Investigation of Microbiological Contamination of Endoscopes After Endoscopic Debridement of Pancreatic Encapsulated Necrosis With Multidrug Resistant Bacterial Infection.

Abstract

Background: To investigate the microbiological contamination of endoscopes after endoscopic debridement of pancreatic encapsulated necrosis with multidrug-resistant bacterial infection by 2 different reprocessing methods of peroxyacetic acid and ethylene oxide.

Methods: Endoscopes with auxiliary water function after endoscopic debridement of pancreatic encapsulated necrosis and multidrug-resistant bacterial infection in a tertiary care hospital in Jiangxi Province were selected and divided into 2 groups by random number table method: group A was sterilized by peracetic acid immersion and group B was sterilized by ethylene oxide low temperature. The 3 channels of the endoscopes, namely, the working channel, the air/water channel, and the auxiliary water channel, were collected by the filter membrane method and sent to the laboratory for microbiological culture within 2 hours. The qualification rate, colony count, and isolation of bacteria were compared between the 2 groups of endoscopes.

Results: In this study, 78 endoscopes were collected, 39 each from group A and group B, with a total of 312 samples. The overall pass rate of group A and group B was 61.54% and 100%, respectively. The pass rate of group A working channel was 82.05%, the pass rate of air/water channel was 89.74%, the pass rate of auxiliary water channel was 74.36%, and the pass rate of all 3 channels in group B was 100%. The pass rate of group A working channel is 82.05%. The ranges of total bacterial colonies in the channel, air/water channel, and auxiliary water channel were 0 to 6 CFU/channel, 0 to 112 CFU/channel, and 0 to 23 CFU/channel, respectively. A total of 36 strains of bacteria were isolated, mainly multidrug resistant Pseudomonas aeruginosa , methicillin-resistant Staphylococcus aureus , and multidrug resistant Klebsiella pneumoniae . After transferring 15 failed endoscopes in group A to low-temperature sterilization with ethylene oxide, the microbiological surveillance pass rate reached 100%.

Conclusion: For endoscopes with pancreatic encapsulated necrosis and multidrug resistant bacterial infection endoscopic debridement, the ethylene oxide cryo-sterilization method is safer and more effective. Routine microbiological surveillance of endoscopes cannot be limited to the surveillance of working channels only, and endoscopes with auxiliary water function need to monitor auxiliary water channels to reduce the risk.