INFECTION CONTROL IN GASTROINTESTINAL ENDOSCOPY

Abstract

Many incidents of infection of patients with microorganisms during endoscopic examinations have been reported. Recently, several guidelines for their prevention have been drawn up and updated by some medical societies. Standard precautions are essential, and endoscopes and apparatuses should be reprocessed according to Spaulding’s classification. Reprocessing of endoscopes requires high-level disinfection using glutaraldehyde, orthophthalaldehyde, or paracetic acid with an automatic re-processor. Apparatuses should be sterilized using autoclaves or ethylene oxide gas, or disposable equipment should be used. The endoscopy suite should be thought of as a very dirty place because of the release of patients’ blood and body fluids. Therefore, endoscopists must make efforts to prevent not only infection from patient to patient, but also infection from patient to endoscopic staff using personal protective equipment. Further, the endoscopist should always be aware of whether each piece of medical equipment is clean or dirty at all times during the endoscopic procedure so that the endoscopist can avoid becoming sources of contamination during endoscopic procedures. To achieve suitable infection control in endoscopy, the person who is responsible for the endoscopy suite should become the leader of infection control. The leader should establish an adequate reprocessing system of endoscopes and apparatuses according to the guidelines, and should educate the endoscopic staff concerning infection control in endoscopy.