DECONTAMINATION
support staff with vital education. This has enabled decontamination professionals to stay informed of what is happening in the industry – from changes in standards and advances in technology, to identifying issues around patient and staff safety.
Are we missing failures? One topic that remains high on the agenda is the importance of identifying decontamination failures. Technologies that help staff inspect, report and trace will be key to protecting patients. While the new threat of COVID-19 has been taking centre stage, familiar foes such as Pseudomonas aeruginosa and vCJD continue to present challenges. Speaking at CSC’s 2021 Autumn Study Day, David Jenkins, from University Hospitals of Leicester NHS Trust, delivered a presentation on ‘How do you
OPINION Software key in a post-COVID era
CSJ asked Brian King, EMEA sales training manager at Cantel Medical: ‘what will be the top transformative decontamination technologies for 2022?’ He believes software – supporting traceability, infection prevention and compliance with guidance – will be vital to ensuring safe recovery of endoscopy services.
“Innovations such as software that
can track the whole endoscope procedure journey should be considered when reviewing infection control methods. This enables departments to trace all endoscopes, from hygiene status to repairs, location and logged tests. Such systems give decontamination teams full visibility of the endoscope lifecycle. Technologies like this, which
focus on the traceability for cleaning and reprocessing endoscopes, will become increasingly important in the effort to enhance infection control measures and make endoscopy services as safe as possible moving forward. “We are by no means out of the
woods with regards to COVID-19, and this will continue to influence how decontamination departments operate in 2022 and beyond. By using the learnings of the last eighteen months, we can ensure patients continue to be kept safe. This will involve focusing on ensuring our understanding of department-specific COVID guidance is up to date, to provide complete confidence that the measures in place will significantly reduce infection risks for patients.”
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know if you have had a decontamination failure?’ He highlighted a case of a patient who has undergone cystoscopy in 2019 and subsequently presented with a urinary tract infection from which P. aeruginosa was isolated. In 2020, the patient went on to present with a knee infection which also grew P. aeruginosa. A few days later a P. aeruginosa positive bloodculture was also detected in a patient who had also had a cystoscopy. All isolates were sensitive to antibiotics and the VNTR profiles identified that both strains were similar and that there may have been a common source. All the cystoscopes had been decontaminated in the same unit. The rinse water was clear. However, additional patients started to be identified as being positive with P. aeruginosa – all with a similar VNTR profile. The cystoscopes were flushed and irrigated
as were the three-way taps (to enable irrigation). Manufacturer’s instructions were to decontaminate the three-way valves using either glutaraldehyde, ethylene oxide or steam sterilisation, none of which were used. Instead, the three-way valves were placed in the decontamination tray and processed through the endoscope washer disinfector. Microbiological analysis identified the three-way tap as being contaminated and a number of different strains of P. aeruginosa were recovered. The outbreak involved 14 patients over a period of eight months. While the rate of infection was relatively low, Jenkins warned that we may be missing many outbreaks associated with endoscopy and highlighted the need for systems to be put in place to identify adverse patient outcomes that could be associated with reusable medical devices. The case review highlights the ongoing importance of track and trace, using electronic patient records, as well as the need to review practices across hospitals to ensure safe decontamination of cystoscopes.
CJD: risks for patients and staff? Vigilance around the risks of Creutzfeldt- Jakob Disease (CJD) must also be sus- tained, as Katy Sinka, Public Health Eng- land, pointed out, during her presentation at the CSC Autumn Study Day. In the UK, key policies remain in place to prevent the transmission of vCJD via blood and surgery (quarantine or disposal of instruments used on known cases; introduction of disposable instruments where appropriate, and provi- sion of clean and non-infectious re-usable surgical instruments).
She pointed out that the NICE IPG 666 guidance was updated in 2020 and deals with surgery involving the high-risk tissues. The updated guidance emphasises the need for instruments to be kept moist to aid the removal of proteins before cleaning and sterilisation and removed the need to
JANUARY 2022
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