Improving Quality and Safety In Your Endoscopy Unit: Live and Virtual | October 2022-08_DeLatour

08_DeLatour_Infection Control Overview

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This document provides an overview of infection control in endoscopy procedures. The risk of endogenous infections during endoscopy varies depending on the procedure, with diagnostic and therapeutic interventions increasing the risk. Routine daily activities also carry a risk of bacteremia. To prevent endogenous infections, measures such as rigorous hand hygiene and proper personal protective equipment should be implemented.<br /><br />Exogenous infections can occur during endoscopy, with multiple modes of transmission including needle stick injuries, blood splashes, inhalation of microorganisms, and direct handling of patients. Healthcare workers may encounter various bacteria, fungi, parasites, and viruses, including influenza, Ebola, tuberculosis, SARS, MERS, MRSA, and COVID-19. Universal precautions, such as hand hygiene, personal protective equipment, and safe handling of equipment, should be followed to prevent patient-to-staff transmission of infections.<br /><br />Patient-to-patient transmission of infections can occur through inadequate reprocessing of endoscopes and accessories, improper handling of sedation tubing, and reuse of needles. Various organisms, including bacteria, viruses, fungi, parasites, and prions, can be transmitted. Standardization of reprocessing protocols and guidelines can help prevent these infections.<br /><br />Duodenoscope-related infections have been reported in multiple outbreaks, with complex design issues, human factors, and waterborne bacteria contributing to contamination. Enhanced reprocessing methods, staff training, and potential duodenoscope redesigns are being explored to address this problem.<br /><br />In summary, preventing infections in endoscopy units requires a multi-disciplinary approach and adherence to infection control practices. Prophylactic antibiotics may be recommended in select circumstances for endogenous infections, while universal precautions and standardized reprocessing protocols significantly reduce the risk of infections. Further research and efforts are needed to address the challenges posed by specialized endoscopes and prevent patient-to-patient transmission of infections.

Keywords

infection control

endoscopy procedures

hand hygiene

personal protective equipment

exogenous infections

universal precautions

reprocessing protocols

duodenoscope-related infections

waterborne bacteria

patient-to-patient transmission