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Duodenoscope-Associated Infections beyond the Elevator Channel: Alternative Causes for Difficult Reprocessing

Objectives: Duodenoscopes have been widely used for both diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) procedures, but recently, numerous outbreaks of multidrug-resistant organisms (MDRO) infections have been reported which has led to extensive research for their p...

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Autores principales: Balan, Gheorghe G., Rosca, Irina, Ursu, Elena-Laura, Fifere, Adrian, Varganici, Cristian-Dragos, Doroftei, Florica, Turin-Moleavin, Ioana-Andreea, Sandru, Vasile, Constantinescu, Gabriel, Timofte, Daniel, Stefanescu, Gabriela, Trifan, Anca, Sfarti, Catalin Victor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6631070/
https://www.ncbi.nlm.nih.gov/pubmed/31242689
http://dx.doi.org/10.3390/molecules24122343
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author Balan, Gheorghe G.
Rosca, Irina
Ursu, Elena-Laura
Fifere, Adrian
Varganici, Cristian-Dragos
Doroftei, Florica
Turin-Moleavin, Ioana-Andreea
Sandru, Vasile
Constantinescu, Gabriel
Timofte, Daniel
Stefanescu, Gabriela
Trifan, Anca
Sfarti, Catalin Victor
author_facet Balan, Gheorghe G.
Rosca, Irina
Ursu, Elena-Laura
Fifere, Adrian
Varganici, Cristian-Dragos
Doroftei, Florica
Turin-Moleavin, Ioana-Andreea
Sandru, Vasile
Constantinescu, Gabriel
Timofte, Daniel
Stefanescu, Gabriela
Trifan, Anca
Sfarti, Catalin Victor
author_sort Balan, Gheorghe G.
collection PubMed
description Objectives: Duodenoscopes have been widely used for both diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) procedures, but recently, numerous outbreaks of multidrug-resistant organisms (MDRO) infections have been reported which has led to extensive research for their possible causes. Consequently, the aim of this study is to search for possible duodenoscope surface damages that could provide an alternative and plausible source of infections. Materials and Methods: In order to assess both outer and inner surfaces, a duodenoscope was dismantled and samples were taken from the outer resin polymer and from the air/water, elevator, and working (biopsy) channels that were characterized by FTIR, DSC, TGA, AFM, SEM techniques and the antimicrobial activity were tested. Results: Alterations were noticed on both the coating and working channel polymers, with external alterations increasing progressively from the proximal sample to the distal sample near the tip of the scope. However, the results showed that the coating surface was still efficient against bacterial adhesion. Changes in surface texture and also morphological changes were shown. Conclusions: The study describes the impact of routine procedural use and reprocessing cycles on the duodenoscope, showing that these may possibly make it susceptible to bacterial contamination and MDRO biofilm formation due to difficult reprocessing of the altered surfaces.
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spelling pubmed-66310702019-08-19 Duodenoscope-Associated Infections beyond the Elevator Channel: Alternative Causes for Difficult Reprocessing Balan, Gheorghe G. Rosca, Irina Ursu, Elena-Laura Fifere, Adrian Varganici, Cristian-Dragos Doroftei, Florica Turin-Moleavin, Ioana-Andreea Sandru, Vasile Constantinescu, Gabriel Timofte, Daniel Stefanescu, Gabriela Trifan, Anca Sfarti, Catalin Victor Molecules Article Objectives: Duodenoscopes have been widely used for both diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) procedures, but recently, numerous outbreaks of multidrug-resistant organisms (MDRO) infections have been reported which has led to extensive research for their possible causes. Consequently, the aim of this study is to search for possible duodenoscope surface damages that could provide an alternative and plausible source of infections. Materials and Methods: In order to assess both outer and inner surfaces, a duodenoscope was dismantled and samples were taken from the outer resin polymer and from the air/water, elevator, and working (biopsy) channels that were characterized by FTIR, DSC, TGA, AFM, SEM techniques and the antimicrobial activity were tested. Results: Alterations were noticed on both the coating and working channel polymers, with external alterations increasing progressively from the proximal sample to the distal sample near the tip of the scope. However, the results showed that the coating surface was still efficient against bacterial adhesion. Changes in surface texture and also morphological changes were shown. Conclusions: The study describes the impact of routine procedural use and reprocessing cycles on the duodenoscope, showing that these may possibly make it susceptible to bacterial contamination and MDRO biofilm formation due to difficult reprocessing of the altered surfaces. MDPI 2019-06-25 /pmc/articles/PMC6631070/ /pubmed/31242689 http://dx.doi.org/10.3390/molecules24122343 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Balan, Gheorghe G.
Rosca, Irina
Ursu, Elena-Laura
Fifere, Adrian
Varganici, Cristian-Dragos
Doroftei, Florica
Turin-Moleavin, Ioana-Andreea
Sandru, Vasile
Constantinescu, Gabriel
Timofte, Daniel
Stefanescu, Gabriela
Trifan, Anca
Sfarti, Catalin Victor
Duodenoscope-Associated Infections beyond the Elevator Channel: Alternative Causes for Difficult Reprocessing
title Duodenoscope-Associated Infections beyond the Elevator Channel: Alternative Causes for Difficult Reprocessing
title_full Duodenoscope-Associated Infections beyond the Elevator Channel: Alternative Causes for Difficult Reprocessing
title_fullStr Duodenoscope-Associated Infections beyond the Elevator Channel: Alternative Causes for Difficult Reprocessing
title_full_unstemmed Duodenoscope-Associated Infections beyond the Elevator Channel: Alternative Causes for Difficult Reprocessing
title_short Duodenoscope-Associated Infections beyond the Elevator Channel: Alternative Causes for Difficult Reprocessing
title_sort duodenoscope-associated infections beyond the elevator channel: alternative causes for difficult reprocessing
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6631070/
https://www.ncbi.nlm.nih.gov/pubmed/31242689
http://dx.doi.org/10.3390/molecules24122343
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