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Contaminated flexible endoscopes: Review of impact of channel sampling methods on culture results and recommendations for root-cause analysis

Published online by Cambridge University Press:  07 May 2021

Michelle J. Alfa*
Affiliation:
Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
Harminder Singh
Affiliation:
Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
*
Author for correspondence: Michelle J. Alfa, E-mail: michellealfa001@gmail.com

Abstract

Recently, infection transmission risk associated with contaminated, patient-ready flexible endoscopes has attracted attention. Outbreaks of multidrug-resistant organisms resulting in infection and/or colonization have been particularly concerning. Recent CDC and FDA recommendations focus on reducing “exogenous” infection transmission and specifically recommend that endoscopy sites have quality systems in place for endoscope reprocessing. Another key recommendation is the culture of patient-ready endoscopes to detect contamination with organisms of concern. Remaining gaps in the guidelines include ensuring that optimal endoscope-channel sample methods are used and ensuring effective root-cause analysis and remediation when contamination is detected. In this review, we summarize the critical aspects of endoscope sample collection and present a practical approach to root-cause analysis and remedial action plans.

Type
Review
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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