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Krankenhaushygiene up2date 2021; 16(01): 8-16
DOI: 10.1055/a-0919-1549
DOI: 10.1055/a-0919-1549
SOP / Arbeitsablauf
Probenahme zur hygienisch-mikrobiologischen Überprüfung flexibler Endoskope – aktuelle Empfehlungen
Die hygienisch-mikrobiologische Überprüfung von flexiblen Endoskopen ist ein zusätzliches Element der Qualitätssicherung bei der Aufbereitung von flexiblen Endoskopen. Hierbei sind aussagekräftige Probenahmen für die spätere mikrobiologische Analytik essenziell. Dieser Beitrag vergleicht die aktuellen Empfehlungen verschiedener Länder und Fachgesellschaften.
Publication History
Article published online:
22 February 2021
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Literatur
- 1 Aumeran C, Poincloux L, Souweine B. et al. Multidrug-resistant Klebsiella pneumoniae outbreak after endoscopic retrograde cholangiopancreatography. Endoscopy 2010; 42: 895-899
- 2 Verfaillie C, Bruno M, in’t holt Voor A. et al. Withdrawal of a noveldesign duodenoscope ends outbreak of a VIM-2-producing Pseudomonas aeruginosa. Endoscopy 2015; 47: 493-502
- 3 Kola A, Piening B, Pape UF. et al. An outbreak of carbapenem-resistant OXA-48-producing Klebsiella pneumonia associated to duodenoscopy. Antimicrob Resist Infect Control 2015; 4: 8
- 4 Gillespie E, Kotsanas D, Stuart R. Microbiological monitoring of endoscopes: 5-year review. J Gastroenterol Hepatol 2008; 23: 1069-1074
- 5 Kovaleva J, Peters F, van der Mei H. et al. Transmission of Infection by Flexible Gastrointestinal Endoscopy and Bronchoscopy. Clinical Microbiology Rev 2013; 26: 231-254
- 6 Mughal M, Minau O, Culver D. et al. Reprocessing the Bronchoscope: The Challenges. Semin Respir Crit Care Med 2004; 25: 443-449
- 7 Alipour N, Karagoz A, Taner A. et al. Outbreak of Hospital Infection from Biofilm-embedded Pan Drugresistant Pseudomonas aeroginosa, Due to a Contaminated Bronchoscope. J Prev Med (Wilmington) 2017; 2: 1 DOI: 10.21767/2572-5483.100014.
- 8 Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert-Koch-Institut (RKI) und des Bundesinstituts für Arzneimittel und Medizinprodukte (BfArM). Anforderungen an die Hygiene bei der Aufbereitung von Medizinprodukten. Bundesgesundheitsbl 2012; 55: 1244-1310
- 9 Gastroenterological Society of Australia (GESA-GENCA). Infection Control in Endoscopy 2010. Update Clinical Guideline Microbiological Testing of Endoscopes Clinical Guideline Version 1.0 (Mar 2017). Im Internet: (Stand: 24.09.2020) www.gesa.org.au/public/13/files/Clinical%20Updates%20and%20Guidelines/Infection_Control_in_Endoscopy_Guidelines_2010.pdf
- 10 Comité Technique des Infections Nosocomiales et des Infections Liées aux Soins (CTINILS). Éléments d’assurance qualitéen hygiène relatifs au contrôle microbiologique des endoscopes et à la traçabilité en endoscopie. French Ministery of Health and Solidarity. 2007 Im Internet: (Stand: 24.09.2020) http://social-sante.gouv.fr/IMG/pdf/microbio_endoscopes-2.pdf
- 11 Stuurgroep flexibeleendoscopenreinigingendesinfectie (SFERD). Professional standard handbook cleaning and disinfection flexible endoscopes. 2019 Im Internet: https://www.mdl.nl/sites/www.mdl.nl/files/richlijnen/SFERD_Kwaliteitshandboek_5.pdf
- 12 BSG Guidance for decontamination of equipment for gastrointestinal endoscopy 2017. The Report of a Working Party of the British Society of Gastroenterology Endoscopy Committee. Im Internet: https://www.bsg.org.uk/wp-content/uploads/2019/12/Guidance-for-Decontamination-of-Equipment-for-Gastrointestinal-Endoscopy_-2017-Edition-3.pdf
- 13 Superior Health Council (SHC). Recommendations for the prevention of infectons and management of heat sensitive endocavitary medical devices and endoscopes. Update and extension of the previous recommendations (SHC 8355 – 2010). May 2019 SHC NR 9446. https://healthpr.belgium.be/sites/default/files/uploads/fields/fpshealth_theme_file/200120_shc-9446_endoscopes_vweb.pdf
- 14 Centre for Disease Control and Prevention (CDC). Interim protocol for healthcare facilities regarding surveillance for bacterial contamination of duodenoscopes after reprocessing 2015. Im Internet: (Stand: 24.09.2020) https://wayback.archive-it.org/7993/20170113091333/http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/MedicalDevicesAdvisoryCommittee/Gastroenterology-UrologyDevicesPanel/UCM445598.pdf
- 15 Public Health Agency of Canada (PHAC). Infection prevention and control guideline for flexible gastrointestinal endoscopy and flexible bronchoscopy 2010. Im Internet: (Stand: 24.09.2020) www.phac-aspc.gc.ca/nois-sinp/guide/endo/pdf/endo-eng.pdf
- 16 American National Standards Institute (ANSI), Association for the Advancement of Medical Instrumentation (AAMI). ANSI/AAMI ST91:2015 Flexible and semi-rigid endoscope processing in health care facilities. Im Internet: (Stand: 24.09.2020) https://my.aami.org/aamiresources/previewfiles/ST91_1504_preview.pdf
- 17 Society of Gastroenterology Nurses and Associates (SGNA). SGNA Standards of Infection Prevention in Reprocessing of Flexible Gastrointestinal Endoscopes 2018. Im Internet: (Stand: 24.09.2020) https://www.sgna.org/Portals/0/SGNA%20Standards%20of%20infection%20prevention%20in%20reprocessing_FINAL.pdf?ver=2018-11-16-084835-387
- 18 Centers for Disease Control and Prevention (CDC). Essential Elements of a Reprocessing Program for Flexible Endoscopes – Recommendations of the Healthcare Infection Control Practices Advisory Committee HICPAC. Update 2017. Im Internet: (Stand: 24.09.2020) https://www.cdc.gov/hicpac/recommendations/flexible-endoscope-reprocessing.html
- 19 US Food and Drug Administration (FDA). Brief summary of the gastroenterology and urology devices panel meeting May 14-15, 2015. Im Internet: https://wayback.archive-it.org/7993/20170112083625/http:/www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/MedicalDevicesAdvisoryCommittee/Gastroenterology-UrologyDevicesPanel/UCM447407.pdf
- 20 American Society for Gastrointestinal Endoscopy (ASGE). Multisociety guideline on reprocessing flexible GI endoskopes: 2016 Update; 2017. Gastrointestinal Endoscopy 2017; 85: 282-294 DOI: 10.1016/j.gie.2016.10.002.
- 21 Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention beim Robert Koch-Institut (RKI). Anforderungen an die Hygiene bei der Aufbereitung flexibler Endoskope und endoskopischen Zusatzinstrumentariums. Bundesgesundheitsbl 2002; 45: 395-411
- 22 Temizel S. Neues und bewährtes bei der hygienisch-mikrobiologischen Überprüfung flexibler Endoskope. Endo-Satellite: Symposium: Hygiene in der Endoskopie. Endo Update Augsburg 28./29.11.2019
- 23 Rauwers AW, Voor in’t holt AF, Buijs JG. et al. High prevalence rate of digestive tract bacteria in duodenoscopes: a nationwide study. Gut 2018; 0: 1-9 DOI: 10.1136/ gutjnl-2017-315082.
- 24 Beilenhoff U, Neumann CS, Rey JF. ESGE Guidelines Committee. et al. ESGE-ESGENA guideline for quality assurance in reprocessing: microbiological surveillance testing in endoscopy. Endoscopy 2007; 39: 175-181
- 25 US Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and American Society for Microbiology (ASM): FDA, CDC, ASM working group. Duodenoscope surveillance sampling and culturing protocols. Reducing the risks of Infection 2018. Im Internet: (Stand: 24.09.2020) www.fda.gov/media/111081/download
- 26 Schweizerischen Gesellschaft für Gastroenterologie (SGG), Schweizerischen Gesellschaft für Pneumologie (SGP), Schweizerischen Gesellschaft für Spitalhygiene (SGSH), Schweizerischen Vereinigung für Endoskopiepersonal (SVEP). Schweizerische Richtlinie zur Aufbereitung flexibler Endoskope 2020. Im Internet: (Stand: 24.09.2020) https://sggssg.ch/fileadmin/user_upload/CH_Richtlinie_ESGE_2020_07_10.pdf
- 27 Oliver J. Recent findings on the viable but nonculturable state in pathogenic bacteria. FEMS Microbiological Reviews 2010; 34: 415-425 DOI: 10.1111/j.1574-6976.2009.00200.x.
- 28 Alfa MJ, Harminder S, Duerksen DR. et al. Improper positioning of the elevator lever of duodenoscopes may lead to sequestered bacteria that survive disinfection by automated endoscope reprocessors. American Journal of Infection Control 2017; DOI: 10.1016/j.ajic.2017.07.021.
- 29 Xy J, Ning PY, Fei CN. et al. The importance of sampling technique and rinse water for assessing flexible gastrointestinal endoscope reprocessing. A 3-year study covering 59 centers. American Journal of Infection Control 2020; 48: 19-25
- 30 Kimkes T, Heinemann M. How bacteria recognize and respond to surface contact. FEMS Microbiology Reviews 2020; 44: 106-122 DOI: 10.1093/femsre/fuz02.
- 31 Pajkos A, Vickery K, Cossart Y. Is biofilm accumulation on endoscope tubing a contributor to the failure of cleaning and decontamination?. Journal of Hospital Infection 2004; 58: 224-229 DOI: 10.1016/j.jhin.2004.06.023.
- 32 Ofstead C, Heymann L, Quick M. et al. Residual moisture and waterborne pathogens inside flexible endoscopes: Evidence from a multisite study of endoscope drying effectiveness. American Journal of Infection Control 2018; 46: 689-696 DOI: 10.1016/j.ajic.2018.03.002.
- 33 Kovaleva J, Busse A. Usefulness of Bacteriological Monitoring of Endoscope Reprocessing. In: Pascu O, Tantau M. , Hrsg. Therapeutic Gastrointestinal Endoscope. Rijeka, Kroatien: InTech; 2011
- 34 Alfa MJ, Howie R. Modeling microbial survival in buildup biofilm for complex medical devices. BMC Infect Diseases 2009; 56: 1-14
- 35 Alfa MJ, Singh H, Nugend Z. et al. Sterile reverse osmosis water combined with friction are optimal for channel and lever cavity sample collection of flexible duodenoscopes. Frontiers in Medicine 2017; 4: 191 DOI: 10.3389/fmed.med2017.00191.
- 36 Sohn SY, Alfa MJ, Lai R. et al. Turbulent fluid flow is a novel closed-system sample extraction method for flexible endoscope channels of various inner diameters. Journal of Microbiological Methods 2020; 168 DOI: 10.1016/j.mimet.2019.105782.
- 37 Aumeran C, Poincloux L, Souweine B. et al. Multidrug-resistant Klebsiella pneumoniae outbreak after endoscopic retrograde cholangiopancreatography. Endoscopy 2010; 42: 895-899 DOI: 10.1055/s-0030-1255647.
- 38 Zweites Europäisches Hygiene-Experten Forum „Hygiene in der Endoskopie“ in Hamburg. Zentralsterilisation 2019; 27: 2