Recent advances in epidemiology and prevention of gastrointestinal endoscopy related infections.
OBJECTIVE
This article reviews recent publications relevant to endoscope reprocessing and the potential for transmission of infection during gastrointestinal endoscopy.


RESULTS
There have been a number of established reprocessing failures of gastrointestinal endoscopes at various healthcare facilities across the US resulting in patient notifications. These episodes have been associated with user errors and reprocessing equipment failures, highlighting the need for increased compliance with established guidelines. Surveillance cultures may be useful to monitor the outcome of reprocessing, although their use is controversial. New technology to allow point-of-use monitoring is promising. Biofilm accumulation may be an issue when reprocessing gastrointestinal endoscopes. Although peracetic acid has been promoted as superior to aldehyde-type liquid chemical germicides with regard to soil fixation, it may only be a modest improvement. Electrolyzed acid water is an emerging liquid chemical germicide that may be equivalent to currently accepted disinfectants. There appears to be no benefit to an additional reprocessing cycle before use for endoscopes that have been appropriately cleaned, disinfected, and stored.


CONCLUSIONS
With the recent media attention on gastrointestinal endoscope reprocessing failures, despite the absence of documented transmission of infection, increased compliance with existing guidelines and new initiatives to enhance endoscope reprocessing are increasingly important to maintain public confidence.
Minneapolis VA Medical Center, University of Minnesota, Minneapolis, Minnesota, USA. douglas.nelson@med.va.gov
Douglas B
DB
Nelson
D018441:Biofilms; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control*; D004202:Disinfectants / Q000494:pharmacology; D004203:Disinfection; D020776:Endoscopes, Gastrointestinal / Q000382:microbiology*; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D004866:Equipment Contamination / Q000517:prevention & control; D017743:Equipment Reuse / Q000592:standards*; D006801:Humans; D017053:Infection Control
D004202:Disinfectants