Evaluation of efficacy of endoscope reprocessing by ATP method and bacterial cultivation

Year 2017, Issue: Issue 1(2) - 3. INTERNATIONAL BIOCIDAL CONGRESS, 28 - 28, 01.02.2017

Ebru Eren Ayşegül Karahasan Burak Aksu Gülden Zaman Ayşe Öztürk Atilla Çırak

Abstract

Introduction

Flexible
endoscopes are categorized as semi-critical devices according to the Spaulding
Classification System and high-level disinfection (HLD) for reprocessing is
needed. The manual cleaning (MC) phase has been shown to be the process most
prone to human error. To reduce the risk of human error and infection
transmission the efficacy of reprocessing method should be evaluated
continuously. Microbiological surveillance methods can be classified into two
kinds: microbial culture and non-culture methods, eg. bioburden assays,
adenosine triphosphate (ATP) bioluminescence.

Method

Data was
collected during 34 endoscope encounters which occurred in August 4-28, 2016. All
reprocessing steps were performed in accordance with guidelines. Three samples
were taken for each endoscope: before and after manual cleaning and after HLD.
Samples were taken from the surface and the inner channel of endoscopes by
swabbing and distilled water infusion methods, respectively. ATP levels were
detected using Clean-Trace Surface ATP and Clean- Trace Water ATP tests (3M,
USA). The technique measures ATP in a sensitive luminometer with results
usually expressed as Relative Light Units (RLU). The proposed criterion is
achieved when the bioluminescence reading is <200 RLU. For bacterial
culture, samples were inoculated on sheep-blood agar plates and incubated
overnight. Pathogen identification was performed by culture on chromogenic agar
and MALDI-TOF MS.

Findings

There was
no bacterial growth in samples taken from the surfaces after MC. The reduction
of colony number in samples taken from channels was more prominent after HLD
than MC although it was not statistically significant. Significant decrease in
ATP levels was detected after MC and HLD for both surface and channels
(p<0.05; Fig.1). ATP levels except three samples were in acceptable limits
after HLD.

Result

We may
conclude that ATP measurement can provide a reliable, rapid and practical
assessment of endoscope cleanliness for routine monitoring in the clinical
setting.

 

 

 

 

Keywords:
endoscope, reprocessing, ATP

 

 

 

 

 

 

Fig 1. Microbiological
surveillance results of endoscopes by using ATP bioluminescence.

Keywords

Evaluation of efficacy of endoscope reprocessing by ATP method and bacterial cultivation

References

• Ebru Eren, Ayşegül Karahasan, Burak Aksu, Gülden Zaman, Ayşe Öztürk, Atilla Çırak
• Marmara University Faculty of Medicine, Medical Microbiology Department, İstanbul Marmara University Hospital, Endoscopy Unit, Pendik/İstanbul Marmara University Hospital, Sterilization Unit, Pendik/İstanbul