Saudi Journal of Gastroenterology
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Comparison of channel sampling methods and brush heads in surveillance culture of endoscope reprocessing: A propensity score matching and paired study

1 Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, Tianjin, China
2 Department of Pathogenic Microbiology Institute, Tianjin Centers for Disease Control and Prevention, Tianjin, China
3 Department of Hospital Infection Management Office, Tianjin Medical University General Hospital, Tianjin, China
4 Department of Infection Management, Tianjin Hospital, Tianjin, China

Correspondence Address:
Chun-Nan Fei,
Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, No. 6, Huayue Road, Hedong District, Tianjin
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjg.sjg_437_21

PMID: 34856726

Background: Endoscopy-related infections have caused multiple outbreaks. The importance of surveillance culture is gradually recognized, but sampling techniques are not consistent in many guidelines. It is unclear whether the Flush-Brush-Flush sampling method (FBFSM) is more sensitive than the conventional flush sampling method (CFSM) and whether different sampling brushes have different effects. Methods: The propensity score matching method was done with two matching ways, 1:1 nearest neighbor propensity score matching and full matching was used to analyze the surveillance culture data collected by FBFSM and CFSM. We fit a confounder-adjusted multiple generalized linear logistic regression model to estimate the marginal odds ratio (OR). A paired study was applied to compare the sampling effect of polyurethane foam (PU) head brush and polyamide (PA) head brush. Result: From 2016 to 2020, 316 reprocessed endoscope samples were collected from all 59 endoscopy centers in Tianjin. About 279 (88.3%) reprocessed endoscopes met the threshold of Chinese national standards (<20 CFU/Channel). The qualified rate of reprocessed endoscopes sampling by CFSM (91.8%) and FBFSM (81.6%) was statistically different (p < 0.05). The adjusted OR by full matching for FBFSM was 7.98 (95% confidence interval: 3.35-21.78). Forty one pairs of colonoscopes, after reprocessing from 27 centers, were tested by PA and PU brushes, and no difference was found in microbial recovery. Conclusion: FBFSM was confirmed to be a more sensitive sampling technique. PU and PA brushes had no significant difference in sampling effect.

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