Reprocessing flexible gastrointestinal endoscopes after a period of disuse: is it necessary?
Bibliographic record
Abstract
BACKGROUND: Gastrointestinal endoscopy is an integral tool in the evaluation and management of many gastrointestinal and hepatobiliary conditions. Although rare, media reports of infectious complications following gastrointestinal endoscopy persist in this new millennium. With only limited data available, society guidelines continue to suggest that endoscopes undergo a reprocessing cycle before the first patient of the day. This preliminary study aimed to assess the microbiological stability of gastrointestinal endoscopes after high-level disinfection. METHODS: In this multiphase study, four endoscopic retrograde cholangiopancreatography (ERCP) scopes and three colonoscopes were evaluated. In phase 1, endoscopes were assayed after initial high-level disinfection and daily for a period of 2 weeks. In phase 2, this procedure was repeated to confirm phase 1 results. In phase 3, endoscopes were assayed after high-level disinfection and again following a 7-day storage period. RESULTS: In phase 1, 6 of 70 (8.6 %) assays were positive. This involved 4 of 7 (57 %) endoscopes (2 colonoscopes and 2 ERCP scopes) and was limited to the first 5 days of the study. No cultures were positive in phase 2. In phase 3, one endoscope had a positive culture. Positive cultures grew only STAPHYLOCOCCUS EPIDERMIDIS, a low-virulence skin organism. DISCUSSION: With proper disinfection and storage, it appears that reprocessing of gastrointestinal endoscopes is unnecessary after periods of disuse of at least 7 days and possibly up to 2 weeks. Despite recent media reports of infectious complications, society guidelines that recommend more frequent reprocessing seem to lack scientific merit and need to be revisited.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.028 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".