APIC Sessions Explore the Latest in Scope Disinfection

By John Egan

Over the past several years, the importance of effectively disinfecting scopes used in healthcare settings has come into sharper focus.

For example, the Los Angeles Times reported in 2016 that as many as 350 patients at 41 medical facilities in the United States and around the world had been infected by or exposed to tainted gastrointestinal scopes from January 2010 through October 2015. That was according to data from the U.S. Food and Drug Administration (FDA) collected during a congressional investigation.

Other recent developments related to infections and scopes include:

  • A 2015 bacterial outbreak at Ronald Reagan UCLA Medical Center sickened eight patients, three of whom later died. A study of the outbreak traced the infections—caused by carbapenem-resistant Enterobacteriaceae, or CRE, a group of antibiotic-resistant bacteria—to two reusable duodenoscopes that had been tainted. Duodenoscopes are used in more than 500,000 endoscopic retrograde cholangiopancreatography (ERCP) procedures each year to diagnose and treat problems in the pancreas and bile ducts.
  • A study published in 2017 in APIC’s American Journal of Infection Control found that current techniques employed to clean flexible endoscopes for reuse are not consistently effective. The study’s authors concluded that careful visual inspection and cleaning verification tests must be undertaken to ensure endoscopes are free of damage and debris before they are disinfected or sterilized and used on another patient.
  • A study presented at APIC’s 2017 Annual Conference determined that the techniques used to clean and sterilize flexible ureteroscopes leave behind contamination including debris, residue, and bacteria. Researchers concluded that these failures might lead to the use of dirty scopes.
  • In September 2017, the FDA approved the first duodenoscope with a disposable distal cap, a new feature designed to improve cleaning and reprocessing. “We believe the new disposable distal cap represents a major step towards lowering the risk of future infections associated with these devices,” said William Maisel, chief scientist at the FDA’s Center for Devices and Radiological Health.

The topic of scope safety will be a prominent one during APIC 2018, set for June 13 to 15 in Minneapolis.

For a number of years, the ECRI Institute has included endoscopes in its annual list of the top 10 health technology hazards. The institute cites improper cleaning, disinfection, and sterilization of these instruments as the reason for repeatedly putting endoscopes on the list. And it’s likely that the institute, a nonprofit that seeks to improve patient care, will continue to emphasize this issue.

“Studies highlighting the challenges of this process, along with continuing reports of patient exposures to contaminated instruments, underscore why this topic remains a critical concern,” the institute says.

At APIC 2018, attendees will have opportunities to learn more about this “critical concern.” These include:

  • A pre-conference workshop titled “Disinfection, Sterilization, and Antisepsis: Principles, Practices, Current Issues, New Research, and New Technologies.”
  • A pre-conference Interactive Skills Lab titled “Practical Solutions to Reduce Infection Risk and Ensure Compliance.”
  • Conference sessions including “Moisture Retention in Flexible Endoscopes: Results of a Multisite Drying Study;” “A Multisite Study Evaluating Contamination and Visual Irregularities on Flexible Bronchoscopes;” and “Implementing a Microbial Surveillance Program for Flexible Endoscopes.”

Join thousands of healthcare professionals from around the world to expand your network and learn about evidence-based advances in infection prevention at APIC 2018, June 13 to 15, in Minneapolis. Register today.