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Hübner NO, Assadian O, Poldrack R, et al. Endowashers: an overlooked risk for possible post-endoscopic infections. GMS Krankenhhyg Interdiszip. 2011;6(1):Doc13doi: 10.3205/dgkh000170.
Hübner, N. O., Assadian, O., Poldrack, R., Duty, O., Schwarzer, H., Möller, H., Kober, P., Räther, M., Schröder, L. W., Sinha, J., Lerch, M. M., & Kramer, A. (2011). Endowashers: an overlooked risk for possible post-endoscopic infections. GMS Krankenhaushygiene interdisziplinar, 6(1), Doc13. https://doi.org/10.3205/dgkh000170
Hübner, Nils-Olaf, et al. "Endowashers: an overlooked risk for possible post-endoscopic infections." GMS Krankenhaushygiene interdisziplinar vol. 6,1 (2011): Doc13. doi: https://doi.org/10.3205/dgkh000170
Hübner NO, Assadian O, Poldrack R, Duty O, Schwarzer H, Möller H, Kober P, Räther M, Schröder LW, Sinha J, Lerch MM, Kramer A. Endowashers: an overlooked risk for possible post-endoscopic infections. GMS Krankenhhyg Interdiszip. 2011;6(1):Doc13. doi: 10.3205/dgkh000170. Epub 2011 Dec 15. PMID: 22242094; PMCID: PMC3252647.
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GMS Krankenhhyg Interdiszip. 2011;6(1):Doc13. doi: 10.3205/dgkh000170. Epub 2011 Dec 15.

Endowashers: an overlooked risk for possible post-endoscopic infections.

GMS Krankenhaushygiene interdisziplinar

Nils-Olaf Hübner, Ojan Assadian, Rosmarie Poldrack, Oliver Duty, Heinrich Schwarzer, Hiltraud Möller, Paul Kober, Malte Räther, Lutz Werner Schröder, Jeanette Sinha, Markus M Lerch, Axel Kramer

Affiliations

  1. Institute of Hygiene and Environmental Medicine, University Medicine, Greifswald, Germany.

PMID: 22242094 PMCID: PMC3252647 DOI: 10.3205/dgkh000170

Abstract

BACKGROUND: Prevention of post-endoscopy infections is an important objective to assure patient safety. Endowashers, or high throughput irrigation water pumps, are a frequently used device on endoscopes. Recommendations published by professional bodies and regulatory health agencies cover not only adequate reprocessing of fiber-endoscopes but also state accepted methods of regular microbial sampling. Although major instruments like endoscopes are covered by these recommendations, other devices used as optional add-ons for endoscopes are not included.

OBJECTIVE: The aim of this prospective study was to investigate the potential for endowashers to act as a possible source of infection.

METHOD: 24 endowashers were sampled. Sterile rinse-water was pumped through the endowasher and tested microbiologically according to standardised tests. Sampling was performed in 18 hospitals, including 2 university teaching hospitals, in northern Germany. If endowashers were contaminated, devices were reprocessed and re-tested.

RESULTS: Of 44 samples, 6 (14%) were contaminated with pathogens of up to >20,000 cfu/ml. Pseudomonas aeruginosa and other Gram-negative non-fermenters such as Stenotrophomonas spp. (18x) and Acinetobacter spp. (2x), followed by Staphylococcus aureus (1x), Enterobacter cloacae (1x), Candida albicans (1x), Serratia spp. (1x), Streptococcus spp. (1x) and others (2x).

CONCLUSION: Endowashers can be a potential source of infection. Despite their common use, they are not routinely sampled microbiologically. Endowashers should be clearly mentioned in respective guidelines and routine quality control sampling of endowashers should be part of such recommendations. If endowashers are not monitored regularly, devices with single-use hoses should be used.

Keywords: disinfection; endoscope; endowasher; post-endoscopic infection; reprocessing

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