title: Practical toolkit for monitoring endoscope reprocessing effectiveness: Identification of viable bacteria on gastroscopes, colonoscopes, and bronchoscopes.
abstract: Experts have recommended microbiologic surveillance by external reference laboratories for certain flexible endoscopes. There is currently insufficient evidence on the feasibility and utility of cultures. Researchers evaluated a preassembled toolkit for collecting and processing samples from endoscopes.
  
  
  
  A pilot study was performed in a large academic medical center. A toolkit was used to aseptically sample biopsy ports and suction/biopsy channels of 5 gastroscopes, 5 colonoscopes, and 5 bronchoscopes after full reprocessing. Blinded specimens were packaged and transported on icepacks to a reference laboratory that used standard methodologies for microbial cultures.
  
  
  
  The laboratory detected bacteria in samples from 60% of patient-ready endoscopes, including gram-positive and gram-negative species. Viable microbes (<10 CFU) were recovered from 2 gastroscopes, 3 colonoscopes, and 4 bronchoscopes. Stenotrophomonas maltophilia and Delftia acidovorans were recovered from all 3 endoscope types. Subsequent environmental testing detected S maltophilia in the reprocessing rinse water.
  
  
  
  A preassembled toolkit facilitated the aseptic collection of samples for culturing by a reference laboratory that detected viable microbes on fully reprocessed endoscopes. Speciation allowed identification of potential pathogens and a possible common contamination source, demonstrating that microbial cultures may have value even when colony counts are low.
authors.affiliation: Ofstead & Associates, Inc, St Paul, MN.
authors.forename: Cori L
authors.initials: CL
authors.lastname: Ofstead
authors.affiliation: Ofstead & Associates, Inc, St Paul, MN.
authors.forename: Evan M
authors.initials: EM
authors.lastname: Doyle
authors.affiliation: Ofstead & Associates, Inc, St Paul, MN.
authors.forename: John E
authors.initials: JE
authors.lastname: Eiland
authors.affiliation: Ofstead & Associates, Inc, St Paul, MN.
authors.forename: Miriam R
authors.initials: MR
authors.lastname: Amelang
authors.affiliation: Ofstead & Associates, Inc, St Paul, MN.
authors.forename: Harry P
authors.initials: HP
authors.lastname: Wetzler
authors.affiliation: Department of Infection Prevention, University of Minnesota Health, Minneapolis, MN.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: England
authors.affiliation: Department of Clinical Quality Improvement, University of Minnesota Health, Minneapolis, MN.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Mascotti
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Shaw
mesh_terms: D000046:Academic Medical Centers; D001419:Bacteria / Q000302:isolation & purification*; D001431:Bacteriological Techniques; D020680:Bronchoscopes / Q000382:microbiology*; D020685:Colonoscopes / Q000382:microbiology*; D017743:Equipment Reuse; D020699:Gastroscopes / Q000382:microbiology*; D010865:Pilot Projects; D013242:Sterilization / Q000379:methods*
keywords: High-level disinfection; Microbial cultures; Stenotrophomonas maltophilia