Hospital infection prevention and control quality supervision for flexible endoscope in Shanghai from 2018 to 2022_West China Medical Journal

Authors：

FU Lu ¹ , GAO Xiaodong ² , CUI Yixin ² , SUN Wei ² , SHI Qingfeng ² ,  SHEN Yan ²

1. Department of Infection Control, Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong, Jiangsu 226000, P. R. China;
2. Department of Infection Control, Zhongshan Hospital of Fudan University / Shanghai Infection Control and Prevention Center, Shanghai 200136, P. R. China;

Corresponding?author：

SHEN Yan, Email: annieshenyan@sohu.com

Keywords：

Flexible endoscope; nosocomial infection; quality supervision

DOI：

10.7507/1002-0179.202401160

Video：

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Objective To describe the current state of hospital infection prevention and control for flexible endoscope in Shanghai, and analyze the trend of infection prevention and control quality from 2018 to 2022. Methods According to Regulation for Cleaning and Disinfection Technique of Flexible Endoscope (WS 507－2016), the quality of infection prevention and control for flexible endoscope was divided into seven parts: organizational management, layout, cleaning and disinfection (sterilization) process, environmental disinfection and sterilization, final rinse water, recording and monitoring, and occupational protection. Each quality control item was judged according to the on-site score and the correction opinion, and the item with correction opinion was judged as “unqualified”, otherwise it was “qualified”. The results of the infection prevention and control quality supervision for flexible endoscope from 2018 to 2022 were reviewed and analyzed, and the qualification rates of quality control items for hospitals at different levels and in different years were calculated. Results From 2018 to 2022, the total qualification rates of organization management, final rinse water, environmental disinfection and sterilization, and occupational protection were over 90%, and the total qualification rates of cleaning and disinfection (sterilization) process, and records and monitoring were over 80%. There was no statistically significant difference in the annual qualification rate (P>0.05). The total qualification rate of the layout was 78.19%, which was significantly higher before the outbreak of COVID-19 (2018-2019) than after the outbreak of COVID-19 (2020-2022) (P<0.001). There was no significant difference in the qualification rate of different levels of hospitals in terms of organizational management, layout, cleaning and disinfection (sterilization) process, records and monitoring, or occupational protection item (P>0.05). There were statistical differences in the qualification rates of different levels of hospitals in terms of final rinse water and environmental disinfection and sterilization (P<0.05). Conclusions The infection prevention and control qualification rate of flexible endoscope in Shanghai is high. However, the layout qualification rate after the COVID-19 pandemic is lower than before. There has been no significant trend in the quality of other items in the past five years. Weaknesses in the cleaning and disinfection (sterilization) process, as well as in recording and monitoring, are identified as key areas in management. Targeted training and supervision are recommended to address these weaknesses.

Citation： FU Lu, GAO Xiaodong, CUI Yixin, SUN Wei, SHI Qingfeng, SHEN Yan. Hospital infection prevention and control quality supervision for flexible endoscope in Shanghai from 2018 to 2022. West China Medical Journal, 2024, 39(3): 423-427. doi: 10.7507/1002-0179.202401160 Copy

1.	Benowitz I, Moulton-Meissner HA, Epstein L, et al. Gastrointestinal flexible endoscopes: infection control risks, lessons learned from outbreaks, and centers for disease control and prevention guidance. Gastrointest Endosc Clin N Am, 2020, 30(4): 723-733.
2.	Snyder GM. Introduction to transmission of infection: potential agents transmitted by endoscopy. Gastrointest Endosc Clin N Am, 2020, 30(4): 611-618.
3.	廖想, 李依倪. 消化內鏡醫院感染現狀及其預防措施研究進展. 中國消毒學雜志, 2021, 38(2): 140-143.
4.	Rauwers AW, Kwakman JA, Vos MC, et al. Endoscope-associated infections: a brief summary of the current state and views toward the future. Tech Gastrointest Endosc, 2019, 21(4): 150608.
5.	Kumarage J, Khonyongwa K, Khan A, et al. Transmission of multi-drug resistant Pseudomonas aeruginosa between two flexible ureteroscopes and an outbreak of urinary tract infection: the fragility of endoscope decontamination. J Hosp Infect, 2019, 102(1): 89-94.
6.	Wang P, Xu T, Ngamruengphong S, et al. Rates of infection after colonoscopy and osophagogastroduodenoscopy in ambulatory surgery centres in the USA. Gut, 2018, 67(9): 1626-1636.
7.	張琳, 營建華, 李遠菁, 等. 消化內鏡相關醫院感染現狀及其影響因素. 中華醫院感染學雜志, 2023, 33(15): 2391-2395.
8.	莫海亞, 張道權. 胃動力內鏡檢查發生醫院感染危險因素及管理措施分析. 中國醫藥導報, 2022, 19(24): 65-68.
9.	劉運喜, 邢玉斌, 鞏玉秀. 軟式內鏡清洗消毒技術規范 WS 507-2016. 中國感染控制雜志, 2017, 16(6): 587-592.
10.	孫振球, 徐勇勇. 醫學統計學. 4 版. 北京: 人民衛生出版社, 2014: 107-108.
11.	Pereira ML, Bergamo RT, da Silva FM, et al. Risks of infection associated with aerosol generation during medical procedures in an endoscopy unit. J Hazard Mater Adv, 2022, 8: 100174.
12.	Shimpi RA, Spaete JP. Quality assurance in endoscopic infection control, disposable duodenoscopes, and the environmental impact of endoscopy. Tech Innov Gastrointest Endosc, 2022, 24(3): 290-299.
13.	孔懿, 黃英, 張亞英, 等. 南京市 10 家中醫院的軟式內鏡清洗消毒現狀調查. 中國消毒學雜志, 2020, 37(12): 934-937.
14.	申良榮, 李倩, 李寶珍. 陜西省 170 所醫療機構消化內鏡清洗消毒現狀調查. 中國消毒學雜志, 2017, 34(12): 1129-1131.
15.	Suresh S, Pande M, Patel K, et al. Education, training, and knowledge of infection control among endoscopy technicians and nurses. Am J Infect Control, 2021, 49(6): 836-839.
16.	Suresh S, Mahometano LD, Romero LG, et al. Tu1105 survey of education, training, and knowledge of endoscopy nurses and techs on infection control in the endoscopy unit. Gastrointest Endosc, 2020, 91(6S): AB547-AB548.
17.	馮翠蘭. 消化內鏡消毒效果監測研究新進展. 中國醫學工程, 2017, 25(8): 28-31.
18.	黃茜莎, 劉波, 張翔, 等. 濾膜法與涂抹法檢測內鏡清洗消毒效果及成本比較. 中國感染控制雜志, 2019, 18(6): 571-576.
19.	朱炫瑞, 莊宜錦, 劉文龍, 等. 吉林省 72 所醫療機構軟式內鏡終末漂洗用水管理現狀調查. 中國感染控制雜志, 2022, 21(7): 642-650.
20.	史慶豐, 胡必杰, 崔揚文, 等. 上海市 30 所三級醫療機構軟式內鏡終末漂洗水現狀調查. 中華醫院感染學雜志, 2020, 30(6): 923-926.
21.	王偉民, 馬久紅. 67 所醫療機構內鏡終末漂洗水使用調查及相關因素分析. 中華醫院感染學雜志, 2019, 29(10): 1587-1590.
22.	王萍, 鮑容, 史慶豐, 等. 某綜合醫院消化內鏡生物膜形成現狀及影響因素分析. 華西醫學, 2021, 36(3): 348-352.
23.	Walker JT, Bak A, Marsden G, et al. Final rinse water quality for flexible endoscopy to minimize the risk of post-endoscopic infection. Report from Healthcare Infection Society Working Party. J Hosp Infect, 2022, 124: 79-96.

1. Benowitz I, Moulton-Meissner HA, Epstein L, et al. Gastrointestinal flexible endoscopes: infection control risks, lessons learned from outbreaks, and centers for disease control and prevention guidance. Gastrointest Endosc Clin N Am, 2020, 30(4): 723-733.
2. Snyder GM. Introduction to transmission of infection: potential agents transmitted by endoscopy. Gastrointest Endosc Clin N Am, 2020, 30(4): 611-618.
3. 廖想, 李依倪. 消化內鏡醫院感染現狀及其預防措施研究進展. 中國消毒學雜志, 2021, 38(2): 140-143.
4. Rauwers AW, Kwakman JA, Vos MC, et al. Endoscope-associated infections: a brief summary of the current state and views toward the future. Tech Gastrointest Endosc, 2019, 21(4): 150608.
5. Kumarage J, Khonyongwa K, Khan A, et al. Transmission of multi-drug resistant Pseudomonas aeruginosa between two flexible ureteroscopes and an outbreak of urinary tract infection: the fragility of endoscope decontamination. J Hosp Infect, 2019, 102(1): 89-94.
6. Wang P, Xu T, Ngamruengphong S, et al. Rates of infection after colonoscopy and osophagogastroduodenoscopy in ambulatory surgery centres in the USA. Gut, 2018, 67(9): 1626-1636.
7. 張琳, 營建華, 李遠菁, 等. 消化內鏡相關醫院感染現狀及其影響因素. 中華醫院感染學雜志, 2023, 33(15): 2391-2395.
8. 莫海亞, 張道權. 胃動力內鏡檢查發生醫院感染危險因素及管理措施分析. 中國醫藥導報, 2022, 19(24): 65-68.
9. 劉運喜, 邢玉斌, 鞏玉秀. 軟式內鏡清洗消毒技術規范 WS 507-2016. 中國感染控制雜志, 2017, 16(6): 587-592.
10. 孫振球, 徐勇勇. 醫學統計學. 4 版. 北京: 人民衛生出版社, 2014: 107-108.
11. Pereira ML, Bergamo RT, da Silva FM, et al. Risks of infection associated with aerosol generation during medical procedures in an endoscopy unit. J Hazard Mater Adv, 2022, 8: 100174.
12. Shimpi RA, Spaete JP. Quality assurance in endoscopic infection control, disposable duodenoscopes, and the environmental impact of endoscopy. Tech Innov Gastrointest Endosc, 2022, 24(3): 290-299.
13. 孔懿, 黃英, 張亞英, 等. 南京市 10 家中醫院的軟式內鏡清洗消毒現狀調查. 中國消毒學雜志, 2020, 37(12): 934-937.
14. 申良榮, 李倩, 李寶珍. 陜西省 170 所醫療機構消化內鏡清洗消毒現狀調查. 中國消毒學雜志, 2017, 34(12): 1129-1131.
15. Suresh S, Pande M, Patel K, et al. Education, training, and knowledge of infection control among endoscopy technicians and nurses. Am J Infect Control, 2021, 49(6): 836-839.
16. Suresh S, Mahometano LD, Romero LG, et al. Tu1105 survey of education, training, and knowledge of endoscopy nurses and techs on infection control in the endoscopy unit. Gastrointest Endosc, 2020, 91(6S): AB547-AB548.
17. 馮翠蘭. 消化內鏡消毒效果監測研究新進展. 中國醫學工程, 2017, 25(8): 28-31.
18. 黃茜莎, 劉波, 張翔, 等. 濾膜法與涂抹法檢測內鏡清洗消毒效果及成本比較. 中國感染控制雜志, 2019, 18(6): 571-576.
19. 朱炫瑞, 莊宜錦, 劉文龍, 等. 吉林省 72 所醫療機構軟式內鏡終末漂洗用水管理現狀調查. 中國感染控制雜志, 2022, 21(7): 642-650.
20. 史慶豐, 胡必杰, 崔揚文, 等. 上海市 30 所三級醫療機構軟式內鏡終末漂洗水現狀調查. 中華醫院感染學雜志, 2020, 30(6): 923-926.
21. 王偉民, 馬久紅. 67 所醫療機構內鏡終末漂洗水使用調查及相關因素分析. 中華醫院感染學雜志, 2019, 29(10): 1587-1590.
22. 王萍, 鮑容, 史慶豐, 等. 某綜合醫院消化內鏡生物膜形成現狀及影響因素分析. 華西醫學, 2021, 36(3): 348-352.
23. Walker JT, Bak A, Marsden G, et al. Final rinse water quality for flexible endoscopy to minimize the risk of post-endoscopic infection. Report from Healthcare Infection Society Working Party. J Hosp Infect, 2022, 124: 79-96.

West China Medical Journal

Hospital infection prevention and control quality supervision for flexible endoscope in Shanghai from 2018 to 2022

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