A44 ENDOSCOPISTS PERFORMING ADVANCED UPPER GI ENDOSCOPY ARE AT HIGHER RISK OF FACIAL BACTERIAL CONTAMINATION
Bibliographic record
Abstract
Abstract Background Gastrointestinal (GI) endoscopy has been recognized as putting endoscopists at risk for bacterial exposure. However, whether longer, more advanced procedures such as endoscopic submucosal dissection (ESD) or endoscopic retrograde cholagiopancreatography (ERCP) confer greater risk has not been investigated. Aims This study aimed to investigate the degree of exposure on endoscopists who performed ESD or ERCP and find out if longer time or procedure type are risk factors for exposure. Methods This was a prospective study examining the facemasks of endoscopists who performed ESD or ERCP at a university hospital, with 40 procedures planned for each procedure. The face shield was swabbed in a standardized way before and at the end of the procedure. Swabs were also taken from face shields placed 2 meters away on the endoscopy suite wall, patient recovery room wall, and after direct contamination by the endoscope immediately after the procedure. The swabs were cultured for 48 hours, and growth was reported as no growth or by number of colony-forming units (CFUs). The groups were compared for +CFU rate. Risk of contamination was analyzed by procedure time and type. Results 55 ESDs and ERCPS were performed during the study dates. It was decided to terminate the study early, due to the COVID-19 situation, as facemasks were deemed too important to be used for walls. Excluding one facemask group in which the endoscopist’s facemask was exposed before the procedure, 54 groups of masks were analyzed. There were 33 ESDs and 21 ERCPS performed, with 26 upper GI and 7 lower GI ESDs. A cut-off of 30 CFUs were determined as indication of definite exposure. Interestingly, none of the 7 lower GI ESDs resulted in any exposure, so it was decided to analyze only the 47 orally inserted procedures. There were 9 positive exposures, 6 ESDs (23.1%) and 3 ERCPs (14.3%). Mean procedure time was 30.3 ± 15.2 minutes. Procedure time (Odds ratio 1.014, 0.968-1.061, P=0.564) and type (ERCP compared to ESD, OR 0.556, 0.121-2.553, P=0.556) were not positive risk factors for contamination. The most commonly cultured pathogens were Staphylococcus, Streptococcus, Bacillus, and Moraxella species. Conclusions This study confirmed that advanced procedures such as upper GI ESDs and ERCPs have a high risk of facial exposure. Facemasks and other protective equipment should be used during GI endoscopy. Basic Characteristics of Endoscopy ESD - endoscopic submucosal dissection, ERCP - endoscopic retrograde cholangiopancreatography Funding Agencies None
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.007 | 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".