A randomized trial of single versus double high-level disinfection of duodenoscopes and linear echoendoscopes using standard automated reprocessing

Gastrointestinal Endoscopy
Rebecca L BartlesJack J Brandabur

Abstract

In a pilot study, we demonstrated that current guidelines for duodenoscope and linear echoendoscope (DLE) reprocessing using a single cycle of high-level disinfection (HLD) in an automated reprocessor may be inadequate. In August 2015, the U.S. Food and Drug Administration offered double HLD as a possible response to address this concern. As a result, Providence Health and Services adopted double HLD as standard procedure for DLEs, but no rigorous clinical studies supported this practice. We undertook a quality improvement study to compare single HLD versus double HLD at 4 of our 34 hospitals. HLD of DLE was randomized, separately in each facility, to either single HLD or double HLD on weekdays, with standard double HLD on weekends or holidays. There was 99.7% compliance with the randomization scheme. Daily qualitative surveillance cultures of dried, post-HLD DLEs were collected for 6 months (1 swab sample from the elevator mechanism and 1 combined brush sample from the suction and working channels for each encounter), and each sample was incubated for 48 hours. Positivity rates of any microbial growth and growth of high-concern pathogens (potentially pathogenic enteric flora) were compared between the 2 study arms. Altogether,...Continue Reading

Citations

Mar 19, 2020·Biomedical Instrumentation & Technology·Cori L Ofstead, Krystina M Hopkins
Dec 21, 2018·Digestive Diseases and Sciences·M Rubayat RahmanHemant Goyal
Dec 4, 2020·Endoscopy International Open·Cori L OfsteadDavid R Lichtenstein
Sep 7, 2020·Gastrointestinal Endoscopy Clinics of North America·Jennifer T Higa, Andrew S Ross
Sep 7, 2020·Gastrointestinal Endoscopy Clinics of North America·Neil B Marya, Raman V Muthusamy
Sep 7, 2020·Gastrointestinal Endoscopy Clinics of North America·Monique T Barakat, Subhas Banerjee
Mar 14, 2021·Gastrointestinal Endoscopy·Arvind J TrindadeDavid R Lichtenstein
Mar 21, 2021·Gastrointestinal Endoscopy·Sushrut Sujan Thiruvengadam, V Raman Muthusamy
Oct 27, 2020·Techniques and Innovations in Gastrointestinal Endoscopy·Tiffany ChuaSofiya Reicher
Aug 8, 2021·Infectious Disease Clinics of North America·William A Rutala, David J Weber
Dec 24, 2020·Gastrointestinal Endoscopy·Lukejohn W DaySachin Wani
Sep 7, 2021·Gastrointestinal Endoscopy·Mark A Gromski, Stuart Sherman
Nov 18, 2018·American Journal of Infection Control·Vanessa Molloy-SimardBradley J Catalone

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