当前位置: X-MOL 学术Gastrointest. Endosc. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Results of duodenoscope culture and quarantine after manufacturer-recommended cleaning process.
Gastrointestinal Endoscopy ( IF 7.7 ) Pub Date : 2020-01-13 , DOI: 10.1016/j.gie.2019.12.050
Jacob A Mark 1 , Karin Underberg 2 , Robert E Kramer 1
Affiliation  

BACKGROUND AND AIMS Outbreaks of infections transmitted by duodenoscopes have prompted changes to duodenoscope cleaning protocols. However, little is known about effectiveness of clinical cleaning practices. We present culture data after duodenoscope manufacturer-recommended high-level disinfection (HLD) and quarantine. METHODS Our institution adopted a combination of manufacturer-recommended cleaning with the Centers for Disease Control and Prevention-recommended culture and quarantine in 2015. Duodenoscopes (models TJF-Q180V, TJF-160, and PJF-160; Olympus, Center Valley, Penn, USA) underwent HLD according to the manufacturer's reprocessing manual protocols after use. Two culture specimens were then obtained using a sterile brush from the distal tip, including elevator mechanism, and by flushing sterile water through the working channel. Duodenoscopes were quarantined until cultures resulted. Positive cultures were defined as >10 colony-forming units (CFUs) of low-concern organisms or any CFUs of high-concern organisms according to Centers for Disease Control and Prevention recommendations. If either culture specimen was positive, the process was repeated until cultures were negative. Data were collected from December 2015 to July 2018. RESULTS There were 140 instances of duodenoscope cleaning with 280 specimens. Twenty-eight of 234 (12%) initial culture specimens (18% of cultured duodenoscopes) were positive. Five of 36 (14%) second cultures were positive. Two of 8 (25%) third cultures were positive. Ninety-eight percent of organisms cultured were gram positive. In 8 instances both culture methods (brushing and flush) were positive; otherwise, only 1 method was positive. In 11 instances (8%) duodenoscopes were removed from quarantine before final culture results. No patient had infections related to ERCP. CONCLUSIONS Eighteen percent of duodenoscopes had a positive culture after initial HLD. Only 3% were gram-negative bacteria. Repeated HLD was 86% and 75% effective at eliminating initial and repeat positive cultures, respectively. Initial HLD per manufacturer recommendations is not always effective at eliminating bacterial contamination. Additional steps are necessary to decrease risks of duodenoscope-transmitted infections.

中文翻译:

经制造商推荐的清洁过程后,十二指肠镜的培养和检疫结果。

背景和目的十二指肠镜传播的感染暴发促使十二指肠镜清洁协议发生了变化。但是,人们对临床清洁实践的有效性知之甚少。在十二指肠镜制造商推荐的高水平消毒(HLD)和隔离后,我们将提供培养数据。方法我们的机构在2015年采用了制造商推荐的清洁方法与疾病控制与预防中心建议的文化和检疫相结合。十二指肠镜(型号TJF-Q180V,TJF-160和PJF-160;奥林巴斯,中心山谷,宾夕法尼亚州,使用后,美国)根据制造商的后处理手册协议进行了HLD。然后使用无菌刷从远端尖端(包括升降机构)通过冲洗无菌水,通过工作通道获得两个培养标本。十二指肠镜被隔离直到产生培养物。根据疾病控制与预防中心的建议,阳性培养物定义为低关注生物体的菌落形成单位(CFU)> 10或高关注生物体的任何CFU。如果任一培养标本均为阳性,则重复此过程,直到培养阴性。从2015年12月至2018年7月收集了数据。结果共有140例十二指肠镜清洁术,其中有280个标本。234个初始培养标本中有28个(12%)(十二指肠镜的18%)呈阳性。36个第二文化中有五个(14%)呈阳性。8种第三文化中有2种(25%)呈阳性。培养的98%的生物为革兰氏阳性。在8种情况下,两种培养方法(刷涂和冲洗)均呈阳性。否则,只有一种方法是阳性的。在最终培养结果之前,有11例(8%)的十二指肠镜从检疫中取出。没有患者有与ERCP相关的感染。结论最初HLD后18%的十二指肠镜具有阳性培养。仅有3%为革兰氏阴性菌。重复的HLD在消除初始和重复的阳性培养物中分别有86%和75%的有效率。根据制造商的建议,最初的HLD并不总是能有效消除细菌污染。必须采取额外的步骤来降低十二指肠镜传播的感染风险。重复的HLD在消除初始和重复的阳性培养物中分别有86%和75%的有效率。根据制造商的建议,最初的HLD并不总是能有效消除细菌污染。必须采取额外的步骤来降低十二指肠镜传播的感染风险。重复的HLD在消除初始和重复的阳性培养物中分别有86%和75%的有效率。根据制造商的建议,最初的HLD并不总是能有效消除细菌污染。必须采取额外的步骤来降低十二指肠镜传播的感染风险。
更新日期:2020-01-13
down
wechat
bug