The implementation of a manual pretreatment phase increases the efficacy of automated reprocessing procedures in postprocedural bronchoscopes

Authors

  • Lamia Melalka Center for Doctoral Studies in Life and Health Sciences, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University of Rabat, Morocco https://orcid.org/0009-0000-9296-3338 (unauthenticated)
  • Nada Saout Center for Doctoral Studies in Life and Health Sciences, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University of Rabat, Morocco https://orcid.org/0000-0002-8424-9393 (unauthenticated)
  • Fouad Assi Center for Doctoral Studies in Life and Health Sciences, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University of Rabat, Morocco https://orcid.org/0009-0000-7554-0202 (unauthenticated)
  • Yassine Sekhsoukh Center for Doctoral Studies in Life and Health Sciences, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University of Rabat, Morocco Department of the P3 Research and Biosafety Laboratory. Mohammed V Military Training Hospital, Rabat Morocco
  • Mimoun Zouhdi Center for Doctoral Studies in Life and Health Sciences, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University of Rabat, Morocco Department of the Bacteriology, Serology, Hygiene Laboratory at the Ibn Sina Rabat University Hospital Center Morocco

DOI:

https://doi.org/10.62438/tunismed.v103i5.5237

Keywords:

Endoscope reprocessing, , pretreatment phase, automated disinfection, microbial contamination, infection control

Abstract

Introduction: The reprocessing of flexible endoscopes has become a major research topic in

recent decades. The risk of endoscopy-related bacterial, fungal or viral outbreaks is increasing,

particularly those involving multi-resistant strains.

Aim: The aim of the present study was to assess the importance of implementing a manual pre-

treatment phase in conjunction with HDL (High Level Disinfection) cleaning using a Steelco

automated washer-disinfector. The aim of the study was to determine whether neglecting the

manual pre-treatment phase, despite the use of a high-quality automated disinfector, leads to the spread of biofilms and of germs likely to cause healthcare-associated infections.

Methods: To achieve this objective, an extensive microbiological sampling process was carried

out on bronchoscopes under normal cleaning and disinfection conditions prior to the introduction

of the pre-treatment phase.

Based on the results of these samplings, the Quality Control Circle (QCC) team proceeded to

identify and analyze potential causes using the ISHIKAWA diagram during brainstorming

sessions, following which microbiological sampling of the bronchoscopes after implementation

of the results of the cause analysis was carried out.

Results: The results indicate complete elimination of bacterial strains after implementation of

manual pretreatment followed by automated treatment, in line with international disinfection

standards.

Conclusion: The implementation of a pre-treatment phase followed by a Steelco

automated washer-disinfector significantly reduced microbial contamination in bronchoscopes.

Downloads

Download data is not yet available.

References

(1) Kovaleva, J., Peters, F. T., van der Mei, H. C., & Degener, J. E. (2013). Transmission of

infection by flexible gastrointestinal endoscopy and bronchoscopy. Clinical microbiology

reviews, 26(2), 231-254. https://doi.org/10.1128%2FCMR.00085-12

(2) McCafferty CE, Aghajani MJ, Abi-Hanna D, Gosbell IB, Jensen SO (2018) An update on

gastrointestinal endoscopy-associated infections and their contributing factors. Ann Clin

Microbiol Antimicrob 17:1-6. https://doi.org/10.1186/s12941-018-0289-2

(3) Kakoullis L, Economidou S, Mehrotra P, Panos G, Karampitsakos T, Stratakos G (2023)

Bronchoscopy-related outbreaks and pseudo-outbreaks: A systematic review. Infect Control

Hosp Epidemiol 1-11. https://doi.org/10.1017/ice.2023.250

(4) Nelson DB, Muscarella LF (2006) Current issues in endoscope reprocessing and infection

control during gastrointestinal endoscopy. World J Gastroenterol 12(25):3953.

https://doi.org/10.3748/wjg.v12.i25.3953

(5) Chang, W. K., Peng, C. L., Chen, Y. W., Sun, C. K., Chen, C. C., Liu, T. C., ... & Chiu, C.

T. (2023). Recommendations and guidelines for endoscope reprocessing: Current position

statement of digestive endoscopic society of Taiwan. Journal of Microbiology, Immunology

and Infection. https://doi.org/10.1016/j.jmii.2023.12.001

(6) Oh, H. J., & Kim, J. S. (2015). Clinical practice guidelines for endoscope reprocessing.

Clinical endoscopy, 48(5), 364-368. http://dx.doi.org/10.5946/ce.2015.48.5.364.

(7) ISO. (2021). ISO 15883-5:2021, Washer-disinfectors — Part 5: Performance requirements

and test method criteria for demonstrating cleaning efficacy

https://www.iso.org/obp/ui/#iso:std:iso:15883:-5:ed-1:v1:en

(8) SF2H (2022) Guide de bonnes pratiques de traitement des dispositifs médicaux réutilisables.

Hygiènes. 2022 ; XXX (5).

(9) Day LW, Kwok K, Visrodia K, Petersen BT (2021) American Society for Gastrointestinal

Endoscopy Infection Control Summit: updates, challenges, and the future of infection

control in GI endoscopy. Gastrointest Endosc 93(1):1-10.

https://doi.org/10.1016/j.gie.2020.06.024

(10) Ministère des affaires sociales et de la sante. (2013). Guide technique traitement des

endoscopes souples thermosensibles à canaux.

sante.gouv.fr/IMG/pdf/dgos_traitement_endoscopes.pdf

(11) Bharti B, Li H, Ren Z, Zhu R, Zhu Z (2022) Recent advances in sterilization and

disinfection technology: A review. Chemosphere 308:136404.

https://doi.org/10.1016/j.chemosphere.2022.136404

(12) Wilson GM (2019) Environmental and pharmaceutical risk factors for the transmission of

Clostridium difficile and other multidrug resistant hospital acquired infections. Dissertation,

University of Iowa. https://doi.org/10.17077/etd.cp4w-j0zs

(13) Maillard JY, Centeleghe I (2023) How biofilm changes our understanding of cleaning and

disinfection. Antimicrob Resist Infect Control 12(1):95. https://doi.org/10.1186/s13756-023-

-4

(14) Cottarelli A, De Giusti M, Solimini AG, Venuto G, Palazzo C, Del Cimmuto A, et al.

(2020) Microbiological surveillance of endoscopes and implications for current reprocessing

procedures adopted by an Italian teaching hospital. Ann Ig 32(2).

https://doi.org/10.7416/ai.2020.2340

(15) Bédard E, Prévost M, Déziel E (2016) Pseudomonas aeruginosa in premise plumbing of

large buildings. Microbiol Open 5(6) : 937-956. https://doi.org/10.1002/mbo3.391

(16) Ofstead, C. L., Wetzler, H. P., Snyder, A. K., & Horton, R. A. (2010). Endoscope

reprocessing methods: a prospective study on the impact of human factors and automation.

Gastroenterology Nursing, 33(4), 304-311.

(17) Forte L, Shum C (2011) Comparative cost-efficiency of the EVOTECH endoscope

cleaner and reprocessor versus manual cleaning plus automated endoscope reprocessing in a

real-world Canadian hospital endoscopy setting. BMC Gastroenterol 11:105.

https://doi.org/10.1186/1471-230x-11-105

(18) Hervé RC, Kong MG, Bhatt S, Chen HL, Comoy EE, Deslys JP, et al. (2023) Evaluation

of cold atmospheric plasma for the decontamination of flexible endoscopes. J Hosp Infect

:100-109. https://doi.org/10.1016/j.jhin.2023.03.013

Additional Files

Published

2025-05-01

Issue

Section

Original articles

Categories