Do Disposable Duodenoscope Tips Eliminate Contamination?

Prevention Challenges

Do Disposable Duodenoscope Tips Eliminate Contamination?

Researchers found bacterial contamination remained on duodenoscopes despite disposable endcaps.

Disposable tips decrease duodenoscope bacterial contamination but don’t eliminate it entirely.

That’s the conclusion reached by researchers from Duke University, who shared their findings in an award-winning poster at ACG 2022 Annual Scientific Meeting in Charlotte, North Carolina.

Researchers found bacterial contamination remained on duodenoscopes despite disposable endcaps. Cultures revealed it remained on the scopes’ distal opening but not within the channel or on the elevator tab.

The study included 46 duodenoscopes with disposable tips that were cultured twice — once after initial manual wash and high-level disinfection (HLD) and again after the process was repeated — from four different sites on each duodenoscope tip.

After one manual wash and HLD cycle, eight of 184 samples were contaminated with low/moderate risk organisms. Eleven samples were contaminated with Enterococcus spp.

After the second manual wash and HLD cycle, five samples contained low/moderate risk organisms and two were contaminated with Enterococcus spp.

Last year, the U.S. Food and Drug Administration updated a safety communication on duodenoscopes recommending that hospitals and endoscopy facilities transition to innovative duodenoscope designs due to concerns about reprocessing and patient cross-contamination. According to the communication, emerging data “suggests that the best solution to reducing the risk of disease transmission by duodenoscopes is through innovative device designs that make reprocessing easier, more effective, or unnecessary.”

Novel single-use endoscopes, including those manufactured by Ambu A/S, remove the need for reprocessing entirely as they are used once and discarded.

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