Some flexible scopes end up with debris or moisture that eventually may accelerate microbial growth. This can happen even when the staff carries out reprocessing according to the manufacturer’s specifications. In addition, it is important to dry the scopes thoroughly to avoid the risks that humidity poses: both costly scope damage and, more importantly, transmission of disease to patients.
Manual cleaning of scopes is an important first step in removing organic material that can later foster biofilm. There seems to be agreement that adequate manual cleaning, followed by high-level disinfection (HLD), is critical to removing organic debris from scopes. Without manual cleaning, HLD will not be sufficient in removing biofilms, which can later become resistant to reprocessing efforts.
The importance of audits
Cori L. Ofstead, president and CEO of the independent research organization Ofstead & Associates, has this to say on the subject: “An expert should do periodic audits to confirm proper reprocessing practices. Clinicians should ask to see their reports so they can feel confident that any issues have been resolved. To reduce risk, clinicians should also visually inspect every scope before use to confirm that it’s free of damage and debris.”
The FDA’s August 2015 Safety Communication lists supplemental measures for reinforcing reprocessing efforts for most types of flexible scopes. The FDA is monitoring three manufacturers of duodenoscopes sold in the U.S. — Olympus, Pentax, and Fujifilm — to ensure they provide post-market studies to determine whether healthcare facilities were able to properly disinfect the scopes to help mitigate the risk of patient infection.