Department of Gastroenterology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 University Street, 700115 Iași, Romania.
Centre of Advanced Research in Bionanoconjugates and Biopolymers (IntelCentru), ''Petru Poni'' Institute of Macromolecular Chemistry, 41A Grigore Ghica Vodă Alley, 700487 Iași, Romania.
Molecules. 2019 Jun 25;24(12):2343. doi: 10.3390/molecules24122343.
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.
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.
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.
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.
十二指肠镜广泛应用于诊断和治疗性内镜逆行胰胆管造影（ERCP），但最近报道了多药耐药菌（MDRO）感染的大量暴发，这促使人们对其可能的原因进行了广泛的研究。因此，本研究旨在寻找可能导致十二指肠镜表面损伤的原因，这种损伤可能为感染提供替代的、合理的来源。
为了评估外表面和内表面，对十二指肠镜进行了拆卸，并从外树脂聚合物和空气/水、提升器和工作（活检）通道中取样，采用傅里叶变换红外光谱（FTIR）、差示扫描量热法（DSC）、热重分析（TGA）、原子力显微镜（AFM）、扫描电子显微镜（SEM）等技术对其进行了表征，并测试了其抗菌活性。
在涂层和工作通道聚合物上都观察到了变化，从近端样本到靠近镜尖端的远端样本，外部变化逐渐增加。然而，结果表明，涂层表面仍然能够有效地抵抗细菌黏附。显示出表面纹理的变化和形态变化。
本研究描述了常规程序使用和再处理周期对十二指肠镜的影响，表明由于改变后的表面难以进行再处理，这些因素可能使其易受细菌污染和 MDRO 生物膜形成的影响。
