Program Schedule

Association between Storage Interval and Contamination of Reprocessed Flexible Endoscopes in a Pediatric Gastrointestinal Procedural Unit

Session: Poster Abstract Session: Cleaning and Disinfection in Healthcare Settings
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
  • Hang time poster 2014 IDWeek_TS-PMS 9-30-14.pdf (423.7 kB)
  • Background: The maximum safe storage interval after endoscope reprocessing remains unknown. We sought to assess the association between storage interval and scope contamination to inform the need for scope reprocessing prior to patient use.

    Methods: We conducted a study in two phases. First, we cultured 9 gastrointestinal (GI) endoscopes (6 gastroscopes, 2 duodenoscopes, 1 colonoscope) that had been in storage for >7 days since reprocessing. Each scope had 3 cultures: the external surface (using a sterile swab moistened with sterile saline for the suction/biopsy ports and scope handle); the insertion tube (using sterile gauze moistened with sterile saline); and the internal channels (flushed with sterile saline, then brushed with a sterile brush). Second, after reprocessing these scopes, we hung and cultured them prospectively in a similar fashion at 1, 2 and 4 week intervals without patient use. All specimens were cultured for bacteria and fungi. We defined clinically relevant contamination as >100 CFU/mL.

    Results: In phase 1, the median hang time was 69 days (range, 8-555). Three of 27 cultures (11.1%) from 3/9 scopes were positive, all with nonpathogenic flora at ≤100 CFU/mL (10 CFU/mL coagulase-negative staphylococcus [CoNS] from biopsy/suction ports at 69 days, 100 CFU/mL Micrococcus from surface insertion tube at 69 days, 100 CFU/mL CoNS from channel flush/brush at 85 days). Median hang time was not statistically different between scopes with positive and negative cultures (P=0.68). In phase 2, 4 of 69 prospective cultures (5.8%) from 3 scopes were positive, all at ≤100 CFU/mL. At 7 days, 1/27 (3.7%) was positive (90 CFU/mL CoNS from biopsy/suction ports); at 14 days, 2/27 (7.4%) were positive (100 CFU/mL CoNS from surface insertion tube and 10 CFU/mL Candida albicans from flush/brush); at 28 days, 1/15 (6.7%) grew 3 organisms (10 CFU/mL CoNS, 10 CFU/mL viridans streptococci, 10 CFU/mL Neisseria subflava) from biopsy/suction ports.

    Conclusion: No endoscopes demonstrated clinically relevant contamination at hang times ranging from 7-555 days, and most scopes remained uncontaminated up to 28 days after reprocessing. Our data suggest that properly cleaned and disinfected GI endoscopes could be stored safely for at least 4 weeks, and potentially longer, before patient use.

    Patricia Scanlon, RN, MPH, CIC1, Kathleen Flaherty, BS, MT (ASCP), CIC1, Erik Reilly, M. Ed, RN, CGRN, CPN, CHES, CFER2, Ellen Barth, RN, CORN2, Maria Morrissey, RN, BSN2, Carol Walling, RN, BSN2, Nancy Wilson, CSPM2, Gail Potter-Bynoe, BS, CIC1, Jeff Cardini, RN, MS, CPN, NE-BC2, Alexander Mcadam, MD, PhD3, Ann Marie Riley, BS, MT (ASCP)3 and Thomas J. Sandora, MD, MPH4, (1)Infection Prevention and Control, Boston Children's Hospital, Boston, MA, (2)Boston Children's Hospital, Boston, MA, (3)Laboratory Medicine, Boston Children's Hospital, Boston, MA, (4)Division of Infectious Diseases, Boston Children's Hospital, Boston, MA


    P. Scanlon, None

    K. Flaherty, None

    E. Reilly, None

    E. Barth, None

    M. Morrissey, None

    C. Walling, None

    N. Wilson, None

    G. Potter-Bynoe, None

    J. Cardini, None

    A. Mcadam, None

    A. M. Riley, None

    T. J. Sandora, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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