Dive Brief:
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Approved disinfection procedures are ineffective at rendering medical scopes free of infectious bacteria, according to a seven month study published in the American Journal of Infection Control.
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Of the 20 gastroscopes and colonoscopes examined for the study, 12 tested positive for bacterial growth.
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More than half of the gastroscopes were still contaminated after one cleaning, and 11% remained contaminated even after two instances of manually cleaning, two rounds of automated cleaning, and high-level disinfection, the findings show.
Dive Insight:
This small study focused on colonoscopies and gastroscopes – thought to be easier to clean than other scope types – and only tracked the presence of contamination, not actual infections. Seventeen of the 20 scopes were found to have serious defects and were returned to the manufacturer for repair. That damage is thought to be a major factor in the contamination as scratches and dents can hold bacteria, as well as blood and tissue.
Colonoscopes were nearly always clean after one manual cleaning. The researchers suggested that gastroscopes may be exposed to a more acidic environment and are thus more likely to sustain damage. Olympus' scopes, which have been linked to multiple deaths over the past four years due to contamination, manufactured the scopes used in the study.
The findings could help in the fight against hospital acquired infections (HAIs), which are dangerous, too common, and often preventable. On any given day, roughly 1 of every 25 hospital patients has one or more HAIs, according to the CDC. Hospitals have made progress, and they have reason to be even more motivated to address the issue by the prospect of the CMS applying financial penalties for poor safety performance. The study also comes at a time when the country is battling against the growing threat of antibiotic resistance.
It seems that scopes should be examined much more frequently for damage. But scopes are only a small piece of the puzzle. Catheter-associated urinary tract infections, central line infections, pressure ulcers and surgical site infections also pose challenges, particularly with the infections that are resistant to antibiotics.
Best practices saved about 125,000 lives between 2010 and 2015. But they can be difficult to enforce. New technologies may be the answer. For example, sensors integrated with sanitizer or soap dispensers detect usage and have increased compliance by up to 300%. And ultraviolet light systems can be used after regular cleaning in rooms that have held a patient with multidrug-resistant organisms.