Improving Quality and Safety in the Endoscopy Unit (On-Demand) | October 2024-10_Pannala

10_Pannala_Infection Control Overview

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The presentation by Dr. Rahul Pannala from Mayo Clinic Arizona provides a comprehensive analysis of infection control in endoscopy, outlining the potential risks and preventive measures for both endogenous and exogenous infections. <br /><br />**Background and Risks**: Endogenous infections arise from the patient's own body, with bacteremia rates for various procedures such as esophageal sclerotherapy reaching 14.6%. Factors increasing these risks include therapeutic interventions and immunosuppressed status, similar to everyday activities like brushing teeth, which can have a high bacteremia rate. Exogenous infections, transmitted from patient to personnel or equipment, carry different risks, notably in endoscopy staff exposed to pathogens like H. pylori and COVID-19.<br /><br />**Prevention**: Preventing infection during endoscopy necessitates rigorous reprocessing of equipment, encompassing cleaning, high-level disinfection, and proper drying and storage protocols. Universal precautions are vital (hand hygiene, PPE use) to prevent staff exposure to bloodborne pathogens (HIV, HBV, HCV). <br /><br />**Challenges with Specific Equipment**: duodenoscopes present particular challenges due to complex design, which may harbor organisms despite standard reprocessing. Enhancements in reprocessing techniques, such as ethylene oxide sterilization and employing single-use duodenoscopes, are recommended to mitigate these risks.<br /><br />**Conclusions and Recommendations**: The adherence to strict infection control practices and a multidisciplinary team approach is paramount in managing infection risks in endoscopy units. Despite advancements in guidelines and equipment reprocessing, the rise in specialized endoscope-related infections indicates a need for ongoing research and improved training and protocol adherence. Enhanced staff training and competency in reprocessing methods are crucial to ensure patient safety and reduce infection transmission.

Keywords

infection control

endoscopy

endogenous infections

exogenous infections

bacteremia

equipment reprocessing

universal precautions

duodenoscopes

ethylene oxide sterilization

multidisciplinary team