Analysis of current situation and influencing factors of biofilm formation of digestive endoscopy in a general hospital_West China Medical Journal

Authors：

WANG Ping ¹ , BAO Rong ² , SHI Qingfeng ³ , FAN Liming ¹ ,  GAO Xiaodong ³

1. Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China;
2. Clinical Laboratory, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China;
3. Department of Hospital Infection Control, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China;

Corresponding?author：

GAO Xiaodong, Email: gaoxd5@vip.sina.com

Keywords：

Digestive endoscopy; Biofilm; Aquatic bacteria; Affecting factors

DOI：

10.7507/1002-0179.202101032

Video：

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Objective To study the current situation and influencing factors of biofilm formation of digestive endoscopy in Zhongshan Hospital, Fudan University.Methods From September 1st to 13th, 2020, ATP fluorescence assay and membrane filtration method were carried out on 130 endoscopes from the Endoscopy Center of Zhongshan Hospital, Fudan University. The type, number, source, duration of use and disinfection times in the past week were collected. Positive culture samples were identified by matrix-assisted laser desorption / ionization time of flight mass spectrometry. Logistic regression analysis was used to explore the factors affecting the formation of biofilms.Results The total qualified rate of ATP assay and bacterial culture was 94.62% and 92.31% respectively. The 10 positive culuture samples were mainly composed of Pseudomonas aeruginosa, Moraxella osloensis, Stenotrophomonas maltophilia, Pseudomonas putida and Micrococcus luteus. Multivariate logistic regression analysis showed that the frequency of disinfection in the past week was associated with positive biofilm culture (P=0.001). The odds ratio of disinfection frequency more than 30 times in past week compared with disinfection frequency less than 15 times was 0.040, and 95% confidence interval was (0.005, 0.295).Conclusions The biofilm of digestive endoscopy in the Endoscopy Center of Zhongshan Hospital, Fudan University is mainly formed by aquatic bacteria. The formation biofilm can decrease by increasing disinfection frequency, and attention should be paid to the monitoring of endoscopic biofilm in the future.

Citation： WANG Ping, BAO Rong, SHI Qingfeng, FAN Liming, GAO Xiaodong. Analysis of current situation and influencing factors of biofilm formation of digestive endoscopy in a general hospital. West China Medical Journal, 2021, 36(3): 348-352. doi: 10.7507/1002-0179.202101032 Copy

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2.	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.
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6.	任哲, 魏秋華. 醫療機構中生物膜污染現狀與應對措施. 中國消毒學雜志, 2019, 36(9): 702-704.
7.	錢麟, 史慶豐, 許華, 等. 一種新型次氯酸消毒劑對纖維支氣管鏡的消毒效果. 中國感染控制雜志, 2020, 19(7): 662-665.
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9.	李紅云, 吳丹, 李應龍. 次氯酸鈉對口腔綜合治療臺水路系統生物膜的殺滅效果及對金屬腐蝕性研究. 中國消毒學雜志, 2019, 36(8): 574-577.
10.	馬蘇, 傅增軍, 丁文霞, 等. 消化內鏡腔細菌生物膜有效清除方法. 中國消毒學雜志, 2017, 34(9): 807-810.
11.	Li W, Tan Q, Zhou W, et al. Impact of substrate material and chlorine/chloramine on the composition and function of a young biofilm microbial community as revealed by high-throughput 16S rRNA sequencing. Chemosphere, 2020, 242: 125310.
12.	馬向盛, 蘇成君, 何曉芳, 等. 自來水管網生境中細菌多樣性的研究. 中國衛生檢驗雜志, 2016, 26(17): 2482-2486.
13.	廖丹, 胡必杰, 史慶豐, 等. ICU 水龍頭及其周圍污染情況的調查. 中國感染控制雜志, 2019, 18(6): 566-570.
14.	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.
15.	舒東嬌, 張麗娜, 曹子晶, 等. 消毒后消化內鏡中分離的銅綠假單胞菌對消毒劑的抗性分析. 中國消毒學雜志, 2015, 32(9): 948-950.
16.	孟照全, 張朝貴, 王桂林. 機械通氣的重癥肺炎患者管道中冷凝水污染情況分析. 中國呼吸與危重監護雜志, 2020, 19(06): 582-585.
17.	劉志鵬, 張蓉, 祝丙華, 等. 某老年病醫院嗜麥芽窄食單胞菌臨床分布及耐藥性分析. 中國消毒學雜志, 2018, 35(2): 111-113.
18.	石磊, 吳安華, 曹嵐, 等. 重癥監護病房嗜麥芽窄食單胞菌醫院感染的危險因素. 中國感染控制雜志, 2019, 18(5): 403-409.
19.	趙璐, 楊冬華, 綻麗, 等. 透析機與供水回路間軟管生物膜形成對透析用水微生物指標的影響分析. 中華醫院感染學雜志, 2017, 27(18): 4171-4174.
20.	周冬梅, 周巖巖, 盧玉文. 清洗環節質量控制對內鏡管腔生物膜的影響. 中國消毒學雜志, 2018, 35(2): 159-160.

1. Neves MS, da Silva MG, Ventura GM, et al. Effectiveness of current disinfection procedures against biofilm on contaminated GI endoscopes. Gastrointest Endosc, 2016, 83(5): 944-953.
2. 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.
3. Dirlam Langlay AM, Ofstead CL, Mueller NJ, et al. Reported gastrointestinal endoscope reprocessing lapses: the tip of the iceberg. Am J Infect Control, 2013, 41(12): 1188-1194.
4. Funk SE, Reaven NL. High-level endoscope disinfection processes in emerging economies: financial impact of manual process versus automated endoscope reprocessing. J Hosp Infect, 2014, 86(4): 250-254.
5. 劉衛平, 何歡, 楊永芳, 等. 內蒙古自治區 24 家醫院軟式內鏡生物膜現狀研究. 中國消毒學雜志, 2020, 37(7): 502-504.
6. 任哲, 魏秋華. 醫療機構中生物膜污染現狀與應對措施. 中國消毒學雜志, 2019, 36(9): 702-704.
7. 錢麟, 史慶豐, 許華, 等. 一種新型次氯酸消毒劑對纖維支氣管鏡的消毒效果. 中國感染控制雜志, 2020, 19(7): 662-665.
8. 李秀梅, 潘麗云, 鄧金川, 等. 內鏡專用過氧乙酸消毒劑對生物膜去除效果研究. 中國消毒學雜志, 2019, 36(2): 89-91.
9. 李紅云, 吳丹, 李應龍. 次氯酸鈉對口腔綜合治療臺水路系統生物膜的殺滅效果及對金屬腐蝕性研究. 中國消毒學雜志, 2019, 36(8): 574-577.
10. 馬蘇, 傅增軍, 丁文霞, 等. 消化內鏡腔細菌生物膜有效清除方法. 中國消毒學雜志, 2017, 34(9): 807-810.
11. Li W, Tan Q, Zhou W, et al. Impact of substrate material and chlorine/chloramine on the composition and function of a young biofilm microbial community as revealed by high-throughput 16S rRNA sequencing. Chemosphere, 2020, 242: 125310.
12. 馬向盛, 蘇成君, 何曉芳, 等. 自來水管網生境中細菌多樣性的研究. 中國衛生檢驗雜志, 2016, 26(17): 2482-2486.
13. 廖丹, 胡必杰, 史慶豐, 等. ICU 水龍頭及其周圍污染情況的調查. 中國感染控制雜志, 2019, 18(6): 566-570.
14. 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.
15. 舒東嬌, 張麗娜, 曹子晶, 等. 消毒后消化內鏡中分離的銅綠假單胞菌對消毒劑的抗性分析. 中國消毒學雜志, 2015, 32(9): 948-950.
16. 孟照全, 張朝貴, 王桂林. 機械通氣的重癥肺炎患者管道中冷凝水污染情況分析. 中國呼吸與危重監護雜志, 2020, 19(06): 582-585.
17. 劉志鵬, 張蓉, 祝丙華, 等. 某老年病醫院嗜麥芽窄食單胞菌臨床分布及耐藥性分析. 中國消毒學雜志, 2018, 35(2): 111-113.
18. 石磊, 吳安華, 曹嵐, 等. 重癥監護病房嗜麥芽窄食單胞菌醫院感染的危險因素. 中國感染控制雜志, 2019, 18(5): 403-409.
19. 趙璐, 楊冬華, 綻麗, 等. 透析機與供水回路間軟管生物膜形成對透析用水微生物指標的影響分析. 中華醫院感染學雜志, 2017, 27(18): 4171-4174.
20. 周冬梅, 周巖巖, 盧玉文. 清洗環節質量控制對內鏡管腔生物膜的影響. 中國消毒學雜志, 2018, 35(2): 159-160.

West China Medical Journal

Analysis of current situation and influencing factors of biofilm formation of digestive endoscopy in a general hospital

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