GI endoscopic reprocessing practices in the United States.
GI endoscopic reprocessing practices in the United States.
复制标题
美国的胃肠道内窥镜再处理实践。
DOI：
10.1053/ge.1999.v50.99615
复制
发表时间：
1999
影响因子：
7.7
通讯作者：
A. Dimarino
中科院分区：
文献类型：
--
作者：
Raynard J. Cheung;Daisy Ortiz;A. Dimarino
背景
胃肠道 (GI) 内窥镜污染引起的患者感染通常可归因于未遵循适当的再处理指南。最近，美国食品和药物管理局建议将胃肠道内窥镜暴露在加热至 25 摄氏度的 2.4% 戊二醛溶液中 45 分钟。同时，美国胃肠内窥镜协会 (ASGE)、美国胃肠病学协会和胃肠病学护士协会认可了一项强调手动预清洁的再处理指南，并建议将其暴露在 2.4% 戊二醛溶液中 20 分钟在室温下。从那时起，关于美国实际后处理实践的信息就很少了。
方法
先前制定的有关内窥镜消毒实践的调查问卷已邮寄给随机选择的 ASGE 成员。
结果
该调查已发送给 730 名会员，其中 294 名会员做出了回应（40.3%）。 90.7%的受访者进行了适当的手动清洁（通过附件通道吸除清洁剂并刷洗通道和阀门）； 69.9% 随后使用自动洗消机进行消毒或灭菌。戊二醛是应用最广泛的化学消毒剂； 85.3% 使用戊二醛作为主要消毒剂之一。最常用的 2.4% 戊二醛消毒时间是 20 分钟（83.9%），其次是 45 分钟（11.4%）。 Only 23.8% of users of 2.4% glutaraldehyde heat their solution; 59.6% 的中心每天或更频繁地测试消毒剂浓度； 74.0%的非一次性镊子在使用前进行消毒； 29.2% of centers re-use disposable endoscopic accessories (which are more frequently disinfected rather than sterilized).十二名受访者报告了内镜交叉感染的病例。
结论
相当少数的内窥镜中心仍然不完全符合最近的 ASGE、美国胃肠病学协会和胃肠病学护士协会的消毒指南，并且他们可能没有对胃肠道内窥镜进行适当的消毒。强烈鼓励严格遵守推荐的指南，以确保患者安全。
BACKGROUND
Patient infection from contaminated gastrointestinal (GI) endoscopes can generally be attributed to failure to follow appropriate reprocessing guidelines. Recently, the Food and Drug Administration recommended a 45-minute exposure of GI endoscopes to 2.4% glutaraldehyde solutions heated to 25 degrees C. Simultaneously, the American Society for Gastrointestinal Endoscopy (ASGE), the American Gastroenterological Association, and the Society of Gastroenterology Nurses and Associates endorsed a reprocessing guideline that emphasized manual precleaning and recommended a 20-minute exposure to a 2.4% glutaraldehyde solution at room temperature. Since then, little information has become available regarding actual reprocessing practices in the United States.
METHODS
A previously developed questionnaire regarding endoscopic disinfection practices was mailed to randomly selected members of the ASGE.
RESULTS
The survey was sent to 730 members and 294 responded (40.3%). Appropriate manual cleaning (suctioning detergent through the accessory channel and brushing the channel and valves) is performed by 90.7% of respondents; 69.9% then use automated reprocessors for disinfection or sterilization. Glutaraldehyde is the most widely used chemical disinfectant; 85.3% use glutaraldehyde as one of their primary disinfectants. The most commonly used disinfection time with 2.4% glutaraldehyde is 20 minutes (83.9%) followed by 45 minutes (11.4%). Only 23.8% of users of 2.4% glutaraldehyde heat their solution; 59.6% of centers test disinfectant concentration daily or more frequently; 74.0% sterilize nondisposable forceps before use; 29.2% of centers re-use disposable endoscopic accessories (which are more frequently disinfected rather than sterilized). Twelve respondents reported cases of endoscopic cross infection.
CONCLUSIONS
A significant minority of endoscopy centers still do not completely conform to recent ASGE, American Gastroenterological Association, and the Society of Gastroenterology Nurses and Associates guidelines on disinfection, and they may not be appropriately disinfecting GI endoscopes. Rigid adherence to recommended guidelines is strongly encouraged to ensure patient safety.