title: Monitoring of endoscope reprocessing with an adenosine triphosphate (ATP) bioluminescence method.
abstract: Background:The arising challenges over endoscope reprocessing quality proposes to look for possibilities to measure and control the process of endoscope reprocessing.Aim:The goal of this study was to evaluate the feasibility of monitoring endoscope reprocessing with an adenosine triphosphate (ATP) based bioluminescence system.Methods:60 samples of eight gastroscopes have been assessed from routine clinical use in a major university hospital in Germany. Endoscopes have been assessed with an ATP system and microbial cultures at different timepoints during the reprocessing.Findings:After the bedside flush the mean ATP level in relative light units (RLU) was 19,437 RLU, after the manual cleaning 667 RLU and after the automated endoscope reprocessor (AER) 227 RLU. After the manual cleaning the mean total viable count (TVC) per endoscope was 15.3 CFU/10 ml, and after the AER 5.7 CFU/10 ml. Our results show that there are reprocessing cycles which are not able to clean a patient used endoscope.Conclusion:Our data suggest that monitoring of flexible endoscope with ATP can identify a number of different influence factors, like the endoscope condition and the endoscopic procedure, or especially the quality of the bedside flush and manual cleaning before the AER. More process control is one option to identify and improve influence factors to finally increase the overall reprocessing quality, best of all by different methods. ATP measurement seems to be a valid technique that allows an immediate repeat of the manual cleaning if the ATP results after manual cleaning exceed the established cutoff of 200 RLU.
authors.affiliation: HyKoMed GmbH, Dortmund, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Parohl
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Essen, Germany.
authors.forename: Doris
authors.initials: D
authors.lastname: Stiefenhöfer
authors.affiliation: 3M Deutschland GmbH, Neuss, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Heiligtag
authors.affiliation: 3M Deutschland GmbH, Neuss, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Reuter
authors.affiliation: Department of Hospital Hygiene, University Hospital Essen, Germany.
authors.forename: Dana
authors.initials: D
authors.lastname: Dopadlik
authors.affiliation: Department of Clinical Microbiology, University Hospital Essen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Mosel
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Essen, Germany.
authors.forename: Guido
authors.initials: G
authors.lastname: Gerken
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Essen, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Dechêne
authors.affiliation: Department of Clinical Microbiology, University Hospital Essen, Germany.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Heintschel von Heinegg
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Essen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Jochum
authors.affiliation: Department of Clinical Microbiology, University Hospital Essen, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Buer
authors.affiliation: HyKoMed, Dortmund, Germany.
authors.forename: Walter
authors.initials: W
authors.lastname: Popp
keywords: ATP; adenosine triphosphate; contamination; endoscope reprocessing; microbial cultures; process control; surveillance