Prospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jan 16, 2018; 10(1): 51-55
Published online Jan 16, 2018. doi: 10.4253/wjge.v10.i1.51
Bacterial presence on flexible endoscopes vs time since disinfection
Katlin I Mallette, Peter Pieroni, Sonny S Dhalla
Katlin I Mallette, Sonny S Dhalla, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba R3E 3P5, Canada
Peter Pieroni, Diagnostic Services of Manitoba, Westman Laboratory, Department of Microbiology, Brandon Regional Health Centre, Brandon, Manitoba R7A 7H8, Canada
Sonny S Dhalla, Gastrointestinal Endoscopy Unit, Brandon Regional Health Centre, Brandon, Manitoba R7A 2B3, Canada
Author contributions: Mallette KI, Pieroni P and Dhalla SS participated in the design of the research and collection of data; Mallette KI conducted the data analysis and drafted the manuscript; Pieroni P and Dhalla SS assisted with the drafting of the manuscript; all authors read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Gastrointestinal Endoscopy department administration at Brandon Regional Health Centre.
Informed consent statement: All patients provided written consent prior to the performed procedure; all data was anonymized prior to analysis.
Conflict-of-interest statement: Sonny S Dhalla is a member of the World Journal of Gastrointestinal Endoscopy Editorial Board. Katlin I Mallette and Peter Pieroni have no conflicts of interest to declare.
Data sharing statement: Complete dataset is available from the first author by e-mail at mallett4@myumanitoba.ca. No additional data is available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Sonny S Dhalla, MD, FRCSC, FACS, Gastrointestinal Endoscopy Unit, Brandon Regional Health Centre, 339 Princess Avenue, Brandon, Manitoba R7A 2B3, Canada. varsity@wcgwave.ca
Telephone: +1-204-7293727 Fax: +1-204-7289535
Received: July 10, 2017
Peer-review started: July 18, 2017
First decision: September 7, 2017
Revised: October 22, 2017
Accepted: November 10, 2017
Article in press: November 10, 2017
Published online: January 16, 2018
ARTICLE HIGHLIGHTS
Background

Due to the nature of endoscopy, all endoscopes must undergo high level disinfection after use. Previously, guidelines suggested that endoscopes be reprocessed prior to use, regardless of the hang time. These guidelines led to excessive wear on the instruments, and were quite costly for institutions. A previous study conducted at our institution suggested that endoscopes could be stored for up to 7 d prior to requiring reprocessing. The aim of this study was to determine if there was a correlation between the hang time and bacterial load on endoscopes.

Research frontiers

There have recently been several documented cases of transmission of antibiotic resistant organisms, specifically carbapenem-resistant Enterobacteriaceae via endoscopy. This has led to increased interest in the bacterial contamination on endoscopes after thorough disinfection.

Innovations and breakthroughs

The study demonstrates that endoscopes can be stored for a period of up to 7 d without significant levels of bacterial contamination, there does not appear to be a correlation between hang time and bacterial load. There does not appear to be a need for reprocessing of endoscopes prior to use if disinfected and stored properly. This is contrary to previous society guidelines which suggested disinfection prior to use.

Applications

Endoscopes if disinfected and stored properly can be stored for up to 7 d without requiring reprocessing prior to use.

Terminology

Hang time refers to the number of days an endoscope was stored, from disinfection to microbiological evaluation.