l Endogenous infections
l Exogenous infections caused by inadequately reprocessed equipment from one patient to another
l Risk of infection to staff working in endoscopy
Appropriate reprocessing of flexible endoscopes and endoscopic accessories is an essential part of safety and quality assurance in gastrointestinal endoscopy.
Since the late 1970s there have been sporadic reports of nosocomial infections linked to endoscopic procedures. These include bacterial infections caused for example by Salmonella spp, Helicobacter pylori and Pseudomonas spp, as well as viruses such as Hepatitis B and C . The majority of documented cases were due to non-compliance with national and international reprocessing guidelines.
Since 1994, the ESGE-ESGENA* Guideline Committee has developed a number of guidelines focused on hygiene and infection control in Endoscopy (see www.esge.com or www.esgena.org).
This year, the Committee has updated the current guideline on reprocessing of flexible endoscopes and accessories. It addresses several important aspects of safety in gastrointestinal endoscopy. In addition to general statements, the guideline provides detailed technical protocols for the daily work of medical staff as there are multiple local variations in the application of general guidelines. The consensus guideline has been prepared by endoscopists, microbiologists, hygienists, endoscopy nurses, and representatives of the biomedical industry.
In 2007, two guidelines were published that also address the necessity of hygiene control in GI Endoscopy:
l ESGE-ESGENA Guideline for process validation and routine testing for endoscope reprocessing in washer-disinfectors, according to the European Standard EN ISO 15883 parts 1, 4 and 5
l ESGE-ESGENA Guideline for quality assurance in reprocessing: Microbiological surveillance testing in endoscopy
These two guidelines must be taken into account when establishing local quality management of hygiene and infection control in Endoscopy.
The ESGE-ESGENA guidelines can be adapted locally to comply with national laws and regulations.
Source: Ulrike Beilenhoff/ESGENA
* ESGE - European Society of Gastrointestinal Endoscopy