Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo Horizonte, MG, Brazil.
Rev Lat Am Enfermagem. 2022 Oct 17;30:e3684. doi: 10.1590/1518-8345.5969.3684. eCollection 2022.
to analyze the cleaning process of gastroscopes, colonoscopes and duodenoscopes in eight in-hospital health services.
a cross-sectional study conducted with 22 endoscopes (eight gastroscopes, eight colonoscopes and six duodenoscopes), and microbiological analysis of 60 samples of air/water channels (all endoscopes) and elevator (duodenoscopes), in addition to protein testing. Descriptive statistics with calculation of frequencies and central tendency measures was used in data analysis.
the processing of 22 endoscopes was monitored with microbiological analysis for 60 channels. In the pre-cleaning procedure, in 82.3% (14/17) of the devices, gauze was used in cleaning the insertion tube. Incomplete immersion of the endoscope in detergent solution occurred in 72.3% (17/22) of the cases, and in 63.6% (14/22) there was no standardization of filling-in of the channels. Friction of the biopsy channel was not performed in 13.6% (3/22) of the devices. In the microbiological analysis, 25% (7/32) of the samples from the stored endoscopes were positive for microbial growth (from 2x101 to 9.5x104 CFU/mL), while after processing, contamination was 32% (9/28). Protein residues in the elevator channel were detected in 33% of duodenoscopes.
the results indicate important gaps in the stages of pre-cleaning and cleaning of endoscopes that, associated with presence of protein residues and growth of microorganisms of epidemiological importance, indicate limitations in safety of the processing procedures, which can compromise the disinfection processes and, consequently, their safe use among patients subjected to such tests.
分析 8 家医院内卫生服务机构中胃镜、结肠镜和十二指肠镜的清洗流程。
这是一项横断面研究，共涉及 22 个内镜（8 个胃镜、8 个结肠镜和 6 个十二指肠镜），对 60 个气/水通道（所有内镜）和抬升装置（十二指肠镜）的 60 个样本进行微生物分析，同时进行蛋白检测。数据分析采用描述性统计，计算频率和集中趋势度量。
通过对 60 个通道进行微生物分析，监测了 22 个内镜的处理过程。在预清洗程序中，82.3%（17/22）的设备中，纱布用于清洁插入管。72.3%（17/22）的情况下，内镜未完全浸没于清洁剂溶液中，63.6%（14/22）的情况下，通道未标准化填充。13.6%（3/22）的设备未对活检通道进行摩擦。在微生物分析中，32%（9/28）的处理后内镜样本存在微生物生长（2x101 至 9.5x104 CFU/mL），而储存后的内镜样本中 25%（7/32）存在微生物生长。在 33%的十二指肠镜中，抬升装置通道中检测到蛋白质残留。
结果表明，内镜的预清洗和清洗阶段存在重要差距，这些差距与蛋白质残留和具有流行病学意义的微生物生长有关，表明处理程序的安全性存在局限性，这可能会影响消毒过程，从而危及接受此类检查的患者的安全使用。
