Background and Aims
Duodenoscopes have been implicated in the transmission of multidrug-resistant organisms
(MDROs). Echoendoscopes could potentially transmit infection. The aim of this study
was to assess the effectiveness of standard high-level disinfection (HLD) for radial
and linear echoendoscopes and to compare it with that of duodenoscopes.
Methods
We performed a prospective single-center study sampling echoendoscopes immediately
before use, from the working channel (radial and linear echoendoscopes) and the transducer
(radial echoendoscope) or elevator mechanism and transducer (linear echoendoscope).
The primary outcome was the proportion of echoendoscopes with any culture showing ≥1
MDRO; secondary outcomes included bacterial growth >0 colony forming units (CFUs)
and ≥10 CFUs on either sampling location. We compared these findings with duodenoscope
cultures from the previously published DISINFECTS trial.
Results
During the study period, 101 echoendoscopes were sampled (n = 50 radial echoendoscopes,
n = 51 linear echoendoscopes). No MDROs were recovered. Bacterial growth >0 CFUs was
noted in 6% and ≥10 CFUs in 3% of all echoendoscopes. There was no significant difference
in growth between radial and linear echoendoscopes (P = .4 for >0 CFU growth; P = .6 for ≥10 CFUs growth). The proportion of transducer and/or elevator mechanism
positive for bacterial growth was significantly higher in duodenoscopes as compared
with echoendoscopes (P = .02).
Conclusions
After standard HLD, no echoendoscope showed MDRO growth, 6% showed >0 CFUs, and 3%
showed ≥10 CFUs bacterial growth. Bacterial growth was higher in duodenoscopes at
the level of the transducer and/or elevator mechanism when compared with echoendoscopes.
Abbreviations:
CFU (colony-forming unit), MDRO (multidrug-resistant organism), HLD (high-level disinfection)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 14, 2019
Accepted:
December 29,
2018
Received:
September 24,
2018
Footnotes
DISCLOSURE: This study was supported in part by a grant from the American Society for Gastrointestinal Endoscopy. All other authors disclosed no financial relationships relevant to this publication.
Identification
Copyright
© 2019 by the American Society for Gastrointestinal Endoscopy
