Investigation On Disinfect And Bacterial Contamination Of Duodenoscopes In Hospital

Objective1.According to questionnaire survey about reprocessing process and related questions of duodenoscopes,and get a preliminary understanding of current status in hospitals of our country.2.To investigate the microorganism contamination of disinfected duodenoscopes of the biopsy channel,the air/water channel,the elevator channel and distal end,get a preliminary investigation of the current status of disinfection effect of duodenoscopes,and provide research support for developing sampling and culture methods about duodenoscope surveillance scientifically.Methods1.Investigation of current status:depend on national hospital disinfection and infection control monitoring net,a questionnaire survey was conducted among 15 provinces,38 hospitals about duodenoscope related questions.2.Study of bacterial contamination:a method of on-site sampling was taken at four sites(the biopsy channel,the air/water channel,the elevator channel and distal end)of disinfected duodenoscopes in five 3A hospitals in Beijing.Flushing method or full pipe perfusion method was used to collect three sites of the biopsy channel,air/water channel and elevator channel,and ultrasonic cleaner oscillation method was used to collect distal end.Treat the samples with total filtration for colony count and bacterial species identification.Results1.Investigation of cleaning and disinfection of duodenoscopes in hospitalTotally 38 hospitals were surveyed,and all hospitals had a range of 1?6 duodenoscopes in use,more than 90%hospitals had 1?4 duodenoscopes;18.4%hospitals didn't hire full-time staff who meet competency standard for repeocessing endoscopes.Different hospitals had different compliance rate with recommendations for duodenoscope reprocessing.The rate ranged from 60.5%to 89.5%,and the qualified rate of the pre-cleaning,the final rinsing and drying were low.30.6%(11/36)hospitals performed high level disinfection after used the reusable accessories.At the beginning of the endoscopy clinic,88.6%(33/38)hospitals perfom disinfection and rinsing for the endoscopes,94.7%(36/38)hospitals used test strips to test disinfectants effective concentration,44.7%(17/38)hospitals performed cleaning effcet monitoring,33 hospitals(86.8%)performed periodic microbiological monitoring of endoscopes.2.bacterial contamination of duodenoscopes39 duodenoscopes were collected,including a total of 117 samples for flushing method.The qualified rate of the 39 duodenoscopes was 41.0%,and the qualified rate of distal end was 56.4%and the range of colony-forming unit was 0?1.0×103 CFU/site;the qualified rate of biopsy channel was 61.5%and the range of colony-forming unit was 0?5.3×103 CFU/site;the qualified rate of elevator channel was 74.4%and the range of colony-forming unit was 0?2.4×104 CFU/site;31 duodenoscopes were collected,including 124 samples for full pipe perfusion method.The total qualified rate of the 31 duodenoscopes was 41.9%.The qualified rate of distal end was 51.6%and the range of colony-forming unit was 0?7.5×104 CFU/site;the qualified rate of biopsy channel was 71.0%and the range of colony-forming unit was 0?1.0×103 CFU/site;the qualified rate of air/water channel was 80.6%and the range of colony-forming unit was 0?1.8×103 CFU/site;the qualified rate of elevator channel was 80.6%and the range of colony-forming unit was 0?1.7×104 CFU/site.Totally,70 duodenoscopes were investigated for two methods,the total qualified rate was 41.4%,68 species 318 strains of bacteria were isolated from 70 duodenoscopes.The qualified rate of distal end,biopsy channel,elevator channel and air/water channel were 54.3%,65.7%,77.1%and 80.6%.Conclusion1.Most hospitals had few number of duodenoscopes but high demand for diagnostic and therapeutic,excessive to use duodenospces may lead insufficient reprocessing time for duodenoscopes,and impact the disinfection efficacy.2.the staffs had low complicance with recommendations for duodenoscope reprocessing,and insufficient reprocessing the duodenoscopes may pose a risk for cross infection.3.The qualified rate of duodenoscopes was low,and the serious microbial contamination of every site,especially for distal end may result nosocomial cross-infection.4.Many hopstitals lack of attention for cleaning and disinfection efficacy and had low microbiological surveillance rate.It is necessary to monitoring the disinfection efficacy of duodenoscopes regularly,especially for the distal end and biopsy channel.