Healthcare Hygiene magazine November 2019 | Page 21

Manufacturing and Regulatory/Compliance SUBMISSIONS WANTED Epidemiology Manufacturing and Regulatory/Compliance prevention-driven prevention-driven Healthcare Hygiene magazine, a new monthly publication uniting infection prevention-driven stakeholders in the quest for clean, invites you to submit to us your articles addressing evidence-based practices. Articles should be robustly scientific and non-commercial in nature. For submissions guidelines, send an inquiry to: [email protected] We are building bridges between Infection Prevention/Epidemiology, Scientific R&D, Manufacturing and Regulatory/Compliance through a comprehensive online and digital platform. Prevention/Epidemiology one of the newer ACs. Although gastroscopes were found to be more highly contaminated than colonoscopes, they were used for fewer procedures than colonoscopes. Every endoscope had <10 CFU except one intervention AC with 15 CFU. Positive control samples were highly contami- nated (ATP, 4,831 RLU; protein, 29 µg/mL; and microbial cultures, >600 CFU). Negative control samples had low ATP levels (9 RLU), negative protein tests (0 µg/mL), and no microbial growth. Technicians conducted ATP tests after manual cleaning for all intervention endoscopes. Post-cleaning benchmarks (<200 RLU) were met during 301 of 304 (99 percent) colo- noscope encounters (mean, 17 RLU and median, 11 RLU), and during 69 of 143 (48 percent) gastroscope encounters (mean, 571 RLU and median, 214 RLU). In 16 (11 percent) gastroscope encounters, the ATP levels were still high after double manual cleaning and 2 cycles of cleaning and HLD in the AER. The take-home message from this study is that the researchers found microbial growth in samples from 60 percent of endoscopes, and that residual fluid was found in most endoscopes, which suggests insufficient drying methods that can foster the growth of bacteria and fungi. As the researchers emphasized, “This study demonstrated that more rigorous reprocessing practices may not be suffi- cient to ensure that patient-ready endoscopes are free from residual contamination, particularly when the endoscope has defects that could harbor organic debris and biofilm. Visual inspection and routine monitoring for biochemical markers evidence- based practices Scientific R&D were higher for gastroscopes than colonoscopes. Eighty- five percent of endoscopes required repair due to findings. Surprisingly, the researchers found that more rigorous reprocessing was not consistently effective. Seven-day incu- bation allowed identification of slow-growing microbes. The researchers say their findings bolster the need for routine visual inspection and cleaning verification tests recommended in new reprocessing guidelines. During the final assessment, researchers had observed discoloration, scaly deposits, debris, scratches, and dents on external surfaces. Gastroscope insertion tubes were commonly stained yellow or orange and buckling was also observed. Irregularities were often found on distal ends. Borescope examinations revealed numerous irregularities, including discoloration, scratches, and filaments of debris protruding into channels. Researchers observed fluid in 19 of 20 (95 percent) patient-ready endoscopes, which were stored vertically after reprocessing. Researchers tested every endoscope in use at the final assessment and found a similar proportion of endoscopes in each group exceeded the post-cleaning benchmarks for ATP (20 percent control and 30 percent intervention) and protein (20 percent control and 20 percent intervention). Overall, more gastroscopes exceeded the ATP benchmark (67 percent gastroscope and 7 percent colonoscope; but there was no difference in protein levels (17 percent gastroscope and 21 percent colonoscope). There were no differences in cleaning effectiveness by endoscope age or use history, and the highest post-HLD microbial colony count was found in Infection Prevention Join this vibrant new online community and be alerted when new monthly issues of the magazine and other supplements are released. SIGN UP TODAY h ealthcarehygienemagazine www.healthcarehygienemagazine.com www.healthcarehygienemagazine.com • november 2019 Announcing our Annual Meeting! January 22-23, 2020 This two-day event brings together a diverse group of healthcare professionals and all of the Institute’s Initiative Groups for face-to-face meetings. For the first time, day two will offer educational sessions open to healthcare stakeholders. Visit our website to learn more about our 2020 event, including: • Training for healthcare professionals • Our new Certification & Standards program healthcaresurfacesinstitute.org 21