Heroux Riley, Sheppard Michelle, Wright Sharon B, Sawhney Mandeep, Hirsch Elizabeth B, Kalaidjian Robin, Snyder Graham M
Beth Israel Deaconess Medical Center, Boston, MA.
Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA.
Am J Infect Control. 2017 Apr 1;45(4):360-364. doi: 10.1016/j.ajic.2016.11.021. Epub 2016 Dec 26.
Current professional guidelines recommend a maximum hang time for reprocessed duodenoscopes of 5-14 days. We sought to study the association between hang time and risk of duodenoscope contamination.
We analyzed cultures of the elevator mechanism and working channel collected in a highly standardized fashion just before duodenoscope use. Hang time was calculated as the time from reprocessing to duodenoscope sampling. The relationship between hang time and duodenoscope contamination was estimated using a calculated correlation coefficient between hang time in days and degree of contamination on the elevator mechanism and working channel.
The 18 study duodenoscopes were cultured 531 times, including 465 (87.6%) in the analysis dataset. Hang time ranged from 0.07-39.93 days, including 34 (7.3%) with hang time ≥7.00 days. Twelve cultures (2.6%) demonstrated elevator mechanism and/or working channel contamination. The correlation coefficients for hang time and degree of duodenoscope contamination were very small and not statistically significant (-0.0090 [P = .85] for elevator mechanism and -0.0002 [P = 1.00] for working channel). Odds ratios for hang time (dichotomized at ≥7.00 days) and elevator mechanism and/or working channel contamination were not significant.
We did not find a significant association between hang time and risk of duodenoscope contamination. Future guidelines should consider a recommendation of no limit for hang time.
当前的专业指南建议，重新处理后的十二指肠镜最长悬挂时间为5 - 14天。我们试图研究悬挂时间与十二指肠镜污染风险之间的关联。
我们分析了在十二指肠镜使用前以高度标准化方式采集的升降机构和工作通道的培养物。悬挂时间计算为从重新处理到十二指肠镜采样的时间。使用计算出的以天数表示的悬挂时间与升降机构和工作通道污染程度之间的相关系数，来估计悬挂时间与十二指肠镜污染之间的关系。
18台研究用十二指肠镜共培养了531次，其中465次（87.6%）纳入分析数据集。悬挂时间范围为0.07 - 39.93天，其中34次（7.3%）悬挂时间≥7.00天。12次培养（2.6%）显示升降机构和/或工作通道有污染。悬挂时间与十二指肠镜污染程度的相关系数非常小，且无统计学意义（升降机构为-0.0090 [P = 0.85]，工作通道为-0.0002 [P = 1.00]）。悬挂时间（以≥7.00天为界进行二分法划分）与升降机构和/或工作通道污染的优势比不显著。
我们未发现悬挂时间与十二指肠镜污染风险之间存在显著关联。未来的指南应考虑建议对悬挂时间不设限制。
