Endoscopy 2021; 53(S 01): S270
DOI: 10.1055/s-0041-1725216
Abstracts | ESGE Days
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Gastrointestinal Endoscope Contamination Rate Beyond The Elevator: A Systematic Review And Meta-Analysis Based On European Data

S Larsen
1   Ambu A/S, Ballerup, Denmark
,
N Birk Larsen
2   Aalborg University, School of Medicine and Health, Aalborg, Denmark
,
L Klinten Ockert
1   Ambu A/S, Ballerup, Denmark
,
S Adamsen
1   Ambu A/S, Ballerup, Denmark
3   Bispebjerg Hospital, University of Copenhagen, Digestive Disease Center, Copenhagen, Denmark
› Author Affiliations
 
 

    Aims The elevator has been suggested a key factor in multiple European outbreaks associated with contaminated reusable patient-ready duodenoscopes. The outbreaks have led to increased focus on contamination of the elevator. However, numerous studies have documented microbes in gastrointestinal (GI) endoscopes without an elevator and in the channels of both duodenoscopes and linear echoendoscopes. We aimed estimate the contamination rate beyond the elevator of GI endoscopes based on currently available European data.

    Methods We searched PubMed, Web of Science, and Embase from 1 January 2010 until 10 October 2020, for European studies investigating contamination rates of patient-ready GI endoscopes. Analysis and inclusion criteria were based on the PRISMA guideline. A random-effects model based on the proportion distribution was used to calculate the total weighted contamination rate beyond the elevator of patient-ready GI endoscopes. Heterogeneity between the included studies was analysed using the inconsistency index (I2) statistics. Publication bias was assessed using funnel plot and Egger’s regression test.

    Results Based on the inclusion criteria, we identified seven European studies including 383 positive cultures from a total of 1,834 samples. The total weighted contamination rate was 18.16 % ± 0.053 (95 % confidence interval [Cl]: 7.75 % - 28.57 %). I2 indicated high heterogeneity (98.1 %). Egger’s regression test indicated significant publication bias (Egger’s test of publication bias: p = 0.0025).

    Conclusions Our analysis demonstrates, that 18.16 % of patient-ready GI endoscopes may be contaminated when used in patients. These findings highlight that the elevator mechanism is not the only obstacle when reprocessing flexible reusable GI endoscopes. Additionally, these findings also indicate that contamination issues are present in European health care settings despite less acknowledgement compared to the United States. However, high heterogeneity and significant publication bias should be considered when interpreting these results.

    Citation Larsen S, Birk Larsen N, Klinten Ockert L et al. eP517 GASTROINTESTINAL ENDOSCOPE CONTAMINATION RATE BEYOND THE ELEVATOR: A SYSTEMATIC REVIEW AND META-ANALYSIS BASED ON EUROPEAN DATA. Endoscopy 2021; 53: S270.


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    Publication History

    Article published online:
    19 March 2021

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