title: Analysis of the air/water channels of gastrointestinal endoscopies as a risk factor for the transmission of microorganisms among patients.
abstract: BACKGROUND
  For the effective reprocessing of gastrointestinal endoscopes, contaminants must be removed from the entire surface. However, these devices have long and narrow channels that can make this process difficult.
  
  
  METHODS
  In this cross-sectional study, the staff assigned to reprocess gastroscopes and colonoscopes in 37 services located throughout Brazil completed a questionnaire regarding reprocessing practices geared toward the channels in these devices. In addition, samples from these air/water channels were collected for microbiological analysis.
  
  
  RESULTS
  Contamination was detected in 71.8% (28/39) of the samples obtained from the air/water channels of colonoscopes, and in 70% (42/60) of the samples from the air/water channels of gastroscopes. The median microbial load was 1,800 colony-forming units (CFU)/mL in the colonoscopes and 750 CFU/mL in the gastroscopes. The main microorganisms isolated from the air/water channels of gastroscopes were Pseudomonas aeruginosa (26.4%), Escherichia coli (18.9%), and Acinetobacter baumannii (9.4%), and those isolated from the colonoscopes included P aeruginosa (46.4%), A baumannii (14.3%), and Klebsiella pneumoniae (10.7%), among others. The possible causes of the contamination of these devices included the failure to fill these channels with cleaning solution, lack of friction during cleansing, and inadequate rinsing.
  
  
  CONCLUSIONS
  The contamination of the air/water channels did in fact represent a risk for the transmission of microorganisms during gastrointestinal endoscopy exams, possibly related to the inadequate reprocessing of these channels.
authors.affiliation: Service of Epidemiology and Safety Assistance, Hospital Unimed, Belo Horizonte, Minas Gerais, Brazil. mairamarquesribeiro@yahoo.com.br
authors.forename: Maíra Marques
authors.initials: MM
authors.lastname: Ribeiro
authors.forename: Adriana Cristina
authors.initials: AC
authors.lastname: de Oliveira
mesh_terms: D000391:Air Microbiology; D001938:Brazil; D015169:Colony Count, Microbial; D003141:Communicable Diseases / Q000382:microbiology / Q000635:transmission*; D003430:Cross-Sectional Studies; D004203:Disinfection / Q000379:methods; D020776:Endoscopes, Gastrointestinal / Q000382:microbiology*; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006801:Humans; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014871:Water Microbiology