacteriologic surveillance and reprocessing strategies for minimizing risk of infection transmission by duodenoscopes. Gastrointest Endosc, 2017, 85(6): 1180-1187.
32.	Quan E, Mahmood R, Naik A, et al. Use of adenosine triphosphate to audit reprocessing of flexible endoscopes with an elevator mechanism. Am J Infect Control, 2018, 46(11): 1272-1277.

1. Epstein L, Hunter JC, Arwady MA, et al. New Delhi metallo-β-lactamase-producing carbapenem-resistant Escherichia coli associated with exposure to duodenoscopes. JAMA, 2014, 312(14): 1447-1455.
2. Robertson P, Smith A, Anderson M, et al. Transmission of Salmonella enteritidis after endoscopic retrograde cholangiopancreatography because of inadequate endoscope decontamination. Am J Infect Control, 2017, 45(4): 440-442.
3. Kovaleva J. Infectious complications in gastrointestinal endoscopy and their prevention. Best Pract Res Clin Gastroenterol, 2016, 30(5): 689-704.
4. Ofstead CL, Heymann OL, Quick MR, et al. Residual moisture and waterborne pathogens inside flexible endoscopes: evidence from a multisite study of endoscope drying effectiveness. Am J Infect Control, 2018, 46(6): 689-696.
5. 刘卫平, 何欢, 杨永芳, 等. 内蒙古自治区24家医院软式内镜生物膜现状研究. 中国消毒学杂志, 2020, 37(7): 502-504.
6. 付喜梅, 俞秋华, 刘莉莉, 等. 四川省部分医院软式内镜清洗消毒现状调查及效果监测. 预防医学情报杂志, 2021, 37(8): 1100-1104.
7. 孔懿, 林泓怡, 黄英, 等. 南京市35家医疗机构的软式内镜清洗消毒现状调查. 中国消毒学杂志, 2021, 38(7): 518-521.
8. 张晓玲, 雷毅, 陈宝宝, 等. 陕西省属医院软式内镜消毒现状及影响因素分析. 中国消毒学杂志, 2021, 38(4): 275-278.
9. Day LW, Muthusamy VR, Collins J, et al. Multisociety guideline on reprocessing flexible GI endoscopes and accessories. Gastrointest Endosc, 2021, 93(1): 11-33.
10. 鞠春晓, 张瑶, 刘晓林, 等. 慢性心力衰竭防治指南和共识的方法学质量评价. 中国循证医学杂志, 2021, 21(9): 1091-1097.
11. 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.
12. 李晔, 胡国庆. 临床使用软式内镜生物膜污染研究进展. 中国消毒学杂志, 2021, 38(7): 542-545.
13. 徐东平, 潘勤勤, 肖玲. 软式内镜消毒灭菌方法进展. 中华医院感染学杂志, 2021, 31(6): 957-960.
14. 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.
15. Alfa MJ, Singh H. Impact of wet storage and other factors on biofilm formation and contamination of patient-ready endoscopes: a narrative review. Gastrointest Endosc, 2020, 91(2): 236-247.
16. Alfa MJ, Ribeiro MM, da Costa Luciano C, et al. A novel polytetrafluoroethylene-channel model, which simulates low levels of culturable bacteria in buildup biofilm after repeated endoscope reprocessing. Gastrointest Endosc, 2017, 86(3): 442-451.
17. ASGE Technology Committee, Parsi MA, Sullivan SA, et al. Automated endoscope reprocessors. Gastrointest Endosc, 2016, 84(6): 885-892.
18. 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.
19. Wendorf KA, Kay M, Baliga C, et al. Endoscopic retrograde cholangiopancreatography-associated AmpC Escherichia coli outbreak. Infect Control Hosp Epidemiol, 2015, 36(6): 634-642.
20. Marsh JW, Krauland MG, Nelson JS, et al. Genomic epidemiology of an endoscope-associated outbreak of klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae. PLoS One, 2015, 10(12): e0144310.
21. Thaker AM, Muthusamy VR, Sedarat A, et al. Duodenoscope reprocessing practice patterns in U. S. endoscopy centers:a survey study. Gastrointest Endosc, 2018, 88(2): 316-322.
22. Snyder GM, Wright SB, Smithey A, et al. Randomized comparison of 3 high-level disinfection and sterilization procedures for duodenoscopes. Gastroenterology, 2017, 153(4): 1018-1025.
23. Bartles RL, Leggett JE, Hove S, et al. A randomized trial of single versus double high-level disinfection of duodenoscopes and linear echoendoscopes using standard automated reprocessing. Gastrointest Endosc, 2018, 88(2): 306-313.
24. Muscarella LF. Use of ethylene-oxide gas sterilisation to terminate multidrug-resistant bacterial outbreaks linked to duodenoscopes. BMJ Open Gastroenterol, 2019, 6(1): e000282.
25. Kovaleva J. Endoscope drying and its pitfalls. J Hosp Infect, 2017, 97(4): 319-328.
26. Barakat MT, Huang RJ, Banerjee S. Comparison of automated and manual drying in the elimination of residual endoscope working channel fluid after reprocessing (with video). Gastrointest Endosc, 2019, 89(1): 124-132.
27. Perumpail RB, Marya NB, McGinty BL, et al. Endoscope reprocessing: Comparison of drying effectiveness and microbial levels with an automated drying and storage cabinet with forced filtered air and a standard storage cabinet. Am J Infect Control, 2019, 47(9): 1083-1089.
28. Allen JI, Allen MO, Olson MM, et al. Pseudomonas infection of the biliary system resulting from use of a contaminated endoscope. Gastroenterology, 1987, 92(3): 759-763.
29. Brock AS, Steed LL, Freeman J, et al. Endoscope storage time: assessment of microbial colonization up to 21 days after reprocessing. Gastrointest Endosc, 2015, 81(5): 1150-1154.
30. Scanlon P, Flaherty K, Reilly EA, et al. Association between storage interval and contamination of reprocessed flexible endoscopes in a pediatric gastrointestinal procedural unit. Infect Control Hosp Epidemiol, 2017, 38(2): 131-135.
31. Sethi S, Huang RJ, Barakat MT, et al. Adenosine triphosphate bioluminescence for bacteriologic surveillance and reprocessing strategies for minimizing risk of infection transmission by duodenoscopes. Gastrointest Endosc, 2017, 85(6): 1180-1187.
32. Quan E, Mahmood R, Naik A, et al. Use of adenosine triphosphate to audit reprocessing of flexible endoscopes with an elevator mechanism. Am J Infect Control, 2018, 46(11): 1272-1277.

Chinese Journal of Evidence-Based Medicine

Partial interpretation of multisociety guideline on reprocessing flexible gastrointestinal endoscopes and accessories issued by ASGE in 2020

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