Tunuguntla Anuradha, Sullivan Michael J
East Tennessee State University, Johnson City, USA.
Tenn Med. 2004 Oct;97(10):453-6.
The purpose of this study is to assess the adequacy of currently approved high-level disinfection (HLD) for flexible endoscopes, by reviewing retrospectively the results of environmental cultures on the endoscopes, which were ready to use.
Cultures of all of our gastrointestinal endoscopes that were ready for use were sent to the laboratory for environmental cultures. Thirty milliliters of sterile water was passed through the biopsy channel of the endoscopes and the flushed water was collected in a sterile container. The specimen was plated onto blood agar, incubated at 37C, and examined for growth at 24 and 48 hours.
Cultures were positive during the initial part of the study repeatedly with the same organism; the source of contamination was traced to be the source water and scope cleaner, after they were suspected and sent for cultures. In addition to Pseudomonas, there was contamination of the endoscopes with Micrococcus and Staphylococcus during the study period.
Using environmental cultures for monitoring effectiveness of standard reprocessing procedures on a regular basis in clinical practice is not only inexpensive but also valuable to identify the source of possible contamination and rectify reprocessing methods to prevent transmission of infection secondary to endoscopy.
本研究的目的是通过回顾性分析准备投入使用的软性内镜的环境培养结果,评估当前批准的软性内镜高水平消毒(HLD)的充分性。
将所有准备投入使用的胃肠内镜送去实验室进行环境培养。30毫升无菌水通过内镜的活检通道,冲洗后的水收集在无菌容器中。将标本接种于血琼脂平板,在37℃下孵育,并在24小时和48小时检查有无生长。
在研究初期,培养多次呈阳性,且为同一微生物;在怀疑并送去培养后,污染源追溯到水源和内镜清洁剂。在研究期间,除了假单胞菌外,内镜还受到微球菌和葡萄球菌的污染。
在临床实践中定期使用环境培养来监测标准再处理程序的有效性,不仅成本低廉而且对于识别可能的污染源和纠正再处理方法以防止内镜检查继发感染传播具有重要价值。