Higher yield in duodenoscope cultures collected with addition of neutralizing agent

Aim: Microbiological cultures are the gold standard in the monitoring of duodenoscope reprocessing. However, many different sampling and culturing techniques are used, making it difficult to compare results. The latest Centers for Disease Control and Pre-vention protocol advises the use of a neutralizer to deactivate any remaining disinfectants in the samples. This study compared culturing results of duodenoscope samples collected with and without addition of a neutralizer.Methods: Six duodenoscopes were soiled with gut bacteria in a non-clinical experimental setting and reprocessed afterwards. Samples of the tip and working channel were col-lected immediately after decontamination or after drying. Dey-Engley (DE) broth was added as a neutralizer to the samples of four duodenoscopes; samples for the other two duodenoscopes were collected without the addition of DE broth.Results: Post-decontamination cultures were significantly more likely to be positive for growth of the applied micro-organisms in the group of samples with DE broth (88.1% vs 20.2%; P<0.0001). Post-drying samples were significantly more likely to be positive in the group of samples without DE broth (75.7% vs 33.4%; P<0.001).Conclusion: The addition of DE broth to samples collected from wet duodenoscopes increases the yield of those cultures. Remaining disinfectants in wet duodenoscopes can lead to false-negative results. This can be overcome by adding a neutralizer, such as DE broth, to the samples. The higher yield after drying in the group without neutralizer could be due to biofilm formation in these two duodenoscopes, but this was not investigated. Standardization of the sampling method can help to compare both clinical and study results regarding duodenoscope contamination.(c) 2022 The Author(s). Published by Elsevier Ltdon behalf of The Healthcare Infection Society. This is an open access article underthe CC BY license (http://creativecommons.org/licenses/by/4.0/).

Automated summary

This study compared culturing results of duodenoscope samples collected with and without addition of a neutralizer. It found that adding a neutralizer increased the yield of cultures from wet duodenoscope samples, while samples without a neutralizer had higher yield after drying. Standardization of the sampling method can help compare clinical and study results regarding duodenoscope contamination.