What's new in reprocessing endoscopes: Are we going to ensure “the needs of the patient come first” by shifting from disinfection to sterilization?

William A. Rutala, Hajime Kanamori, Emily E. Sickbert-Bennett, David J. Weber

Research output: Contribution to journalReview articlepeer-review

10 Citations (Scopus)

Abstract

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).

Original languageEnglish
Pages (from-to)A62-A66
JournalAmerican Journal of Infection Control
Volume47
DOIs
Publication statusPublished - 2019 Jun

Keywords

  • Infection
  • Instrument reprocessing
  • Patient safety
  • high-level disinfection

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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