How Clean Are Your Endoscopes?
How Clean Are Your Endoscopes?
Visrodia KH, Ofstead CL, Yellin HL, Wetzler HP, Tosh PK, Baron TH
Infect Control Hosp Epidemiol. 2014;35:987-994
More than 50 million endoscopies are performed yearly in the United States. The risk of acquiring an infection during one of these procedures is exceedingly low, because the current cleaning processes are highly effective when used in the appropriate manner. Unfortunately, high-profile incidents of possible blood-borne pathogen exposure affecting thousands of patients have occurred. Also concerning have been recent reports of the transmission of drug-resistant pathogens through endoscopy, despite what were considered appropriate cleaning procedures.
These incidents have suggested that some quality assurance of the effectiveness of endoscope cleaning is needed, although US guidelines do not currently recommend this. In Europe and Australia, intermittent surveillance cultures are recommended after high-level disinfection (HLD), but the slow turnaround time and lack of standardization of methods and interpretation make this approach problematic.
Standard cleaning of endoscopes involves first a bedside cleaning to remove visible soil and blood, with suctioning of detergent through any channels or ports. This is followed by a manual cleaning of the scope with additional scrubbing and flushing of any channels. HLD is then applied, typically with automated washers, with subsequent drying in a vertical position to avoid pooling of liquids. Manual cleaning is essential because biofilms and debris prevent HLD from working.
The Use of Rapid Indicators for the Detection of Organic Residues on Clinically Used Gastrointestinal Endoscopes With and Without Visually Apparent Debris
Visrodia KH, Ofstead CL, Yellin HL, Wetzler HP, Tosh PK, Baron TH
Infect Control Hosp Epidemiol. 2014;35:987-994
Standard Endoscope Cleaning
More than 50 million endoscopies are performed yearly in the United States. The risk of acquiring an infection during one of these procedures is exceedingly low, because the current cleaning processes are highly effective when used in the appropriate manner. Unfortunately, high-profile incidents of possible blood-borne pathogen exposure affecting thousands of patients have occurred. Also concerning have been recent reports of the transmission of drug-resistant pathogens through endoscopy, despite what were considered appropriate cleaning procedures.
These incidents have suggested that some quality assurance of the effectiveness of endoscope cleaning is needed, although US guidelines do not currently recommend this. In Europe and Australia, intermittent surveillance cultures are recommended after high-level disinfection (HLD), but the slow turnaround time and lack of standardization of methods and interpretation make this approach problematic.
Standard cleaning of endoscopes involves first a bedside cleaning to remove visible soil and blood, with suctioning of detergent through any channels or ports. This is followed by a manual cleaning of the scope with additional scrubbing and flushing of any channels. HLD is then applied, typically with automated washers, with subsequent drying in a vertical position to avoid pooling of liquids. Manual cleaning is essential because biofilms and debris prevent HLD from working.
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