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Surveillance of Endoscopes: Comparison of Different Sampling Techniques.

ABSTRACT: OBJECTIVE To compare different techniques of endoscope sampling to assess residual bacterial contamination. DESIGN Diagnostic study. SETTING The endoscopy unit of an 1,100-bed university hospital performing ~13,000 endoscopic procedures annually. METHODS In total, 4 sampling techniques, combining flushing fluid with or without a commercial endoscope brush, were compared in an endoscope model. Based on these results, sterile physiological saline flushing with or without PULL THRU brush was selected for evaluation on 40 flexible endoscopes by adenosine triphosphate (ATP) measurement and bacterial culture. Acceptance criteria from the French National guideline (<25 colony-forming units [CFU] per endoscope and absence of indicator microorganisms) were used as part of the evaluation. RESULTS On biofilm-coated PTFE tubes, physiological saline in combination with a PULL THRU brush generated higher mean ATP values (2,579 relative light units [RLU]) compared with saline alone (1,436 RLU; P=.047). In the endoscope samples, culture yield using saline plus the PULL THRU (mean, 43 CFU; range, 1-400 CFU) was significantly higher than that of saline alone (mean, 17 CFU; range, 0-500 CFU; P<.001). In samples obtained using the saline+PULL THRU brush method, ATP values of samples classified as unacceptable were significantly higher than those of samples classified as acceptable (P=.001). CONCLUSION Physiological saline flushing combined with PULL THRU brush to sample endoscopes generated higher ATP values and increased the yield of microbial surveillance culture. Consequently, the acceptance rate of endoscopes based on a defined CFU limit was significantly lower when the saline+PULL THRU method was used instead of saline alone. Infect Control Hosp Epidemiol 2017;38:1062-1069.

SUBMITTER: Cattoir L

PROVIDER: S-EPMC5647674 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Surveillance of Endoscopes: Comparison of Different Sampling Techniques.

Cattoir Lien L Vanzieleghem Thomas T Florin Lisa L Helleputte Tania T De Vos Martine M Verhasselt Bruno B Boelens Jerina J Leroux-Roels Isabel I

Infection control and hospital epidemiology 20170621 9

OBJECTIVE To compare different techniques of endoscope sampling to assess residual bacterial contamination. DESIGN Diagnostic study. SETTING The endoscopy unit of an 1,100-bed university hospital performing ~13,000 endoscopic procedures annually. METHODS In total, 4 sampling techniques, combining flushing fluid with or without a commercial endoscope brush, were compared in an endoscope model. Based on these results, sterile physiological saline flushing with or without PULL THRU brush was select ...[more]

PMID: 28633677

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Project description:BackgroundStreptococcus agalactiae (group B streptococcus; GBS) is a significant cause of perinatal and neonatal infections worldwide. To detect GBS colonization in pregnant women, the CDC recommends isolation of the bacterium from vaginal and anorectal swab samples by growth in a selective enrichment medium, such as Lim broth (Todd-Hewitt broth supplemented with selective antibiotics), followed by subculture on sheep blood agar. However, this procedure may require 48 h to complete. We compared different sampling and culture techniques for the detection of GBS.MethodsA total of 300 swabs was taken from 100 pregnant women at 35-37 weeks of gestation. For each subject, one rectovaginal, one vaginal and one rectal ESwab were collected. Plating onto Columbia CNA agar (CNA), group B streptococcus differential agar (GBSDA) (Granada Medium) and chromID Strepto B agar (CA), with and without Lim broth enrichment, were compared. The isolates were confirmed as S. agalactiae using the CAMP test on blood agar and by molecular identification with tDNA-PCR or by 16S rRNA gene sequence determination.ResultsThe overall GBS colonization rate was 22%. GBS positivity for rectovaginal sampling (100%) was significantly higher than detection on the basis of vaginal sampling (50%), but not significantly higher than for rectal sampling (82%). Direct plating of the rectovaginal swab on CNA, GBSDA and CA resulted in detection of 59, 91 and 95% of the carriers, respectively, whereas subculturing of Lim broth yielded 77, 95 and 100% positivity, respectively. Lim broth enrichment enabled the detection of only one additional GBS positive subject. There was no significant difference between GBSDA and CA, whereas both were more sensitive than CNA. Direct culture onto GBSDA or CA (91 and 95%) detected more carriers than Lim broth enrichment and subculture onto CNA (77%). One false negative isolate was observed on GBSDA, and three false positives on CA.ConclusionsIn conclusion, rectovaginal sampling increased the number GBS positive women detected, compared to vaginal and/or rectal sampling. Direct plating on CA and/or GBSDA provided rapid detection of GBS that was at least as sensitive and specific as the CDC recommended method of Lim broth subcultured onto non chromogenic agar.

Project description:Airborne coal dust generated during mining can deposit and accumulate on mine surfaces, presenting a dust explosion hazard. When assessing dust hazard mitigation strategies for airborne dust reduction, sampling is done in high-velocity ventilation air, which is used to purge the mining face and gallery tunnel. In this environment, the sampler inlet velocity should be matched to the air stream velocity (isokinetic sampling) to prevent oversampling of coarse dust at low sampler-to-air velocity ratios. Low velocity ratios are often encountered when using low flow rate, personal sampling pumps commonly used in underground mines. In this study, with a goal of employing mine-ready equipment, a personal sampler was adapted for area sampling of coarse coal dust in high-velocity ventilation air. This was done by adapting an isokinetic nozzle to the inlet of an Institute of Occupational Medicine (Edinburgh, Scotland) sampling cassette (IOM). Collected dust masses were compared for the modified IOM isokinetic sampler (IOM-MOD), the IOM without the isokinetic nozzle, and a conventional dust sampling cassette without the cyclone on the inlet. All samplers were operated at a flow rate typical of personal sampling pumps: 2 L/min. To ensure differences between collected masses that could be attributed to sampler design and were not influenced by artifacts from dust concentration gradients, relatively uniform and repeatable dust concentrations were demonstrated in the sampling zone of the National Institute for Occupational Safety and Health experimental mine gallery. Consistent with isokinetic theory, greater differences between isokinetic and non-isokinetic sampled masses were found for larger dust volume-size distributions and higher ventilation air velocities. Since isokinetic sampling is conventionally used to determine total dust concentration, and isokinetic sampling made a difference in collected masses, the results suggest when sampling for coarse coal dust the IOM-MOD may improve airborne coarse dust assessments over "off-the-shelf" sampling cassettes.

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Surveillance of Endoscopes: Comparison of Different Sampling Techniques.

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Surveillance of Endoscopes: Comparison of Different Sampling Techniques.

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