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对意大利南部某移植医院内镜的微生物监测:2016 年至 2019 年的回顾性研究。

Microbiological Surveillance of Endoscopes in a Southern Italian Transplantation Hospital: A Retrospective Study from 2016 to 2019.

机构信息

Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), 90127 Palermo, Italy.

Fondazione Ri.MED, 90127 Palermo, Italy.

出版信息

Int J Environ Res Public Health. 2021 Mar 16;18(6):3057. doi: 10.3390/ijerph18063057.

Abstract

Endoscopes are medical instruments that are used routinely in health structures. Due to their invasive nature and contact with many patients, they may cause hospital-acquired infections if not disinfected correctly. To ensure a high-level disinfection procedure or reprocessing, since the methods currently adopted in our institute are adequate, we evaluated retrospectively the presence of microorganisms in our endoscopes after reprocessing. Microbiological surveillance was performed from January 2016 to December 2019 in the instruments in use in our endoscopic room after reprocessing. In total, 35 endoscopes (3 duodenoscopes, 3 echoendoscopes, 12 bronchoscopes, 5 colonoscopes, and 12 gastroscopes) were evaluated for the presence of microorganisms, including multidrug-resistant pathogens and indicator microorganisms (IMOs). Our procedures were in agreement with an internal protocol based on Italian, international, and the Center for Disease Control and Prevention (CDC) recommendations. Of a total of 811 samples, 799 (98.5%) complied with the regulatory guidelines, while 9 (1.1%) were positive for IMOs, and 3 (0.4%) displayed more than 10 colony-forming units (CFU) of environmental and commensal pathogens. Our results show that the internal reprocessing protocol is very efficient, leading to a very low number of observed contaminations, and it could be easily implemented by other health facilities that face a huge number of hospital-acquired infections due to incorrectly disinfected endoscopes.

摘要

内窥镜是在医疗机构中常规使用的医疗器械。由于其具有侵袭性且与许多患者接触,如果不正确消毒,可能会导致医院获得性感染。为了确保高水平消毒程序或再处理,由于我们研究所目前采用的方法是充分的,我们回顾性地评估了再处理后内窥镜中微生物的存在。从 2016 年 1 月至 2019 年 12 月,对我们内镜室再处理后的仪器中使用的微生物进行了微生物监测。共评估了 35 个内窥镜(3 个十二指肠镜、3 个超声内镜、12 个支气管镜、5 个结肠镜和 12 个胃镜)是否存在微生物,包括多药耐药病原体和指示微生物(IMOs)。我们的程序符合基于意大利、国际和疾病控制与预防中心(CDC)建议的内部协议。在总共 811 个样本中,799 个(98.5%)符合监管指南,而 9 个(1.1%)IMO 呈阳性,3 个(0.4%)显示出超过 10 个环境和共生病原体的菌落形成单位(CFU)。我们的结果表明,内部再处理方案非常有效,导致观察到的污染数量非常低,并且其他面临因不正确消毒内窥镜而导致大量医院获得性感染的卫生机构可以轻松实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6076/8002344/42f179073c52/ijerph-18-03057-g0A1.jpg

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