Implementation of a systematic culturing program to monitor the efficacy of endoscope reprocessing: outcomes and costs

被引：24

作者：

Ma, Gene K. ^{[1
]}

Pegues, David A. ^{[2
]}

Kochman, Michael L. ^{[1
]}

Alby, Kevin ^{[3
]}

Fishman, Neil O. ^{[2
]}

Saunders, Marianne ^{[4
]}

Grous, Carolyn ^{[4
]}

Dempsey, Daniel T. ^{[4
]}

Ginsberg, Gregory G. ^{[1
]}

机构：

[1] Univ Penn, Perelman Sch Med, Dept Med, Div Gastroenterol, Philadelphia, PA 19104 USA

[2] Univ Penn, Perelman Sch Med, Dept Med, Div Infect Dis, Philadelphia, PA 19104 USA

[3] Univ Penn, Perelman Sch Med, Dept Pathol & Lab Med, Philadelphia, PA 19104 USA

[4] Hosp Univ Penn, Perioperat Serv, 3400 Spruce St, Philadelphia, PA 19104 USA

来源：

GASTROINTESTINAL ENDOSCOPY | 2018年 / 87卷 / 01期

关键词：

CARBAPENEM-RESISTANT ENTEROBACTERIACEAE; ESCHERICHIA-COLI; DUODENOSCOPE; TRANSMISSION; OUTBREAK; RISK;

D O I：

10.1016/j.gie.2017.05.001

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and Aims: In 2015, the U.S. Food and Drug Administration and Centers for Disease Control and Prevention (CDC) issued guidance for duodenoscope culturing and reprocessing in response to outbreaks of carbapenem-resistant Enterobacteriaceae (CRE) duodenoscope-related infections. Based on this guidance, we implemented best practices for reprocessing and developed a systematic process for culturing endoscopes with elevator levers. The aim of this study is to report the outcomes and direct costs of this program. Methods: First, clinical microbiology data from 2011 to 2014 were reviewed retrospectively to assess for possible elevator lever-equipped endoscope-related CRE infections. Second, a program to systematically culture elevator lever-equipped endoscopes was implemented. Each week, about 25% of the inventory of elevator lever-equipped endoscopes is cultured based on the CDC guidelines. If any cultures return bacterial growth, the endoscope is quarantined pending repeat culturing. The costs of the program, including staff time and supplies, have been calculated. Results: From 2011 to 2014, none of 17 patients with documented CRE infection had undergone ERCP or endoscopic ultrasound in the previous 36 months. From June 2015 to September 2016, 285 cultures were performed. Three (1.1%) had bacterial growth, 2 with skin contaminants and 1 with an oral contaminant. The associated endoscopes were quarantined and reprocessed, and repeat cultures were negative. The total estimated cost of our program for an inventory of 20 elevator lever-equipped endoscopes was $30,429.60 per year ($1521.48 per endoscope). Conclusions: This 16-month evaluation of a systematic endoscope culturing program identified a low rate of positive cultures after elevator lever endoscope reprocessing. All positive cultures were with non-enteric microorganisms. The program was of modest cost and identified reprocessing procedures that may have led to a low rate of positive cultures.

引用

页码：104 / +

页数：9