Jennifer Yoon, MD1, Arpine Petrosyan, MD2, Adnan Ameer, MD3, Lisa Avalos, RN4, Mark Osburn, RN5, Ana Araujo, RN4 1UCSF Fresno, Fresno, CA; 2University of California San Francisco Fresno, Fresno, CA; 3UCSF Fresno/CCFMG, Fresno, CA; 4CRMC, Fresno, CA; 5CRMC, FResno, CA
Introduction: Despite previously identified CRE (carbepenam-resistant Enterobacterericeae) transmission associated with persistently contaminated elevator-based endoscope (EBE), optimal surveillance of EBE has not been established. Liquid chemical sterilization with standard high-level disinfection of EBE has not been evaluated.
Methods: This is a single-center study conducted at Community Regional Medical Center, Fresno, CA between February 2015 and December 2018. Bacterial cultures were obtained from 17 elevator-based endoscopes (12 ERCP and 5 EUS scopes) after each use. Cultures were obtained immediately after reprocessing with standard method as per industry product guidelines. Second set of bacterial cultures were obtained after reprocessing with standard method and S1ECS.
48-hour culture results were identified as pass or fail which is defined as a negative or positive bacterial culture, respectively. Identification of “low concern” and “high concern” bacteria, including CRE.
Results: A total of 1061 cultures were obtained. 413 cultures after standard method and 648 cultures with S1ECS. 394 EUS cultures and 667 ERCP cultures were obtained. 11.8% of cultures after reprocessing with standard method failed while 4.2% of cultures after reprocessing with S1ECS after standard method failed (Figure1). It was also observed that decontamination with standard method had overall higher fail rates of decontamination of EBE compared to S1ECS.
Amongst the 49 positive cultures obtained in standard method, the most common “low concern” organisms were gram positive rods (24) and coagulase negative Staphylococcus (8). All cultures grew singles species. A single culture after standard method was identified with a “high concern” bacteria (E coli). “Low concern” coagulase negative staphylococcus (10) and bacillus, non-anthracis (7) were the most common bacteria cultured after S1ECS. No CRE were identified during this investigation.
Discussion: S1ECS appears to be more efficient in decontamination of elevator-based endoscopes (EBE) compared to standard high-level disinfection. Our study is limited by lack of “high concern” bacteria including CRE isolates in our cultures. Further studies are needed to validate these findings.
Figure: Figure 1. Graphical representation of study results.
Disclosures: Jennifer Yoon indicated no relevant financial relationships. Arpine Petrosyan indicated no relevant financial relationships. Adnan Ameer indicated no relevant financial relationships. Lisa Avalos indicated no relevant financial relationships. Mark Osburn indicated no relevant financial relationships. Ana Araujo indicated no relevant financial relationships.
Jennifer Yoon, MD1, Arpine Petrosyan, MD2, Adnan Ameer, MD3, Lisa Avalos, RN4, Mark Osburn, RN5, Ana Araujo, RN4. P2517 - Comparison of Elevator-Based Endoscopes Steris 1E Chemical Sterilization Against Standard Method: A Single-Center Study, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.