Improving Quality and Safety in the Endoscopy Unit (On-Demand) | August 2023-07_ASGE Quality_Pannala

07_ASGE Quality_Pannala_Infection Control Overview

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This document provides an overview of infection control in endoscopy procedures. It covers various topics such as the risk of endogenous and exogenous infections, preventing infection transmission during endoscopy, and endoscope reprocessing. <br /><br />The document highlights that there is variation in infection control practices among endoscopy units. It mentions that patients may develop endoscope/endoscopy unit related infections through different modalities. Preventing infections in endoscopy units requires a multidisciplinary team approach.<br /><br />The risk of endogenous infections during endoscopy is discussed, with bacteremia rates varying depending on the procedure. Factors that increase the risk of bacteremia are also mentioned, such as therapeutic interventions and immunosuppressed status.<br /><br />The document also discusses the risk of exogenous infections from patient to staff during endoscopy, including needlestick injuries and inhalation of aerosolized microorganisms. It emphasizes the importance of universal precautions to prevent patient to staff transmission of infections, such as hand hygiene, personal protective equipment, and safe handling of equipment.<br /><br />Exogenous infections from patient to patient are also addressed, citing inadequate reprocessing of endoscopes and accessories as a potential source. Specific organisms reported in outbreaks are listed, including bacteria, viruses, fungi, parasites, and prions.<br /><br />The document provides an overview of endoscope reprocessing, including the steps involved and the importance of routine maintenance. It mentions the challenges and contamination risks associated with duodenoscopes, including complex design, human factors, and prolonged storage.<br /><br />Various interventions and technologies to improve duodenoscope reprocessing and reduce infection risks are mentioned, such as double high-level disinfection, sterilization, culture and quarantine, and single-use duodenoscopes.<br /><br />In summary, infection control in endoscopy procedures is multifaceted and requires adherence to rigorous reprocessing protocols and universal precautions. While infections associated with standard endoscopes have declined, infections related to specialized endoscopes remain a challenge that requires further research and improvement in reprocessing methods.

Keywords

infection control

endoscopy procedures

endogenous infections

exogenous infections

infection transmission

endoscope reprocessing

bacteremia rates

universal precautions

duodenoscope reprocessing

infection risks