TY - JOUR
T1 - What's new in reprocessing endoscopes
T2 - Are we going to ensure “the needs of the patient come first” by shifting from disinfection to sterilization?
AU - Rutala, William A.
AU - Kanamori, Hajime
AU - Sickbert-Bennett, Emily E.
AU - Weber, David J.
N1 - Publisher Copyright:
© 2019
PY - 2019/6
Y1 - 2019/6
N2 - Millions of gastrointestinal endoscopes are performed each year in the United States. Gastrointestinal endoscopes become highly contaminated during use (ie, internal channels contain 7-10-log10 enteric microorganisms). Currently, endoscopes (eg, bronchoscopes and gastrointestinal endoscopes) are classified as semicritical items because they contact intact mucous membranes and most commonly undergo cleaning followed by high-level disinfection, which may result in as little as a 6 -log10 reduction of microorganisms. Therefore, and not surprisingly, in recent years there have been multiple reports that have documented that endoscopes, especially duodenoscopes, frequently remain contaminated with bacterial pathogens after proper cleaning and disinfection. Multiple outbreaks of multidrug-resistant organisms from contaminated duodenoscopes have resulted in substantial death and morbidity. Because duodenoscopes commonly contact nonintact mucous membranes and sterile tissue, such endoscopes should be considered critical items. We propose that to ensure patient safety, we follow the Spaulding scheme and move from high-level disinfection to sterilization of reusable endoscopes or use an alternative diagnostic/therapeutic method (eg, disposable sterile endoscopes).
AB - Millions of gastrointestinal endoscopes are performed each year in the United States. Gastrointestinal endoscopes become highly contaminated during use (ie, internal channels contain 7-10-log10 enteric microorganisms). Currently, endoscopes (eg, bronchoscopes and gastrointestinal endoscopes) are classified as semicritical items because they contact intact mucous membranes and most commonly undergo cleaning followed by high-level disinfection, which may result in as little as a 6 -log10 reduction of microorganisms. Therefore, and not surprisingly, in recent years there have been multiple reports that have documented that endoscopes, especially duodenoscopes, frequently remain contaminated with bacterial pathogens after proper cleaning and disinfection. Multiple outbreaks of multidrug-resistant organisms from contaminated duodenoscopes have resulted in substantial death and morbidity. Because duodenoscopes commonly contact nonintact mucous membranes and sterile tissue, such endoscopes should be considered critical items. We propose that to ensure patient safety, we follow the Spaulding scheme and move from high-level disinfection to sterilization of reusable endoscopes or use an alternative diagnostic/therapeutic method (eg, disposable sterile endoscopes).
KW - Infection
KW - Instrument reprocessing
KW - Patient safety
KW - high-level disinfection
UR - http://www.scopus.com/inward/record.url?scp=85062957831&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062957831&partnerID=8YFLogxK
U2 - 10.1016/j.ajic.2019.01.017
DO - 10.1016/j.ajic.2019.01.017
M3 - Review article
C2 - 31146853
AN - SCOPUS:85062957831
VL - 47
SP - A62-A66
JO - American Journal of Infection Control
JF - American Journal of Infection Control
SN - 0196-6553
ER -