Il reprocessing è una procedura sicura prima del primo riutilizzo dei broncoscopi?: Uno studio cross-sectional in un Ospedale Universitario Romano

[Autom. eng. transl.] OBJECTIVES: The incidence of infections associated with the use of endoscopes is now considered extremely rare (1 in 1,800,000 procedures, equal to 0.000056%). However, almost all infections transmitted to the patient following an endoscopic examination are they occur due to a defect in the cleaning and disinfection procedures of the instrument. Based on the claims of various authors, reprocessing of endoscopes may not be necessary for periods of non-use up to two weeks in case of correct disinfection and storage. The objective of our study is to evaluate the actual usefulness of reprocessing procedures for flexible bronchoscopes after a storage period and before their first re-use. Materials and methods A cross-sectional study was carried out from July 2007 to March 2011 to evaluate the quality of the microbiological outcomes of manual and automatic reprocessing procedures used in the Bronchoscopy Operating Unit of a Roman University Hospital. With quarterly frequency (January, April, July, October) from 1 to 10 bronchoscopes were examined (depending on the number of active instruments) collecting liquid samples from the disinfected instruments and stored after use. The sampling and microbiological analysis methods used are those contained in the ESGE – ESGENA 2007 guidelines. For each bronchoscope, samples were taken before and after reprocessing. The chi-square test, in Fisher's exact version, was used to assess the presence of statistically significant differences in the frequency of contamination before and after reprocessing. RESULTS: 118 samples were analyzed. Only one sample was contaminated before reprocessing and two subsequently. The chi-square test showed the absence of statistically significant differences in the number of contaminated samples before and after reprocessing (p = 0.500). CONCLUSIONS: Our study confirms that the reprocessing of bronchoscopes immediately before their first re-use does not represent a useful method in order to prevent any risk of infection related to an endoscopic examination, but rather could determine its contamination, in addition to affecting costs. For a correct management of the same, comprehensive indications can be provided by the ESGE guidelines.