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Microbiological Testing Guidelines

Microbiological surveillance of endoscopes and automated flexible endoscope reprocessors (AFERs) has proven to be one of the most difficult and controversial areas of infection control in endoscopy.

Surveillance cultures of endoscopes and AFERs as a quality control measure has been recommended by the Gastroenterological Society of Australia and the Gastroenterological Nurses College of Australia Inc since 1951 and endoscope surveillance cultures were also recommended by the New Zealand Standards Expert Committee in 2002. As a result, the majority of endoscopy units in Australia and New Zealand have routinely been performing these cultures.

Endoscope surveillance cultures are also recommended by the French Gastroenterology Society, Canadian endoscopy working group, the German Working Group on Hospital Hygeine, the Robert Koch Institute the Asian Pacific Society of Digestive Endoscopy and the European Society of Gastroenterology and European Society of Gastroenterology and Endoscopy Nurses and Associates have recently published formal guidelines8 for this practice.

In addition, the requirement in European Standard prEN ISO 15883 for the clinical service provider to evaluate outcome quality by technical and microbiological testing of washer disinfectors, endoscopes and water has led to ESGE / ESGENA to also publish guidelines for process validation and routine testing.

However, the adoption of microbiological surveillance of endoscopes and AFERs is not universal; the American College of Chest Physicians and American Association for Bronchology and a panel representing a number of United States Gastroenterology and Infection Control groups11 makes no recommendation for routine surveillance cultures of endoscopes and only 17% of Northeastern USA endoscopy units perform endoscope surveillance cultures.