Document Detail


Endoscope disinfection and its pitfalls--requirement for retrograde surveillance cultures.
MedLine Citation:
PMID:  18264888     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND STUDY AIMS: Several endoscopy-related outbreaks of infection have been reported in recent years. For early recognition of inadequate disinfection of endoscopes we designed a microbiological surveillance system to evaluate the efficacy of the cleaning and disinfection procedure, and to trace disinfection problems to individual endoscopes or washer-disinfectors. METHODS: Our surveillance protocol included anterograde and retrograde sampling, a decision algorithm, genetic fingerprinting, and scanning electron microscopy. RESULTS: Over a period of 29 months we found an increasing number of patient-ready endoscopes testing positive for Candida species other than albicans, especially C. parapsilosis. These yeasts were also isolated from the washer-disinfectors. The number of positive tests for Candida species varied from 1 out of 21 to 14 out of 27 samples from nine frequently used endoscopes. The number of colony-forming units per milliliter ranged from 1 - 10 to 3000 for endoscopes and 0.002 to 0.06 for the washer disinfectors. DNA fingerprinting was not able to discriminate different strains within C. parapsilosis. CONCLUSIONS: Our protocol was able to detect a structural problem in the endoscope disinfection process. Retrograde sampling was crucial for this purpose, because it has much higher sensitivity than anterograde sampling. Endoscopes with damaged working channels are probably the source of the contamination problem with Candida species.
Authors:
A J Buss; M H Been; R P Borgers; I Stokroos; W J Melchers; F T Peters; A J Limburg; J E Degener
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Publication Detail:
Type:  Journal Article     Date:  2008-02-11
Journal Detail:
Title:  Endoscopy     Volume:  40     ISSN:  1438-8812     ISO Abbreviation:  Endoscopy     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-04     Completed Date:  2008-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0215166     Medline TA:  Endoscopy     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  327-32     Citation Subset:  IM    
Affiliation:
Department of Medical Microbiology, University Medical Centre Groningen, Groningen, The Netherlands. a.j.buss@mmb.umcg.nl
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Candida / isolation & purification*
DNA Fingerprinting
Disinfection / methods*
Endoscopes / microbiology*
Equipment Contamination / prevention & control*
Humans
Microscopy, Electron, Scanning
Occupational Exposure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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