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3 Out Of 20 Gastrointestinal Scopes Improperly Cleaned, Contaminated With 'Bio Dirt'

 It might be time to start treating endoscopes like tattoo needles -- making sure  only unused ones go into your body -- because a new study has found that three  out of every 20 gastrointenstinal (GI) endoscopes were improperly cleaned and  found to harbor "bio dirt," including cells, matter, and bacteria leftover from  other patients. 

The study was conducted at five hospitals across the United States.  Researchers from 3M's Infection Prevention Division examined 275 flexible  endoscopes. Types examined include ones inserted through the mouth, such as  duodenoscopes, which examine the first section of the small intestine, and  gastroscopes, which look at the stomach. Researchers also inspected  colonoscopies, which are inserted through the anus to examine the colon. They  found that 30 percent of duodenoscopes, 24 percent of gastroscopes, and 3  percent of colonoscopies didn't pass a cleanliness rating test.

"Three out of 20 is an unexpectedly high number of endoscopes failing a  cleanliness criterion," said Dr. Marco Bommarito, lead investigator and lead  research specialist of the 3M Infection Prevention Division. "Clearly, we'd like  no endoscopes to fail a cleanliness rating."

To test the endoscopes, the researchers first allowed them to be cleaned  manually, which includes using an enzymatic cleaner and flushing by a hospital  technician. The second step, the application of a high-level disinfectant, is  ineffective if the manual cleaning isn't done properly. The researchers skipped  the second step, and flushed the endoscopes with sterile water, using the sample  water to test for adenosine triphosphate (ATP), a marker of bio-contamination.  They then measured the amount of ATP in relative light units (RLU) with a  hand-held luminometer. Any endoscope with more than 200 RLUs of ATP was  considered a cleaning failure.

"The cleaning protocols for flexible endoscopes need improvement, such as  guidelines tailored to the type of scope or identifying if there is a critical  step missing in the manual cleaning process, and documented quality control  measures," Bommarito said. "These types of improvements could have a positive  impact on patient safety."

In the U.S., there are about five million gastrointestinal endoscopies each  year. They're used to screen different parts of a person's GI tract, looking for  polyps or colon cancer. While they are responsible for the most  healthcare-related outbreaks of infection compared to any other medical  instrument, the number of incidences is still very low, at about one out of  every 1.8 million procedures, according to the Centers for Disease Control and  Prevention.

The findings from this study were presented at the annual conference of the  Association for Professionals in Infection Control and Epidemiology, which is  held June 8-10.

Read more at http://www.medicaldaily.com/articles/16347/20130609/colonoscopy-endoscopy-contamination-medical-devices-endoscope-gi-scope.htm#DMJ7BxlApyGMPOre.99

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