scope's channels. ATP is an enzyme found in all living cells and is pres-
ent on any contaminated surface. An ATP monitoring system can
detect the amount of organic matter that remains after manually clean-
ing an endoscope.
• Routine surveillance culturing.
• Inserting a borescope into an endoscope's channels provides
direct views of internal lumens and groves, where biofilm hides and
brushes might not be able to reach. Adding borescopes to your repro-
cessing regimen is arguably the best way to ensure endoscopes are
cleaned properly.
In the news
Reports of deadly antibiotic-resistant bacteria outbreaks have
splashed across national headlines in recent years. In early 2015, 2
patients died after being infected with carbapenem-resistant
Enterobacteriaceae (CRE) during endoscopic retrograde cholan-
giopancreatography (ERCP) performed at UCLA Medical Center in
Los Angeles. Later that year, Virginia Mason Medical Center in Seattle,
Wash., reported the deaths of 11 patients who were also infected with
CRE during ERCP. The outbreaks at both facilities were ultimately
linked to dirty duodenoscopes used during the procedures.
The dangers of cross-contamination aren't limited to tough-to-clean
duodenoscopes. In January 2016, Baystate Noble Hospital in
Westfield, Mass., notified 293 patients that they might have been
exposed to bloodborne pathogens after it was discovered that colono-
scopes used at the facility during a 10-month period weren't properly
disinfected. This past January, an untrained nurse at Crozer-Chester
Medical Center in suburban Philadelphia used an improperly disinfec-
ted endoscope on an elderly patient. State inspectors found that the
nurse first attempted to perform the endoscopy with a properly
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