Improving the Reprocessing Quality of Flexible Thermolabile Endoscopes

How to Learn from Mistakes

Bibliographic Data

ID15499035
AuthorsBeatrice Casini (0000-0003-3609-4419, University of Pisa, corresponding author), Benedetta Tuvo (0000-0001-6562-0321, University of Pisa), Emanuele Marciano (0000-0002-0668-3143, Azienda Ospedaliera Universitaria Pisana), Giuliana Del Magro (Azienda Ospedaliera Universitaria Pisana), Giulia Gemignani (Azienda Ospedaliera Universitaria Pisana), Grazia Luchini (Azienda Ospedaliera Universitaria Pisana), Maria Luisa Cristina (0000-0002-7926-7108, University of Genoa), Anna Laura Costa (University of Pisa), Guglielmo Arzilli (0000-0003-1258-1650, University of Pisa), Michele Totaro (University of Pisa), Angelo Baggiani (0000-0003-2615-7308, University of Pisa), Gaetano Pierpaolo Privitera (0000-0002-8638-2462, University of Pisa), Gaetano Privitera (University of Pisa)
Year2021
Volume18
Issue5
Pages2482-2482
Publication date2021-03-03
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph18052482
PMID33802350
OpenAlexW3135262946
LanguageEN
Citations received1
References cited28

Background: Failure in the reprocessing of thermolabile flexible endoscopes has been reported as one of the most important threats to patient health. Method: A case report and observational study was conducted, from August 2014 to December 2019, in the Digestive Endoscopy Unit of a University Hospital in Italy, where two cases of Klebsiella pneumoniae carbapenemase ( KPC )-producing Klebsiella pneumoniae infections in patients undergoing endoscopic retrograde cholangio-pancreatography were observed. Following the risk/safety management practices, an epidemiological investigation was started, duodenoscopes were removed from use and the reprocessing practices reviewed. Moreover, microbiological surveillance of endoscopes was carried out according to the CDC guidelines. Results: In the first phase of sampling, 10/10 (100%) endoscopes were found to be non-compliant, of which 7 showed results for high-concern organisms (HCOs), such as KPC - K. pneumoniae, P. aeruginosa and E. coli . After implementing corrective actions, 12 out of 17 endoscopes were found to be non-compliant (70.5%), of which 8 showed results for HCOs, such as KPC-K. oxytoca and P. aeruginosa . During the last year of regular microbiological surveillance, only 23% of endoscopes (35/152) were found to be non-compliant, of which 7 showed results for HCOs, such as NDM-K. pneumoniae, P. aeruginosa and A. baumannii . The crucial issues were related to samples collected from the internal channels of duodenoscopes. Conclusion: Managing the risk associated with the reprocessing of digestive endoscopes, through risk assessment at every stage of the process, is important for the prevention of infections associated with the use of these device

Biology · Klebsiella pneumoniae · Healthcare and Environmental Waste Management · Medical Device Sterilization and Disinfection · Medicine

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