109. Adequacy of Duodenoscope Reprocessing Methods as Reported by Infectious Disease Physicians
Session: Oral Abstract Session: Duodenoscope-Related CRE Infections
Thursday, October 8, 2015: 11:30 AM
Room: 5--AB
Background: Two recent outbreaks of multidrug-resistant organism (MDRO) bacterial transmission have been reported via duodenoscopes without reprocessing breaches or duodenoscope defects identified. In March 2015, the CDC released an interim surveillance protocol for duodenoscopes to guide use of surveillance cultures to assess endoscope reprocessing.

Methods: The IDSA’s Emerging Infections Network (EIN) surveyed its physician members later in 03/2015 to determine institutional practices for endoscope decontamination and surveillance cultures. An email with a link to a 5-item electronic survey was sent to 699 EIN members with a recorded interest in hospital epidemiology.

Results: 378 (54%) of 699 EIN members responded; 190 (50%) reported that their facilities used duodenoscopes. 134/190 (70%) reported a single method of decontamination: automated endoscope washers with high-level disinfection by 108 (57%), manual reprocessing using high-level disinfection by 20 (11%), and ethylene oxide gas sterilization by 6 (3%). 38 (20%) respondents reported two methods of decontamination, most often automated washers plus manual reprocessing by 26 (14%); 5 (3%) reported three methods. Respondents were asked to select all methods used to identify possible infections resulting from duodenoscopy in the last 12 months. The most common response was “None” by 59 (31%). A single method was reported by 71 (37%), most commonly surveillance cultures by 25 (13%). Other surveillance methods included clinical cultures, microbiologic patient screening, and follow-up patient contact post procedure. Two surveillance methods were reported by 30 (16%), and 3 or more methods were reported by 13 (7%). Finally, 79% of respondents reported reviewing duodenoscopy policies and procedures currently or in the past 3 months.

Conclusion: Our study shows that a minority of infectious diseases physician respondents reported that their institutions were using multiple reprocessing steps as recommended. In addition, about one-third of respondents reported that their institutions had not used any methods within the last year to identify post-duodenoscopy MDRO transmission or infections. These findings suggest the possibility that endemic bacterial transmission associated with duodenoscopy may occur and may go unrecognized.

Susan E. Beekmann, RN, MPH1, Tara Palmore, M.D.2, Philip M. Polgreen, MD1 and John E. Bennett, MD3, (1)Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, (2)NIH Clinical Center and Niaid, NIH, Bethesda, MD, (3)Clinical Mycology Section, NIAID/NIH, Bethesda, MD


S. E. Beekmann, None

T. Palmore, None

P. M. Polgreen, None

J. E. Bennett, None

Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.