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- Title
Duodenoscope-Associated Infections beyond the Elevator Channel: Alternative Causes for Difficult Reprocessing.
- Authors
Balan, Gheorghe G.; Rosca, Irina; Ursu, Elena-Laura; Fifere, Adrian; Varganici, Cristian-Dragos; Doroftei, Florica; Turin-Moleavin, Ioana-Andreea; Sandru, Vasile; Constantinescu, Gabriel; Timofte, Daniel; Stefanescu, Gabriela; Trifan, Anca; Sfarti, Catalin Victor
- Abstract
Objectives: 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. Materials and Methods: 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. Results: 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. Conclusions: 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.
- Subjects
BACTERIAL contamination; ENDOSCOPIC retrograde cholangiopancreatography; BACTERIAL adhesion; ELEVATORS; SCANNING electron microscopy; ENDOSCOPIC ultrasonography
- Publication
Molecules, 2019, Vol 24, Issue 12, p2343
- ISSN
1420-3049
- Publication type
Article
- DOI
10.3390/molecules24122343