The following is a summary of “Unveiling 8 years of duodenoscope contamination: insights from a retrospective analysis in a large tertiary care hospital,” published in the March 2024 issue of Gastroenterology by Ploeg, et al.

For a study, researchers sought to provide an overview of duodenoscope contamination trends, identify associated risk factors, and evaluate the impact of implemented interventions at a Dutch tertiary care center.

Analysis of duodenoscope culture sets from March 2015 to June 2022 was conducted. Contamination was defined as the presence of microorganisms of oral or gastrointestinal origin (MGO) or any other microorganism with ≥20 colony-forming units/20 mL (AM20). A logistic mixed effects model was employed to identify risk factors and evaluate intervention effects, including the use of duodenoscopes with disposable caps, replacement of automated endoscope reprocessors (AER), and conducting audits in the endoscopy department.

A total of 404 culture sets were analyzed, revealing a variable yearly contamination rate with MGO (14.3% to 47.5%) and an increase in AM20 contamination up to 94.7% by 2022. MGO and AM20 contamination were most frequently observed in the biopsy and suction channels of duodenoscopes. Implemented interventions, such as audits, AER replacement, and using duodenoscopes with disposable caps, did not exhibit a clear association with contamination rates.

Despite intervention efforts, duodenoscope contamination remains a significant challenge, with persistently high contamination rates observed. Reprocessing the biopsy and suction channels poses particular difficulties. Changes in reusable duodenoscope design, such as facilitating sterilization or implementing easily replaceable channels, are essential to improve reprocessing efficacy and mitigate the risk of duodenoscope-related infections.

Reference: gut.bmj.com/content/73/4/613