Background and Aims

Duodenoscopes have been implicated in the transmission of multidrug-resistant organisms (MDROs). Echoendoscopes could potentially transmit infection. The aim of this study was to assess the effectiveness of standard high-level disinfection (HLD) for radial and linear echoendoscopes and to compare it with that of duodenoscopes.

Methods

We performed a prospective single-center study sampling echoendoscopes immediately before use, from the working channel (radial and linear echoendoscopes) and the transducer (radial echoendoscope) or elevator mechanism and transducer (linear echoendoscope). The primary outcome was the proportion of echoendoscopes with any culture showing ≥1 MDRO; secondary outcomes included bacterial growth >0 colony forming units (CFUs) and ≥10 CFUs on either sampling location. We compared these findings with duodenoscope cultures from the previously published DISINFECTS trial.

Results

During the study period, 101 echoendoscopes were sampled (n = 50 radial echoendoscopes, n = 51 linear echoendoscopes). No MDROs were recovered. Bacterial growth >0 CFUs was noted in 6% and ≥10 CFUs in 3% of all echoendoscopes. There was no significant difference in growth between radial and linear echoendoscopes (P = .4 for >0 CFU growth; P = .6 for ≥10 CFUs growth). The proportion of transducer and/or elevator mechanism positive for bacterial growth was significantly higher in duodenoscopes as compared with echoendoscopes (P = .02).

Conclusions

After standard HLD, no echoendoscope showed MDRO growth, 6% showed >0 CFUs, and 3% showed ≥10 CFUs bacterial growth. Bacterial growth was higher in duodenoscopes at the level of the transducer and/or elevator mechanism when compared with echoendoscopes.

中文翻译：

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对超声内窥镜标准高级消毒效果的前瞻性评估

背景和目标

十二指肠镜已经牵涉到多药耐药生物（MDRO）的传播。内窥镜可能会传播感染。这项研究的目的是评估放射状和线性回声内窥镜的标准高级消毒（HLD）的有效性，并将其与十二指肠镜进行比较。

方法

在使用前，我们从工作通道（径向和线性回波内窥镜）和换能器（径向回波内窥镜）或升降机构和换能器（线性回波内窥镜）中进行了前瞻性单中心研究采样回波内窥镜。主要结果是任何文化显示≥1 MDRO的超声内窥镜所占比例；次要结果包括在任一采样位置细菌生长> 0集落形成单位（CFU）和≥10CFU。我们将这些发现与先前发表的DISINFECTS试验中的十二指肠镜文化进行了比较。

结果

在研究期间，对101台超声内窥镜进行了采样（n = 50台径向超声内窥镜，n = 51台线性超声内窥镜）。没有恢复MDRO。在所有超声内镜中，细菌生长> 0 CFU的占6％，而3％≥10CFU。有在之间生长没有差异显著径向和线性echoendoscopes（P  = 0.4为> 0 CFU生长; P  = 0.6为≥10的CFU生长）。与十二指肠镜相比，十二指肠镜对细菌生长呈阳性的传感器和/或升降机构的比例明显更高（P  = .02）。

结论

标准HLD后，没有超声内窥镜显示MDRO增长，6％显示> 0 CFU，3％显示≥10CFU细菌生长。与超声内窥镜相比，十二指肠镜在换能器和/或升降机构的水平细菌生长更高。