Healthcare News & Insights

Alarming new study: 15% of endoscopes weren’t completely clean

Are the endoscopes in your hospital clean? Chances are at least one in four isn’t and contains some kind of “bio-dirt” — cells and material from previous patients. At least that’s what a new study found.

Flexible medical endoscopeThat’s pretty alarming when you consider the fact tens of millions of procedures using endoscopes are done each year in the U.S., and each scope may be used on six to 12 patients a day.

Study results

While the study only examined five hospitals, which volunteered for the survey, Marco Bommarito, PhD, the study author and lead research specialist at 3M‘s infection prevention division, said it’s likely to be the same at other hospitals across the country.

The study found that an alarming 15% of flexible endoscopes used to examine GI tracts and colons were harboring bio-dirt, reported CNBC.

Specifically, the study analyzed 275 flexible duodenoscopes, gastroscopes and colonoscopes, and  found a cleanliness failure rate of 30%, 24% and 3%, respectively.

Bommarito noted that he was surprised by the number of dirty endoscopes researchers found in endoscopy suites. “The expectation would be close to zero,” noted the researcher. “When you start seeing one out of three, one out of four [instruments], failing this cleanliness standard, that’s kind of striking.”

Cleaning process

It’s not that the hospitals in the study weren’t cleaning their endoscopes, they were. Bommarito even noted in the report that everyone he came across was “trying to do the right thing.”

The endoscopes were examined after the first phase of the cleaning process, which is widely accepted as the standard.

The first phase consists of manually cleaning the endoscope with an enzymatic agent after which a technician flushes the device. This process is done to get ride of bio-dirt that can harbor dangerous microorganisms from high-level disinfectants used to soak the scope in the second phase of cleaning.

Bommarito explained in the CNBC report that if the scope isn’t cleaned sufficiently in phase one, the microorganisms can survive through phase two, remain in the scope and possibly infect future patients.

What is needed, according to the researcher, is a better understanding of the cleaning process. Hospitals need to make sure cleanliness is being measured properly and if mistakes in the process are found, they must be corrected immediately.

Not the first time

Four years ago, 10,000 patients who had endoscopies at three U.S. Veterans Affairs hospital between 2003 and 2009 were alerted to the fact they might have been exposed to blood-borne pathogens from dirty instruments. And in 2010, 3,400 patients from Palomar Medical Center in San Diego were notified they could get free testing for diseases, after having been potentially exposed to contaminated equipment.

What worries researchers is that it may deter patients from getting any kind of scope procedure, especially colonoscopies. And in the U.S., colon cancer is the second leading cause of cancer-related deaths.

While the American Society of Gastroenterology reported that documented cases of infectious complications from endoscopic procedures were rare — one in 1.8 million procedures, Bommarito believes that number is higher. Reason: It’s often not apparent that a person’s disease came from an unclean scope, and it’s hard to prove. However, if it is proved the hospital responsible could be potentially liable for any damages that occur to the patient from the illness.

Hopefully, the study will lead to a new — better — cleaning process.

Note: The study results were presented at the 40th annual conference of the Association for Professionals in Infection Control and Epidemiology in Fort Lauderdale, FL.

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