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Persistent residual contamination in endoscope channels; a fluorescence epi-microscopy study

Persistent residual contamination in endoscope channels; a fluorescence epi-microscopy study
Persistent residual contamination in endoscope channels; a fluorescence epi-microscopy study
Background and study aims: The increasing demand for endoscopic procedures poses new contamination challenges, given developing antimicrobial resistance worldwide and potential viral or prion diseases in populations at risk. We examined working channels from reusable luminal endoscopes used in recent years.

Methods: Very sensitive fluorescence epimicroscopy was used to examine working channels from 6 decommissioned and 6 factory-new channels, as received, or following spiking and washing in the laboratory.

Results: After a single contamination and wash test cycle, new channels retained approximately 75?pg/mm2 of proteins; through 7 subsequent cycles residual proteins fluctuated between 25 and 75?pg/mm2. Decommissioned channels harbored 1?–?4?µg of proteins each, except in one gastroscope (33?µg), including up to 2?% amyloid proteins except in one gastroscope and one sigmoidoscope (with over 80?%); lumens showed wearing with established abraded biofilms in 3 cases. After spiking with scrapie-infected blood components and washing, residual protein levels in new channels varied following standard (17.23?pg/mm2), duplicated (2.39?pg/mm2) or extended (11.3?pg/mm2) washing; no changes were measured among the long-established contamination in old channels.

Conclusions: Our observations suggest that wear effects in endoscope lumens may contribute to the adsorption of proteins, thus facilitating retention and survival of bacteria. As demonstrated by recent outbreaks worldwide despite recommended reprocessing, the development of antimicrobial-resistant bacterial strains, and the estimated prevalence of variant Creutzfeldt-Jakob disease (vCJD) in the UK particularly, combined with increasing demand for endoscopic procedures, call for sustained precautions and improved methods for the reprocessing of nonautoclavable, reusable surgical instruments.
0013-726X
1-8
Herve, Rodolphe
9baddc65-93cf-4a18-9388-088d60572b06
Keevil, Charles
cb7de0a7-ce33-4cfa-af52-07f99e5650eb
Herve, Rodolphe
9baddc65-93cf-4a18-9388-088d60572b06
Keevil, Charles
cb7de0a7-ce33-4cfa-af52-07f99e5650eb

Herve, Rodolphe and Keevil, Charles (2016) Persistent residual contamination in endoscope channels; a fluorescence epi-microscopy study. Endoscopy, 1-8. (doi:10.1055/s-0042-105744).

Record type: Article

Abstract

Background and study aims: The increasing demand for endoscopic procedures poses new contamination challenges, given developing antimicrobial resistance worldwide and potential viral or prion diseases in populations at risk. We examined working channels from reusable luminal endoscopes used in recent years.

Methods: Very sensitive fluorescence epimicroscopy was used to examine working channels from 6 decommissioned and 6 factory-new channels, as received, or following spiking and washing in the laboratory.

Results: After a single contamination and wash test cycle, new channels retained approximately 75?pg/mm2 of proteins; through 7 subsequent cycles residual proteins fluctuated between 25 and 75?pg/mm2. Decommissioned channels harbored 1?–?4?µg of proteins each, except in one gastroscope (33?µg), including up to 2?% amyloid proteins except in one gastroscope and one sigmoidoscope (with over 80?%); lumens showed wearing with established abraded biofilms in 3 cases. After spiking with scrapie-infected blood components and washing, residual protein levels in new channels varied following standard (17.23?pg/mm2), duplicated (2.39?pg/mm2) or extended (11.3?pg/mm2) washing; no changes were measured among the long-established contamination in old channels.

Conclusions: Our observations suggest that wear effects in endoscope lumens may contribute to the adsorption of proteins, thus facilitating retention and survival of bacteria. As demonstrated by recent outbreaks worldwide despite recommended reprocessing, the development of antimicrobial-resistant bacterial strains, and the estimated prevalence of variant Creutzfeldt-Jakob disease (vCJD) in the UK particularly, combined with increasing demand for endoscopic procedures, call for sustained precautions and improved methods for the reprocessing of nonautoclavable, reusable surgical instruments.

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Accepted/In Press date: 23 February 2016
e-pub ahead of print date: 25 April 2016
Organisations: Centre for Biological Sciences

Identifiers

Local EPrints ID: 393430
URI: http://eprints.soton.ac.uk/id/eprint/393430
ISSN: 0013-726X
PURE UUID: 24dcc2e4-d7ec-4fa7-8128-b0c02ffd1650
ORCID for Rodolphe Herve: ORCID iD orcid.org/0000-0001-8838-6515
ORCID for Charles Keevil: ORCID iD orcid.org/0000-0003-1917-7706

Catalogue record

Date deposited: 26 Apr 2016 11:44
Last modified: 17 Dec 2019 06:51

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Author: Rodolphe Herve ORCID iD
Author: Charles Keevil ORCID iD

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