Improved screening for duodenoscope contamination after the regulations of 2018 a retrospective multicenter study

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Aims Contaminated duodenoscopes have resulted in multiple outbreaks and deaths involving multi drug-resistant organisms. In France the DGOS (health ministry) published an instruction in 2018 to supervise duodenoscopes disinfection and control. The aim of our study was to determine whether the 2018 guideline have decreased duodenoscopes contamination. Methods We conducted a retrospective multicentric observational French study. Data from results of routine microbiological sampling between the periods “before” (2016 to 2017) and “after” (2019 to 2020) the 2018 DGOS guideline was collected. Primary objective: compare frequency of contaminated samples results. Secondary end point: overview of duodenoscopes fleet, storage mode, disinfection staff, and endoscopy centres. Results 23 centres sent us the results of 1,476 duodenoscopes samples from 182 endoscopes. Average number of ERCP was 442 per year. Comparison of contaminated samples results between the two periods indicate (p < 0.001) : 112 (18.9%) of non-conformities samples "before", vs 241 (27.3%) "after. More indicator germs were in before group (72 vs 38%). The proportion of samples results is not significantly different depending on brand (p=0.3), centre (p = 0,88), age of duodenoscope (p=0.131), and storage (p =0,14). No significant differences in the performance of sampling at least quarterly were shown (p = 0.839). Conclusions There were more contaminated samples in the period “after” the 2018 DGOS instruction, we can presume that sensitivity has increased, detecting more duodenoscopic contamination. Improvements still could be possible, such as respect of the law, evaluation and standardisation of procedures, and technological progress ([ Table 1 ]). Table 1 Comparison of sampling characteristics between the two periods analysed. Publication History Article published online: 14 April 2023 © 2023. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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