Risk factors for excessive microbial contamination levels of repaired endoscopes before reuse

OBJECTIVE To analyze the risk factors for excessive microbial contamination level tested for repaired endoscopes before reuse and to formulate targeted management strategies, providing a reference for handling such events.

METHODS A total of 54 repaired endoscopes reused in the Digestive Endoscopy Room of a hospital in Shanxi Province from Oct. 2021 to Jun. 2024, with a total of 105 repairs, were selected as the study subjects. Microbial contamination levels were tested for all repaired endoscopes before reuse, and they were divided into a positive group (colony count >20 CFU/item) and a negative group (colony count ≤20 CFU/item) based on the test results. The risk factors for excessive microbial contamination levels of repaired endoscopes before reuse were summarized. The positive rates of microbial contamination level tests for repaired endoscopes before reuse were compared between the pre-intervention period (from Oct. 2021 to Jun. 2024) and the post-intervention period (from Jul. 2024 to Dec. 2024).

RESULTS The results of microbial contamination level tests of endoscopes with 105 repairs before reuse showed a positive rate of 27.62% (29/105). Shortening duration between cleaning and disinfection before and after repair (OR=0.285) was a protective factor, scratches/grooves/leak repairs in the endoscope tubes (OR=3.211), improper cleaning and disinfection (OR=5.257) and the less number of enzymatic brushing washes (OR=2.438) were identified as risk factors for excessive microbial contamination levels of repaired endoscopes before reuse (P < 0.05). Before the intervention, the positive rate of microbial contamination level tests for repaired endoscopes was higher than that for non-repaired endoscopes (27.62% vs. 3.45%, P < 0.001). After the intervention, there was no statistically significant difference in the positive rate of microbial contamination level tests between repaired and non-repaired endoscopes (5.26% vs. 4.17%, P=0.681), but the positive rate for repaired endoscopes was lower than that before the intervention (5.26% vs. 27.62%, P=0.004).

CONCLUSIONS The occurrence of excessive microbial contamination levels of repaired endoscopes before reuse frequemly occur. Formulating and implementing targeted management strategies may guarantee the qualified rate of cleaning and disinfection of endoscopes before the reuse, and enhance the safety for the reuse of repaired endoscopes.