Endoscope-associated infections: A microbiologist's perspective on current technologies

Grace Thornhill PhD, Maren David MS
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引用次数: 10

Abstract

In the wake of several highly publicized endoscope-associated multidrug-resistant organism (MDRO) outbreaks, healthcare providers have focused on understanding and improving endoscope reprocessing practices. Microbiological culture of endoscopes has emerged as a critical tool in support of these efforts. As healthcare providers increasingly rely on microbiological culture results to make decisions that impact patient safety, it is important to understand the limitations of the methodology as well as the factors that may impact results. The use of traditional cultures in combination with molecular methods has enabled the investigation of disease transmission during outbreaks. With increased prevalence of MDROs, advanced molecular techniques like whole-genome sequencing provide high resolution data and information on the entire bacterial genome that are needed for thorough investigations and management of transmission events. Elucidation of the true burden of postprocedure patient colonization and infection would benefit from improved clinical lab access to molecular biology tools. Molecular biology tools would facilitate detection of emerging MDROs and ever-increasing diversity of antibiotic resistance genes. Implementation of postprocedure surveillance programs aimed at early recognition of colonized and infected patients could improve appropriate management of endoscope infected patients and guide infection prevention measures to prevent the spread of MDROs.

内镜相关感染:微生物学家对当前技术的看法
在内窥镜相关的多药耐药生物(MDRO)爆发的几次高度宣传之后,医疗保健提供者已将重点放在了解和改进内窥镜再处理实践上。内窥镜微生物培养已成为支持这些努力的关键工具。由于医疗保健提供者越来越依赖微生物培养结果来做出影响患者安全的决策,因此了解方法的局限性以及可能影响结果的因素非常重要。利用传统文化与分子方法相结合,可以调查疾病暴发期间的传播情况。随着MDROs患病率的增加,全基因组测序等先进分子技术提供了关于整个细菌基因组的高分辨率数据和信息,这是彻底调查和管理传播事件所需要的。阐明术后患者定植和感染的真正负担将受益于改进的临床实验室获得分子生物学工具。分子生物学工具将有助于检测新出现的mdro和不断增加的抗生素耐药基因多样性。实施术后监测方案,尽早发现定植和感染患者,可以提高对内窥镜感染患者的合理管理,指导感染预防措施,防止MDROs的传播。
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来源期刊
Techniques in Gastrointestinal Endoscopy
Techniques in Gastrointestinal Endoscopy GASTROENTEROLOGY & HEPATOLOGY-
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期刊介绍: The purpose of each issue of Techniques in Gastrointestinal Endoscopy is to provide a comprehensive, current overview of a clinical condition or surgical procedure in gastrointestinal endoscopy, combining the effectiveness of an atlas with the timeliness of a journal. Each issue places a vigorous emphasis on diagnosis, rationale for and against a procedure, actual technique, management, and prevention of complications. The journal features abundant illustrations, line drawings and color artwork to guide readers through even the most complicated procedure.
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