Skip to main content
SpringerLink
Log in

Endoscopes and Other Special Equipment

  • Chapter
  • First Online:
Prevention and Control of Infections in Hospitals

  • 4753 Accesses

Abstract

Endoscopic procedures are increasingly used in medicine both diagnostic and therapeutic. Complications and infections are rare, 1 per 1.8 million procedures, but there are no other instruments that are associated with as many infections as endoscopes. This is due to lack of routines, not following routines or lack of competence. An analysis of published exogenous endoscopy-related infections, pseudo-infections and toxic reactions between 1974 and 2004 showed 140 outbreaks where more than 94% of the cases could be prevented by improved decontamination of instruments. Endoscopes are often very complex composed equipment that is difficult to sterilize. They may have combined parts that can be sterilized (high hygienic level) and parts that may only be disinfected (lower hygienic level). In addition, scopes may often have long, narrow lumens, are flexible and may be difficult to clean for organic materials. Still there may be great problems concerning certain endoscopes and other equipment that are difficult to decontaminate. The following chapter is focused on practical measures to disinfect, sterilize and control endoscopes and other special equipment in healthcare institutions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rutala WA, Weber DJ. Disinfection, sterilization, and control of hospital waste. In: Mandell, Douglas, and Bennets principles and practice of infectious diseases. 8th ed. vol. 2. Philadelphia: Elsevier Churchill Livingstone; 2015. p. 3294–309.

    Chapter  Google Scholar 

  2. Petersen BT, Chennat J, Cohen J, et al. Multisociety guideline on reprocessing flexible GI endoscopes: 2011. ASGE-SHEA guideline. Infect Control Hosp Epidemiol. 2011;32:527–37.

    Article  Google Scholar 

  3. Røed RT, Gullord TP, Norman BIS, Andersen BM. Flexible endoscope. Prevention of infections, 2002. Oslo: Occupational Committee, Division for Infection Control, Health Region East and Ullevål University Hospital; 2002.

    Google Scholar 

  4. CDC. Disinfection of healthcare equipment. Concerns about implementing the Spaulding scheme. In: Guideline for disinfection and sterilization in healthcare facilities, 2008; 2009.

    Google Scholar 

  5. Greub G, Raoult D. Biocides currently used for bronchoscope decontamination are poorly effective against free-living amoebae. Infect Control Hosp Epidemiol. 2003;24:784–6.

    Article  Google Scholar 

  6. Kressel AB, Kidd F. Pseudo-outbreak of Mycobacterium chelonae and Methylobacterium mesophilicum caused by contamination of an automated endoscopy washer. Infect Control Hosp Epidemiol. 2001;22:414–8.

    Article  CAS  Google Scholar 

  7. Davidson WM, Pitts B, Stewart PS. Spatial and temporal patterns of biocidal action against Staphylococcus epidermidis biofilms. Antimicrob Agents Chemother. 2010;54:2920–7.

    Article  Google Scholar 

  8. Marion K, Freney J, James G, et al. Using an efficient biofilm detaching agent: an essential step for the improvement of endoscope reprocessing protocols. J Hosp Infect. 2006;64:136–42.

    Article  CAS  Google Scholar 

  9. CDC. Interim duodenoscope surveillance protocol. Interim protocol for healthcare facilities regarding surveillance for bacterial contamination of duodenoscopes after reprocessing. CDC; 2015.

    Google Scholar 

  10. Meyer GW, Salzman JR, Travis AC. Endoscope disinfection. UpToDate; 2015.

    Google Scholar 

  11. Zuhlsdorf B, Floss H, Martiny H. Efficacy of 10 different cleaning processes in a washer disinfector for flexible endoscopes. J Hosp Infect. 2004;56:305–11.

    Article  CAS  Google Scholar 

  12. Marek A, Smith A, Peat M, et al. Endoscopy supply water and final rinse testing: five years of experience. J Hosp Infect. 2014;88:207–12.

    Article  CAS  Google Scholar 

  13. Working party report. Rinse water for heat labile endoscopy equipment. J Hosp Infect. 2002;51:7–16.

    Article  Google Scholar 

  14. Sorin M, Segal-Maurer S, Mariano N, et al. Nosocomial transmission or imipenem-resistant Pseudomonas aeruginosa following bronchoscopy associated with improper connection to the Steris system 1 processor. Infect Control Hosp Epidemiol. 2001;22:409–13.

    Article  CAS  Google Scholar 

  15. Weber DJ, Rutala WA. Lessons from outbreaks associated with bronchoscopy. Infect Control Hosp Epidemiol. 2001;22:403–8.

    Article  CAS  Google Scholar 

  16. MacKay WG, Leanord AT, Williams CL. Water, water everywhere nor any a sterile drop to rinse your endoscope. J Hosp Infect. 2002;51:256–61.

    Article  CAS  Google Scholar 

  17. Saviuc P, Picot-Gueraud R, Sing JSC, et al. Evaluation of the quality of reprocessing of gastro-intestinal endoscopes. Infect Control Hosp Epidemiol. 2015;36:1017–23.

    Article  Google Scholar 

  18. Wendorf KA, Meagan K, Baliga C, et al. Endoscopic retrograde cholangiopancreatography-associated AmpC Escherichia coli outbreak. Infect Control Hosp Epidemiol. 2015;36:634–42.

    Article  Google Scholar 

  19. Seoane-Vazquez E, Rodriguez-Mongiuio R, Visaria J, Carlson A. Endoscopy-related infections and toxic reactions: an international comparison. Endoscopy. 2007;39:742–78.

    Article  CAS  Google Scholar 

  20. La Scola B, Rolain JM, Maurin M, Raoult D. Can Whipple’s disease be transmitted by gastroscopes? Infect Control Hosp Epidemiol. 2003;24:191–4.

    Article  Google Scholar 

  21. Akamatsu T, Tabata K, Hironaga M, Uyeda M. Evaluation of the efficacy of a 3.2% glutaraldehyde product for disinfection of fibreoptic endoscopes with an automated machine. J Hosp Infect. 1997;35:47–57.

    Article  CAS  Google Scholar 

  22. Meester HHM, van Loenen AC, de Goede PNFC, Koeleman JGM. Glutaraldehyde: current status and uses. Infect Control Hosp Epidemiol. 1995;16:621–2.

    Article  CAS  Google Scholar 

  23. Wendt C, Kampf B. Evidence-based spectrum of antimicrobial activity for disinfection of bronchoscopes. J Hosp Infect. 2008;70:60–80.

    Article  Google Scholar 

  24. Bou R, Aguilar A, Perpinan J, et al. Nosocomial outbreak of Pseudomonas aeruginosa infections related to a flexible bronchoscope. J Hosp Infect. 2006;64:129–35.

    Article  CAS  Google Scholar 

  25. Silvis SE, Nebel O, Rogers G, et al. Endoscopic complications: results of the 1974 American Society for Gastrointestinal Endoscopy Surgery. JAMA. 1976;235:928–30.

    Article  CAS  Google Scholar 

  26. Kaczmarek RG, Moore RM, McCrohan J, et al. Multistate investigation of the actual disinfection/sterilization of endoscopes in healthcare facilities. Am J Infect Control. 1993;21:75.

    Google Scholar 

  27. Paula H, Presteri E, Tribl B, Diab-Elshahawi M. Microbial surveillance of duodenoscope reprocessing at the Vienna University Hospital from November 2004 through March 2015. Infect Control Hosp Epidemiol. 2015;36:1233–5.

    Article  Google Scholar 

  28. Colin-Jones DG, Cockel R, Schiller KF. Current endoscopic practice in the United Kingdom. Clin Gastroenterol. 1978;7:775–86.

    CAS  PubMed  Google Scholar 

  29. Bilbao MK, Dotter CT, Lee TG. Complications of endoscopic retrograde cholangiopancreatography (ERCP). A study of 10,000 cases. Gastroenterology. 1976;70:314–20.

    CAS  PubMed  Google Scholar 

  30. Alfa MJ, Olson N, DeGagne P, Jackson M. A survey of reprocessing methods, residual viable bioburden, and soil levels in patient-ready endoscopic retrograde cholangiopancreatography duodenoscopes used in Canadian centers. Infect Control Hosp Epidemiol. 2002;23:198–206.

    Article  Google Scholar 

  31. Promed Mail March 4, 2015. Antibiotic-resistant Enterobacteriaceae—USA. (California, Connecticut) ERCP endoscopes.

    Google Scholar 

  32. Bronowicki JP, Botte C, Monhoven N, et al. Patient-to-patient transmission or hepatitis C virus during colonoscopy. N Engl J Med. 1997;337:237–40.

    Article  CAS  Google Scholar 

  33. Hutfless S. Infection rates after colonoscopy, endoscopy at ASCs are far higher than expected. John Hopkins Medicine. Infection control today. 2018.

    Google Scholar 

  34. Ofstead CL, Heyman OL, Quick MR, Eiland JE, Wetzler H. Residual moisture and waterborne pathogens inside flexible scopes: evidence from a multisite study of endoscope drying effectiveness. Am J Infect Control. 2018;46(6):689–96.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Hospital Infections, Oslo University Hospital, Oslo, Norway

    Bjørg Marit Andersen

  2. Faculty of Health and Social Science, University of South-Eastern Norway, Oslo, Norway

    Bjørg Marit Andersen

Authors
  1. Bjørg Marit Andersen
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Andersen, B.M. (2019). Endoscopes and Other Special Equipment. In: Prevention and Control of Infections in Hospitals. Springer, Cham. https://doi.org/10.1007/978-3-319-99921-0_60

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-99921-0_60

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-99920-3

  • Online ISBN: 978-3-319-99921-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation