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IDWeek 2015’ten: ERCP Duodenoskoplarında Tekrar Kullanım Öncesi “Yüksek Önem Arz Eden Mikroorganizmalara” Rastlandı

Infectious Diseases Society of America (IDSA)’nın düzenlediği IDWeek 2015™’de sunulan verilere göre, Utah sağlık sistemi içerisinde tekrar kullanım prosedürleri etkili bulunurken, test edilen endoskopik retrograd kolanjiyografi (ERCP) duodenoskoplarının “yüksek önem arz eden mikroorganizmalar” ile kontamine olduğunun görülmesi yetersiz temizliğin getirdiği risklere dikkat çekti.


ERCP duodenoscopes showed ‘high-concern organisms’ before reprocessing


October 9, 2015

SAN DIEGO — While reprocessing procedures were found to be effective in a Utah health system, a high proportion of endoscopic retrograde cholangiopancreatography duodenoscopes tested were contaminated with “high concern organisms,” underscoring the risks of inadequate cleaning, a presenter said at IDWeek 2015.

In light of the recent FDA reports of “superbug” microbial transmission linked to inadequate reprocessing of ERCP duodenoscopes despite adherence to manufacturer recommendations, Michaela A. Gazdik, PhD, from Intermountain Medical Center in Murray, Utah, and colleagues, aimed to assess the effectiveness of the Intermountain Healthcare system’s reprocessing protocols based on established endoscope surveillance guidelines.

They performed complete microbial sampling of 12 scopes from two endoscopy departments immediately after ERCP was performed and also after reprocessing. They also cultured 11 additional stored scopes from five smaller IHC facilities.

They found 11 out of 12 scopes were contaminated with “high-concern” organisms before reprocessing, nine of the 12 scopes cultured gram negative organisms and no carbapenem or vancomycin resistance was detected by selective media.

Of the then-reprocessed or stored scopes (n = 23), they found four were “of concern,” and found unacceptable quantitative growth in two. They also found high-concern organisms from two of the 23 scopes in swab-broth only.

The researchers concluded their reprocessing protocols are likely effective, as the number of scopes “of concern” was comparable to previously published literature. Furthermore, they added that the high proportion of high-concern organisms before reprocessing underscores the risks of inadequate cleaning, and that swab collection may improve sampling of the distal end elevator mechanism of ERCP duodenoscopes. – by Adam Leitenberger

Reference:

Gazdik MA, et al. Abstract 108. Presented at: IDWeek; Oct. 7-11, 2015; San Diego.

Disclosures: The researchers report no relevant financial disclosures.