Study: 71% of Reusable Scopes Tested Positive for Bacteria

The infection control (IC) issues with endoscopes apparently aren’t limited to duodenoscopes.

In a study published last month in the American Journal of Infection Control, researchers found that 71% of reusable medical scopes that were deemed ready for use on patients tested positive for bacteria at three U.S. hospitals. The study found problems in scopes used for routine operations such as colonoscopies and kidney stone removal.

IC issues related to endoscopes have been frequently linked to inadequate reprocessing. This study “evaluated the effectiveness of endoscope drying and storage methods and accessed associations between retained moisture and contamination” at the hospitals through visual examinations and tests, wrote the authors.

They found that reprocessing and drying practices were substandard at two of the three hospitals they studied last year, and damaged endoscopes were used at all three. Fluid was detected in 22 of 45 endoscopes (49%) and microbial growth was found in 32 (71%). Bacteria discovered on the scopes included Stenotrophomonas maltophilia, Citrobacter freundii, and Lecanicillium lecanii/Verticillium dahliae.

The authors said that the complex design of most endoscopes makes them difficult to clean, which can be compounded when healthcare workers, rushing to reprocess the scopes for the next patient, are not following reprocessing protocols.

“These results are pretty scary,” Janet Haas, president of the Association for Professionals in Infection Control and Epidemiology, told Kaiser Health News. “These are very complicated pieces of equipment, and even when hospitals do everything right, we still have a risk associated with these devices. None of us have the answer right now.”

The study’s authors, led by Minnesota-based epidemiologist Cori Ofstead, concluded that “more effective methods of endoscope reprocessing, drying, and maintenance are needed to prevent the retention of fluid, organic material, and bioburden that could cause patient illness or injury.”

Their findings reinforced that duodenoscopes aren’t the only concern, though those have rightfully been scrutinized after being tied to at least 35 deaths in the U.S. since 2013. They are still being eyed by the FDA, which was also criticized for not alerting the public to the threat until after its 17-month investigation into the matter.