Post written by Mark A. Gromski, MD, from the Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.

This study aimed to answer whether there were any differences in 2 different duodenoscope reprocessing methods that fulfilled supplemental measures to enhance reprocessing: double high-level disinfection and liquid chemical sterilization.

Potential contamination of duodenoscopes and transmission of infection through duodenoscopes has been well documented in the literature and has gained increasing attention in the lay press and among U.S. regulatory authorities. A few years ago, the FDA offered a number of options to augment the reprocessing of duodenoscopes, including surveillance culturing of duodenoscopes, repeat high-level disinfection, liquid chemical sterilization, and ethylene oxide sterilization. We sought to see if either high-level disinfection or liquid chemical sterilization offered different results in reprocessing quality defined as growth on surveillance duodenoscope cultures.

This study from our high-volume ERCP center included 67 duodenoscopes randomized to receive either reprocessing through double manual cleaning and double high-level disinfection or single manual cleaning and liquid chemical sterilization. By analyzing 878 postreprocessing surveillance cultures from these scopes, we found that there were no significant differences in the positive cultures when comparing the double hig-level disinfection and liquid chemical sterilization groups (1.8% vs 2.1% positive cultures, any organisms, P=.8). The rate of high-concern organism growth was 0.5% in both groups, with no multi-drug resistant organisms encountered on surveillance cultures. Both of these supplemental reprocessing strategies had very low growth rates on surveillance cultures despite neither completely eliminating growth of high-concern organisms.

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