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Article

Improving the Reprocessing Quality of Flexible Thermolabile Endoscopes: How to Learn from Mistakes

1
Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
2
Endoscopy Service Division, University Hospital of Pisa, 56126 Pisa, Italy
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Medical Direction, University Hospital of Pisa, 56126 Pisa, Italy
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Department of Health Sciences, University of Genova, 16132 Genova, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Nicola Nante
Int. J. Environ. Res. Public Health 2021, 18(5), 2482; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052482
Received: 8 February 2021 / Revised: 24 February 2021 / Accepted: 26 February 2021 / Published: 3 March 2021
(This article belongs to the Special Issue Hospital Outdoor and Indoor Environmental Impact: Control Measures)
Background: Failure in the reprocessing of thermolabile flexible endoscopes has been reported as one of the most important threats to patient health. Method: A case report and observational study was conducted, from August 2014 to December 2019, in the Digestive Endoscopy Unit of a University Hospital in Italy, where two cases of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae infections in patients undergoing endoscopic retrograde cholangio-pancreatography were observed. Following the risk/safety management practices, an epidemiological investigation was started, duodenoscopes were removed from use and the reprocessing practices reviewed. Moreover, microbiological surveillance of endoscopes was carried out according to the CDC guidelines. Results: In the first phase of sampling, 10/10 (100%) endoscopes were found to be non-compliant, of which 7 showed results for high-concern organisms (HCOs), such as KPC-K. pneumoniae, P. aeruginosa and E. coli. After implementing corrective actions, 12 out of 17 endoscopes were found to be non-compliant (70.5%), of which 8 showed results for HCOs, such as KPC-K. oxytoca and P. aeruginosa. During the last year of regular microbiological surveillance, only 23% of endoscopes (35/152) were found to be non-compliant, of which 7 showed results for HCOs, such as NDM-K. pneumoniae, P. aeruginosa and A. baumannii. The crucial issues were related to samples collected from the internal channels of duodenoscopes. Conclusion: Managing the risk associated with the reprocessing of digestive endoscopes, through risk assessment at every stage of the process, is important for the prevention of infections associated with the use of these device. View Full-Text
Keywords: endoscope reprocessing; duodenoscope; microbiological surveillance; KPC; NDM; Klebsiella pneumoniae endoscope reprocessing; duodenoscope; microbiological surveillance; KPC; NDM; Klebsiella pneumoniae
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MDPI and ACS Style

Casini, B.; Tuvo, B.; Marciano, E.; Del Magro, G.; Gemignani, G.; Luchini, G.; Cristina, M.L.; Costa, A.L.; Arzilli, G.; Totaro, M.; Baggiani, A.; Privitera, G. Improving the Reprocessing Quality of Flexible Thermolabile Endoscopes: How to Learn from Mistakes. Int. J. Environ. Res. Public Health 2021, 18, 2482. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052482

AMA Style

Casini B, Tuvo B, Marciano E, Del Magro G, Gemignani G, Luchini G, Cristina ML, Costa AL, Arzilli G, Totaro M, Baggiani A, Privitera G. Improving the Reprocessing Quality of Flexible Thermolabile Endoscopes: How to Learn from Mistakes. International Journal of Environmental Research and Public Health. 2021; 18(5):2482. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052482

Chicago/Turabian Style

Casini, Beatrice, Benedetta Tuvo, Emanuele Marciano, Giuliana Del Magro, Giulia Gemignani, Grazia Luchini, Maria L. Cristina, Anna L. Costa, Guglielmo Arzilli, Michele Totaro, Angelo Baggiani, and Gaetano Privitera. 2021. "Improving the Reprocessing Quality of Flexible Thermolabile Endoscopes: How to Learn from Mistakes" International Journal of Environmental Research and Public Health 18, no. 5: 2482. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052482

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