Contamination Rates in Duodenoscopes Reprocessed Using Enhanced Surveillance and Reprocessing Techniques: A Systematic Review and Meta-Analysis

Shivanand Bomman; Munish Ashat; Navroop Nagra; Mahendran Jayaraj; Shruti Chandra; Richard A. Kozarek; Andrew Ross; Rajesh Krishnamoorthi

doi:10.5946/ce.2021.212

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Contamination Rates in Duodenoscopes Reprocessed Using Enhanced Surveillance and Reprocessing Techniques: A Systematic Review and Meta-Analysis

Journal article

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Contamination Rates in Duodenoscopes Reprocessed Using Enhanced Surveillance and Reprocessing Techniques: A Systematic Review and Meta-Analysis

Shivanand Bomman, Munish Ashat, Navroop Nagra, Mahendran Jayaraj, Shruti Chandra, Richard A. Kozarek, Andrew Ross and Rajesh Krishnamoorthi

Clinical endoscopy, Vol.55(1), pp.33-40

01/01/2022

DOI: 10.5946/ce.2021.212

PMCID: PMC8831410

PMID: 34974676

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Abstract

Background/Aims: Multiple outbreaks of multidrug-resistant organisms have been reported worldwide due to contaminated duodenoscopes. In 2015, the United States Food and Drug Administration recommended the following supplemental enhanced surveillance and reprocessing techniques (ESRT) to improve duodenoscope disinfection: 1. microbiological culture, 2. ethylene oxide sterilization, 3. liquid chemical sterilant processing system, and 4. double high-level disinfection. A systematic review and meta-analysis was performed to assess the impact of ESRT on the contamination rates. Methods: A thorough and systematic search was performed across several databases and conference proceedings from inception until January 2021, and all studies reporting the effectiveness of various ESRIs were identified. The pooled contamination rates of post-ESRT duodenoscopes were estimated using the random effects model. Results: A total of seven studies using various ESRTs were incorporated in the analysis, which included a total of 9,084 post-ESRT duodenoscope cultures. The pooled contamination rate of the post-ESRT duodenoscope was 5% (95% confidence interval [CI]: 2.3%-10.8%, inconsistency index [F]=97.97%). Pooled contamination rates for high-risk organisms were 0.8% (95% CI: 0.2%-2.7%, I-2 =94.96). Conclusions: While ESRT may improve the disinfection process, a post-ESRT contamination rate of 5% is not negligible. Ongoing efforts to mitigate the rate of contamination by improving disinfection techniques and innovations in duodenoscope design to improve safety are warranted.

Gastroenterology & Hepatology

Life Sciences & Biomedicine

Science & Technology

Details

Title: Subtitle: Contamination Rates in Duodenoscopes Reprocessed Using Enhanced Surveillance and Reprocessing Techniques: A Systematic Review and Meta-Analysis
Creators: Shivanand Bomman - Virginia Mason Medical Center
Munish Ashat - Indiana University Health
Navroop Nagra - Virginia Mason Medical Center
Mahendran Jayaraj - University of Nevada, Las Vegas
Shruti Chandra - Mayo Clinic in Arizona
Richard A. Kozarek - Virginia Mason Medical Center
Andrew Ross - Virginia Mason Medical Center
Rajesh Krishnamoorthi - Virginia Mason Medical Center
Resource Type: Journal article
Publication Details: Clinical endoscopy, Vol.55(1), pp.33-40
DOI: 10.5946/ce.2021.212
PMID: 34974676
PMCID: PMC8831410
NLM abbreviation: Clin Endosc
ISSN: 2234-2400
eISSN: 2234-2443
Publisher: Korean Soc Gastrointestinal Endoscopy
Number of pages: 8
Language: English
Date published: 01/01/2022
Academic Unit: Internal Medicine
Record Identifier: 9984359772002771

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