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Walsh CM, Jackson SR, Baughman NN, Ham JE, Wells JR. Feasibility of a Selective Epoxidation Technique for Use in Quantification of Peracetic Acid in Air Samples Collected on Sorbent Tubes. ACS CHEMICAL HEALTH & SAFETY 2022; 29:378-386. [DOI: 10.1021/acs.chas.2c00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Callee M. Walsh
- Exposure Assessment Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, West Virginia 26505, United States
| | - Stephen R. Jackson
- Exposure Assessment Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, West Virginia 26505, United States
| | - Notashia N. Baughman
- Exposure Assessment Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, West Virginia 26505, United States
| | - Jason E. Ham
- Exposure Assessment Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, West Virginia 26505, United States
| | - J. R. Wells
- Exposure Assessment Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, West Virginia 26505, United States
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Tran VN, Park S, Khan F, Truong VG, Jeong S, Lee DH, Kim YM, Kang HW. Collective bacterial disinfection by opto-chemical treatment on mature biofilm in clinical endoscope. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2022; 226:112367. [PMID: 34847498 DOI: 10.1016/j.jphotobiol.2021.112367] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/12/2021] [Accepted: 11/17/2021] [Indexed: 02/07/2023]
Abstract
The present study proposes an innovative opto-chemical treatment using a basket-integrated optical device (BIOD) to disinfect mature bacterial biofilm on endoscope channels. A BIOD was designed to position an optical diffuser on the central axis of an endoscope channel and to distribute laser light concentrically to the bacterial biofilm on the channel surface. To apply thermal damage and oxidative stress to the bacterial biofilm, a low concentration of a crosslinking agent (glutaraldehyde ~0.5%) was combined with 808 nm infrared (IR) and 405 nm blue (BL) laser lights. The applied irradiances of IR and BL were 10 W/cm2 and 1.6 W/cm2 for Teflon channel model and 20 W/cm2 and 3.2 W/cm2 for a clinical model, respectively. Individual irradiation of either IR or BL for 180 s induced the maximum temperatures of 62 ± 2 °C and 53 ± 3 °C on the biofilm, respectively. The simultaneous opto-chemical treatment reduced a significant population of the bacterial biofilms (7.5-log10 for Staphylococcus aureus and 7.1-log10 for Pseudomonas aeruginosa), which were 2.9-fold and 3.9-fold higher than that of the standard treatment with 2% glutaraldehyde (GA) solution, respectively. The proposed opto-chemical disinfection method can help reduce multi-drug resistant bacteria and prevent cross-infection during the clinical usage of a flexible endoscope.
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Affiliation(s)
- Van Nam Tran
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan 48513, South Korea
| | - Suhyun Park
- Department of Electronic and Electrical Engineering, Ewha Womans University, Seoul 03760, South Korea
| | - Fazlurrahman Khan
- Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan 48513, South Korea
| | - Van Gia Truong
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan 48513, South Korea
| | - Seok Jeong
- Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine, Incheon 22212, South Korea
| | - Don Haeng Lee
- Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine, Incheon 22212, South Korea
| | - Young-Mog Kim
- Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan 48513, South Korea; Department of Food Science and Technology, Pukyong National University, Busan 48513, South Korea
| | - Hyun Wook Kang
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan 48513, South Korea; Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan 48513, South Korea; Department of Biomedical Engineering, Pukyong National University, Busan 48513, South Korea.
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3
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Tran VN, Saravana PS, Park S, Truong VG, Chun BS, Kang HW. Opto-chemical treatment for enhanced high-level disinfection of mature bacterial biofilm in a Teflon-based endoscope model. BIOMEDICAL OPTICS EXPRESS 2021; 12:5736-5750. [PMID: 34692212 PMCID: PMC8515982 DOI: 10.1364/boe.434047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/25/2021] [Accepted: 08/13/2021] [Indexed: 06/13/2023]
Abstract
Medical societies and public health agencies rigorously emphasize the importance of adequate disinfection of flexible endoscopes. The aim of this work was to propose a novel opto-chemical disinfection treatment against Staphylococcus aureus grown in mature biofilm on Teflon-based endoscope channel models. Laser irradiation using near-infrared and blue wavelengths combined with a low concentration of chemical disinfectant induced both irreversible thermal denaturation and intercellular oxidative stress as a combined mechanism for an augmented antimicrobial effect. The opto-chemical method yielded a 6.7-log10 reduction of the mature Staphylococcus aureus biofilms (i.e., approximately 1.0-log10 higher than current requirement of standard treatment). The proposed technique may be a feasible disinfection method for mitigating the risk associated with infection transmission.
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Affiliation(s)
- Van Nam Tran
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, 48513, Republic of Korea
- These authors contributed equally to this work
| | - Periaswamy Sivagnanam Saravana
- Department of Food Science and Technology, Pukyong National University, Busan 48513, Republic of Korea
- These authors contributed equally to this work
| | - Suhyun Park
- Department of Electronic and Electrical Engineering, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Van Gia Truong
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, 48513, Republic of Korea
| | - Byung-Soo Chun
- Department of Food Science and Technology, Pukyong National University, Busan 48513, Republic of Korea
| | - Hyun Wook Kang
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, 48513, Republic of Korea
- Department of Biomedical Engineering and Marine-integrated Biomedical Technology Center, Pukyong National University, Busan 48513, Republic of Korea
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Development of a high-level light-activated disinfectant for hard surfaces and medical devices. Int J Antimicrob Agents 2021; 58:106360. [PMID: 33992750 DOI: 10.1016/j.ijantimicag.2021.106360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/30/2021] [Accepted: 05/01/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Bacterial spores are an important consideration in healthcare decontamination, with cross-contamination highlighted as a major route of transmission due to their persistent nature. Their containment is extremely difficult due to the toxicity and cost of first-line sporicides. METHODS Susceptibility of Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa and Escherichia coli to phenothiazinium photosensitizers and cationic surfactants under white- or red-light irradiation was assessed by determination of minimum inhibitory concentrations, minimum bactericidal concentrations and time-kill assays. B. subtilis spore eradication was assessed via time-kill assays, with and without nutrient and non-nutrient germinant supplementation of photosensitizer, surfactant and photosensitizer-surfactant solutions in the presence and absence of light. RESULTS Under red-light irradiation, >5-log10 colony-forming units/mL reduction of vegetative bacteria was achieved within 10 min with toluidine blue O (TBO) and methylene blue (MB). Cationic surfactant addition did not significantly enhance spore eradication by photosensitizers (P>0.05). However, addition of a nutrient germinant mixture to TBO achieved a 6-log10 reduction after 20 min of irradiation, while providing 1-2 log10 improvement in spore eradication for MB and pyronin Y. CONCLUSIONS Light-activated photosensitizer solutions in the presence of surfactants and germination-promoting agents provide a highly effective method to eradicate dormant and vegetative bacteria. These solutions could provide a useful alternative to traditional chemical agents used for high-level decontamination and infection control within health care.
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Zhang N, Guo J, Liu L, Wu H, Gu J. Study on the Efficacy of Peracetic Acid Disinfectant (Type III) on Gastrointestinal Endoscopy Disinfection. Surg Laparosc Endosc Percutan Tech 2021; 31:395-398. [PMID: 33710104 PMCID: PMC8360655 DOI: 10.1097/sle.0000000000000921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/13/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the disinfection efficacy of peracetic acid disinfectant (Type III) on gastrointestinal endoscopy. METHODS Endoscopes were disinfected, respectively, by 2% glutaraldehyde and peracetic acid disinfectant (Type III) according to the procedures stipulated by the 2016 version of "Regulation for cleaning and disinfection technique of flexible endoscope," then samples were collected through biopsy channel at the specified steps. The bacterial count and pathogenic bacteria of these samples were detected, and hepatitis B virus surface antigen, hepatitis C virus antibody, and Treponemiapallidum antibody were detected by chemiluminescent microparticle immunoassay in peracetic acid disinfectant (Type III) group. The samples from the peracetic acid disinfectant (Type III) group were collected for 5 days continuously. RESULTS In total, 56 gastroscopes and 16 colonoscopes were disinfected by 2% glutaraldehyde (GA Group), 46 gastroscopes, and 15 colonoscopes were disinfected by peracetic acid disinfectant (Type III) (PAA Group). After disinfection, the bacterial count was significantly reduced in the 2 groups (P<0.05). In terms of the qualified rate of gastroscopes and total qualified rate, the PAA Group was better than GA Group [the qualified rate of gastroscopes: 97.83% (45/46) vs. 92.86% (52/56), P>0.05; total qualified rate: 98.36% (60/61) vs. 94.44% (68/72), P>0.05], the qualified rate of colonoscopes in the 2 groups were both 100.00% (15/15, 16/16). After disinfecting by peracetic acid disinfectant (Type III), hepatitis B virus surface antigen, anti-hepatitis C virus, and Treponemiapallidum antibody were negative. In term of colonies number detected for 5 days continuously, there was no significant difference at different collection steps (P>0.05). CONCLUSIONS Peracetic acid disinfectant (Type III) can be well applied to clinical with meeting the standard of high-level disinfection for gastrointestinal endoscopy, and after disinfecting by peracetic acid disinfectant (Type III), there was no obvious bacterial residue in the biopsy channel.
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Wong M, Wang Y, Wang H, Marrone AK, Haugen SP, Kulkarni K, Basile R, Phillips KS. Research: Fluorescence Microscopy-Based Protocol for Detecting Residual Bacteria on Medical Devices. Biomed Instrum Technol 2020; 54:397-409. [PMID: 33339032 DOI: 10.2345/0899-8205-54.6.397] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Standard methods are needed to reliably and efficiently assess bacterial contamination of processed medical devices. This article demonstrates a standard operating procedure (SOP) for fluorescence microscopy-based detection of residual bacteria on medical devices (BAC-VIS). BAC-VIS uses a 4',6-diamidino-2-phenylindole (DAPI) stain with fluorescent microscopy to quickly and cost-effectively detect bacterial contamination of processed medical device parts. The BAC-VIS protocol was optimized and achieved greater than 80% staining efficiency and a signal-to-noise ratio of more than 20 using four representative organisms. The SOP was first validated for use on a buildup biofilm model, accessory channels of contaminated clinically used devices, and inoculated endoscope end caps and O-rings. The buildup biofilm model was used to evaluate BAC-VIS after repeated treatment of adherent bacteria with three common high-level disinfectants: glutaraldehyde, ortho-phthalaldehyde, and peracetic acid. Next, BAC-VIS was used to assess clinically used endoscope parts that cultured positive for Gram-negative bacteria. DAPI-stained cells were found on all culture-positive devices, especially in grooves and imperfections on the surface. Finally, BAC-VIS was used to detect bacteria on inoculated endoscope device components. The results showed potential for BAC-VIS to be a valuable tool for industry and academic/medical researchers for investigations of contaminated medical devices. Results obtained using BAC-VIS can increase understanding of the role of design in cleanability, wear, and prevention of contamination and may lead to improvements in materials and design that could make processed endoscope use safer for patients. Of note, this protocol is not for detecting bacteria on scopes or scope parts that will be put back into clinical use.
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Abstract
Over the past 2 decades, in hospital centers worldwide, there have been numerous outbreaks of multidrug-resistant organisms that have since been attributed to endoscopic transmission of the infections between patients, primarily from duodenoscopes. These outbreaks have focused the attention of endoscope manufacturers, professional societies, and regulatory agencies on improving the reprocessing of these devices. The key steps in this process are point-of-use precleaning, leak testing, manual cleaning, high-level disinfection, and finally drying and storage. The promise of these initial efforts suggest that the aim of minimizing and ultimately eliminating events of endoscope-/duodenoscope-associated transmission of infectious organisms between patients can be achieved.
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Affiliation(s)
- Neil B Marya
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, 200 UCLA Medical Plaza, Suite 214, Los Angeles, CA 90095, USA
| | - Raman V Muthusamy
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, 200 UCLA Medical Plaza, Suite 214, Los Angeles, CA 90095, USA.
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8
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Walters GI, Burge PS, Moore VC, Thomas MO, Robertson AS. Occupational asthma caused by peracetic acid-hydrogen peroxide mixture. Occup Med (Lond) 2020; 69:294-297. [PMID: 30916757 DOI: 10.1093/occmed/kqz032] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Healthcare practice in the UK has moved away from using aldehyde disinfectants for the decontamination of endoscopes, in part due to the risk of respiratory sensitization. Peracetic acid (PAA) in combination with hydrogen peroxide (HP) is a commonly used alternative. AIM We describe a case of occupational asthma (OA) diagnosed at our specialist occupational lung disease clinic and caused by occupational exposure to PAA-HP mixture, used as a disinfectant in an endoscope washer-disinfector machine. CASE REPORT A 48-year-old man employed as a mycologist and environmental microbiologist at a Birmingham city hospital, UK, presented following an acute exposure to PAA-HP mixture causing lacrimation, burning optic pain and headache. He had also experienced symptoms suggestive of OA for the preceding 10 months, and the diagnosis was confirmed through OASYS analysis of serial peak expiratory flow measurements. He had been exposed to PAA-HP mixture whilst working in the endoscopy department for 12 months prior to the acute episode, and a subsequent specific inhalation challenge test was positive with a late asthmatic response to PAA-HP mixture. CONCLUSION This case provides evidence for a sensitization mechanism in OA caused by PAA-HP mixture.
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Affiliation(s)
- G I Walters
- Birmingham Regional NHS Occupational Lung Disease Service, Birmingham Chest Clinic, Queensway, Birmingham, UK.,Occupational and Environmental Medicine, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - P S Burge
- Birmingham Regional NHS Occupational Lung Disease Service, Birmingham Chest Clinic, Queensway, Birmingham, UK.,Occupational and Environmental Medicine, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - V C Moore
- Birmingham Regional NHS Occupational Lung Disease Service, Birmingham Chest Clinic, Queensway, Birmingham, UK
| | - M O Thomas
- Birmingham Regional NHS Occupational Lung Disease Service, Birmingham Chest Clinic, Queensway, Birmingham, UK
| | - A S Robertson
- Birmingham Regional NHS Occupational Lung Disease Service, Birmingham Chest Clinic, Queensway, Birmingham, UK.,Occupational and Environmental Medicine, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
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Calderón-Franco D, Lin Q, van Loosdrecht MCM, Abbas B, Weissbrodt DG. Anticipating Xenogenic Pollution at the Source: Impact of Sterilizations on DNA Release From Microbial Cultures. Front Bioeng Biotechnol 2020; 8:171. [PMID: 32232035 PMCID: PMC7082761 DOI: 10.3389/fbioe.2020.00171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/19/2020] [Indexed: 11/23/2022] Open
Abstract
The dissemination of DNA and xenogenic elements across waterways is under scientific and public spotlight due to new gene-editing tools, such as do-it-yourself (DIY) CRISPR-Cas kits deployable at kitchen table. Over decades, prevention of spread of genetically modified organisms (GMOs), antimicrobial resistances (AMR), and pathogens from transgenic systems has focused on microbial inactivation. However, sterilization methods have not been assessed for DNA release and integrity. Here, we investigated the fate of intracellular DNA from cultures of model prokaryotic (Escherichia coli) and eukaryotic (Saccharomyces cerevisiae) cells that are traditionally used as microbial chassis for genetic modifications. DNA release was tracked during exposure of these cultures to conventional sterilization methods. Autoclaving, disinfection with glutaraldehyde, and microwaving are used to inactivate broths, healthcare equipment, and GMOs produced at kitchen table. DNA fragmentation and PCR-ability were measured on top of cell viability and morphology. Impact of these methods on DNA integrity was verified on a template of free λ DNA. Intense regular autoclaving (121°C, 20 min) resulted in the most severe DNA degradation and lowest household gene amplification capacity: 1.28 ± 0.11, 2.08 ± 0.03, and 4.96 ± 0.28 logs differences to the non-treated controls were measured from E. coli, S. cerevisiae, and λ DNA, respectively. Microwaving exerted strong DNA fragmentation after 100 s of exposure when free λ DNA was in solution (3.23 ± 0.06 logs difference) but a minor effect was observed when DNA was released from E. coli and S. cerevisiae (0.24 ± 0.14 and 1.32 ± 0.02 logs differences with the control, respectively). Glutaraldehyde prevented DNA leakage by preserving cell structures, while DNA integrity was not altered. The results show that current sterilization methods are effective on microorganism inactivation but do not safeguard an aqueous residue exempt of biologically reusable xenogenic material, being regular autoclaving the most severe DNA-affecting method. Reappraisal of sterilization methods is required along with risk assessment on the emission of DNA fragments in urban systems and nature.
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Affiliation(s)
| | | | | | | | - David G. Weissbrodt
- Department of Biotechnology, Delft University of Technology, Delft, Netherlands
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Tran VN, Dasagrandhi C, Truong VG, Kim YM, Kang HW. Antibacterial activity of Staphylococcus aureus biofilm under combined exposure of glutaraldehyde, near-infrared light, and 405-nm laser. PLoS One 2018; 13:e0202821. [PMID: 30148865 PMCID: PMC6110465 DOI: 10.1371/journal.pone.0202821] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 08/09/2018] [Indexed: 01/31/2023] Open
Abstract
Healthcare-associated infections have increasingly become problematic in the endoscopic procedures resulting in several severe diseases such as carbapenem-resistant Enterobacteriaceae (CRE)-related infections, pneumonia, and bacteremia. Especially, some bacterial strains are resistant to traditional antimicrobials. Therefore, the necessity of developing new antibiotics or management to deal with bacterial infections has been increasing. The current study combined a low concentration of glutaraldehyde (GTA) with near-infrared (NIR) light and 405-nm laser to entail antibacterial activity on Staphylococcus aureus biofilm. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay and colony forming unit (CFU) counting were used to quantify the viable cells while fluorescent and scanning electron microscopic images were used to qualitatively evaluate the cell membrane integrity and structural deformation, respectively. Practically, S. aureus biofilm was highly susceptible (7% cell viability and 6.8-log CFU/cm2 bacterial reduction for MTT assay and CFU analysis, respectively) to the combination of GTA (0.1%), NIR light (270 J/cm2), and 405-nm laser (288 J/cm2) exposure. GTA could form either DNA-protein or protein-protein crosslinks to inhibit DNA and protein synthesis. The NIR light induced the thermal damage on protein/enzymes while 405-nm laser could induce reactive oxygen species (ROS) to damage the bacterial membrane. Thus, the proposed technique may be a feasible modality for endoscope cleaning to prevent any secondary infection in the healthcare industry.
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Affiliation(s)
- Van Nam Tran
- Department of Biomedical Engineering, Pukyong National University, Busan, Korea
| | | | - Van Gia Truong
- Department of Biomedical Engineering, Pukyong National University, Busan, Korea
| | - Young-Mog Kim
- Department of Food Science and Technology, Pukyong National University, Busan, Korea
| | - Hyun Wook Kang
- Department of Biomedical Engineering, Pukyong National University, Busan, Korea
- Center for Marine-Integrated Biomedical Technology, Pukyong National University, Busan, Korea
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Lee JM, Lee KM, Kim DB, Go SE, Ko S, Kang Y, Hong S. Efficacy of Peracetic Acid (EndoPA®) for Disinfection of Endoscopes. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2018; 71:319-323. [DOI: 10.4166/kjg.2018.71.6.319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Ji Min Lee
- Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Kang-Moon Lee
- Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Dae Bum Kim
- Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Se Eun Go
- Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Sungwoo Ko
- Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Yoongoo Kang
- Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Solim Hong
- Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
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Moon HS, Choi EK, Seo JH, Moon JS, Song HJ, Kim KO, Hyun JJ, Shin SK, Lee BJ, Lee SH. Education and Training Guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy. Clin Endosc 2017; 50:345-356. [PMID: 28783925 PMCID: PMC5565048 DOI: 10.5946/ce.2017.106] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 07/17/2017] [Accepted: 07/21/2017] [Indexed: 12/26/2022] Open
Abstract
The Korean Society of Gastrointestinal Endoscopy (KSGE) developed a gastrointestinal (GI) endoscopy board in 1995 and related regulations. Although the KSGE has acquired many specialists since then, the education and training aims and guidelines were insufficient. During GI fellowship training, obtaining sufficient exposure to some types of endoscopic procedures is difficult. Fellows should acquire endoscopic skills through supervised endoscopic procedures during GI fellowship training. Thus, the KSGE requires training guidelines for fellowships that allow fellows to perform independent endoscopic procedures without supervision. This document is intended to provide principles that the Committee of Education and Training of the KSGE can use to develop practical guidelines for granting privileges to perform accurate GI endoscopy safely. The KSGE will improve the quality of GI endoscopy by providing guidelines for fellowships and supervisors.
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Affiliation(s)
- Hee Seok Moon
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Eun Kwang Choi
- Department of Internal Medicine, Jeju National University College of Medicine, Jeju, Korea
| | - Ji Hyun Seo
- Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jeong Seop Moon
- Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Ho June Song
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kyoung Oh Kim
- Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea
| | - Jong Jin Hyun
- Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Sung Kwan Shin
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Beom Jae Lee
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sang Heon Lee
- Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
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Cha JM, Moon JS, Chung IK, Kim JO, Im JP, Cho YK, Kim HG, Lee SK, Lee HL, Jang JY, Kim ES, Jung Y, Moon CM, Kim Y, Park BY. National Endoscopy Quality Improvement Program Remains Suboptimal in Korea. Gut Liver 2017; 10:699-705. [PMID: 27282270 PMCID: PMC5003191 DOI: 10.5009/gnl15623] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 01/22/2016] [Accepted: 01/22/2016] [Indexed: 12/17/2022] Open
Abstract
Background/Aims We evaluated the characteristics of the National Cancer Screening Program (NCSP) and opinions regarding the National Endoscopy Quality Improvement Program (NEQIP). Methods We surveyed physicians performing esophagogastroduodenoscopy and/or colonoscopy screenings as part of the NCSP via e-mail between July and August in 2015. The 32-item survey instrument included endoscopic capacity, sedation, and reprocessing of endoscopes as well as opinions regarding the NEQIP. Results A total of 507 respondents were analyzed after the exclusion of 40 incomplete answers. Under the current capacity of the NCSP, the typical waiting time for screening endoscopy was less than 4 weeks in more than 90% of endoscopy units. Performance of endoscopy reprocessing was suboptimal, with 28% of respondents using unapproved disinfectants or not knowing the main ingredient of their disinfectants and 15% to 17% of respondents not following reprocessing protocols. Agreement with the NEQIP was optimal, because only 5.7% of respondents did not agree with NEQIP; however, familiarity with the NEQIP was suboptimal, because only 37.3% of respondents were familiar with the NEQIP criteria. Conclusions The NEQ-IP remains suboptimal in Korea. Given the suboptimal performance of endoscopy reprocessing and low familiarity with the NEQIP, improved quality in endoscopy reprocessing and better understanding of the NEQIP should be emphasized in Korea.
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Affiliation(s)
- Jae Myung Cha
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jeong Seop Moon
- Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea
| | - Il-Kwun Chung
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jin-Oh Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jong Pil Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yu Kyung Cho
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyun Gun Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Sang Kil Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hang Lak Lee
- Department of Internal Medicine, Hanyang University School of Medicine, Seoul, Korea
| | - Jae Young Jang
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Eun Sun Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Yunho Jung
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Chang Mo Moon
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yeol Kim
- Cancer Early Detection Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Bo Young Park
- Cancer Early Detection Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
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Infektionsschutz und spezielle Hygienemaßnahmen in klinischen Disziplinen. KRANKENHAUS- UND PRAXISHYGIENE 2016. [PMCID: PMC7152143 DOI: 10.1016/b978-3-437-22312-9.00005-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ryu JK, Kim EY, Kwon KA, Choi IJ, Hahm KB. Role of Clinical Endoscopy in Emphasizing Endoscope Disinfection. Clin Endosc 2015; 48:351-5. [PMID: 26473114 PMCID: PMC4604269 DOI: 10.5946/ce.2015.48.5.351] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 08/29/2015] [Indexed: 01/12/2023] Open
Abstract
Based on the unexpected Middle East respiratory syndrome (MERS) outbreak in Korea, it was established that the virus can spread easily, MERS exposure in hospitals carries an extreme risk for infection as well as mortality, and the sharing of information was essential for infection control. Although the incidence of exogenous infections related to contaminated endoscopes is very low, the majority of published outbreaks have been caused by various shortcomings in reprocessing procedures, including insufficient training or awareness. Ever since the inauguration of "Clinical Endoscopy" as an English-language journal of the Korean Society of Gastrointestinal Endoscopy in 2011, it has published several articles on disinfection of the endoscope and its accessories. Many Science Citation Index journals have also emphasized high-level disinfection of the gastrointestinal endoscope. Many papers have been produced specifically, since the outbreak of carbapenem-resistant Enterobacteriaceae in 2013. The recent review papers concluded that quality control is the most important issue among all the aspects of procedural care, including the efficiency of the gastrointestinal endoscopy unit and reprocessing room. Thorough reprocessing of endoscopes using high-level disinfection and sterilization methods may be essential for reducing the risk of infection.
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Affiliation(s)
- Ji Kon Ryu
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Young Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Kwang An Kwon
- Department of Gastroenterology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Ki Baik Hahm
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Olmedo GM, Grillo-Puertas M, Cerioni L, Rapisarda VA, Volentini SI. Removal of pathogenic bacterial biofilms by combinations of oxidizing compounds. Can J Microbiol 2015; 61:351-6. [DOI: 10.1139/cjm-2014-0747] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Bacterial biofilms are commonly formed on medical devices and food processing surfaces. The antimicrobials used have limited efficacy against the biofilms; therefore, new strategies to prevent and remove these structures are needed. Here, the effectiveness of brief oxidative treatments, based on the combination of sodium hypochlorite (NaClO) and hydrogen peroxide (H2O2) in the presence of copper sulfate (CuSO4),were evaluated against bacterial laboratory strains and clinical isolates, both in planktonic and biofilm states. Simultaneous application of oxidants synergistically inactivated planktonic cells and prevented biofilm formation of laboratory Escherichia coli, Salmonella enterica serovar Typhimurium, Klebsiella pneumoniae, and Staphylococcus aureus strains, as well as clinical isolates of Salmonella enterica subsp. enterica, Klebsiella oxytoca, and uropathogenic E. coli. In addition, preformed biofilms of E. coli C, Salmonella Typhimurium, K. pneumoniae, and Salmonella enterica exposed to treatments were removed by applying 12 mg/L NaClO, 0.1 mmol/L CuSO4, and 350 mmol/L H2O2for 5 min. Klebsiella oxytoca and Staphylococcus aureus required a 5-fold increase in NaClO concentration, and the E. coli clinical isolate remained unremovable unless treatments were applied on biofilms formed within 24 h instead of 48 h. The application of treatments that last a few minutes using oxidizing compounds at low concentrations represents an interesting disinfection strategy against pathogens associated with medical and industrial settings.
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Affiliation(s)
- Gabriela María Olmedo
- Instituto de Química Biológica “Dr Bernabé Bloj”, Facultad de Bioquímica, Química y Farmacia (UNT) and Instituto Superior de Investigaciones Biológicas, INSIBIO (CONICET-UNT), Chacabuco 461, C.P. T4000ILI, Tucumán-Argentina
- Instituto de Química Biológica “Dr Bernabé Bloj”, Facultad de Bioquímica, Química y Farmacia (UNT) and Instituto Superior de Investigaciones Biológicas, INSIBIO (CONICET-UNT), Chacabuco 461, C.P. T4000ILI, Tucumán-Argentina
| | - Mariana Grillo-Puertas
- Instituto de Química Biológica “Dr Bernabé Bloj”, Facultad de Bioquímica, Química y Farmacia (UNT) and Instituto Superior de Investigaciones Biológicas, INSIBIO (CONICET-UNT), Chacabuco 461, C.P. T4000ILI, Tucumán-Argentina
- Instituto de Química Biológica “Dr Bernabé Bloj”, Facultad de Bioquímica, Química y Farmacia (UNT) and Instituto Superior de Investigaciones Biológicas, INSIBIO (CONICET-UNT), Chacabuco 461, C.P. T4000ILI, Tucumán-Argentina
| | - Luciana Cerioni
- Instituto de Química Biológica “Dr Bernabé Bloj”, Facultad de Bioquímica, Química y Farmacia (UNT) and Instituto Superior de Investigaciones Biológicas, INSIBIO (CONICET-UNT), Chacabuco 461, C.P. T4000ILI, Tucumán-Argentina
- Instituto de Química Biológica “Dr Bernabé Bloj”, Facultad de Bioquímica, Química y Farmacia (UNT) and Instituto Superior de Investigaciones Biológicas, INSIBIO (CONICET-UNT), Chacabuco 461, C.P. T4000ILI, Tucumán-Argentina
| | - Viviana Andrea Rapisarda
- Instituto de Química Biológica “Dr Bernabé Bloj”, Facultad de Bioquímica, Química y Farmacia (UNT) and Instituto Superior de Investigaciones Biológicas, INSIBIO (CONICET-UNT), Chacabuco 461, C.P. T4000ILI, Tucumán-Argentina
- Instituto de Química Biológica “Dr Bernabé Bloj”, Facultad de Bioquímica, Química y Farmacia (UNT) and Instituto Superior de Investigaciones Biológicas, INSIBIO (CONICET-UNT), Chacabuco 461, C.P. T4000ILI, Tucumán-Argentina
| | - Sabrina Inés Volentini
- Instituto de Química Biológica “Dr Bernabé Bloj”, Facultad de Bioquímica, Química y Farmacia (UNT) and Instituto Superior de Investigaciones Biológicas, INSIBIO (CONICET-UNT), Chacabuco 461, C.P. T4000ILI, Tucumán-Argentina
- Instituto de Química Biológica “Dr Bernabé Bloj”, Facultad de Bioquímica, Química y Farmacia (UNT) and Instituto Superior de Investigaciones Biológicas, INSIBIO (CONICET-UNT), Chacabuco 461, C.P. T4000ILI, Tucumán-Argentina
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Park JB, Yang JN, Lim YJ, Koo JS, Jang JY, Park SH, Hong SJ, Kim SW, Chun HJ. Survey of endoscope reprocessing in Korea. Clin Endosc 2015; 48:39-47. [PMID: 25674525 PMCID: PMC4323430 DOI: 10.5946/ce.2015.48.1.39] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 04/20/2014] [Accepted: 06/02/2014] [Indexed: 01/01/2023] Open
Abstract
Background/Aims There is a growing emphasis on quality management in endoscope reprocessing. Previous surveys conducted in 2002 and 2004 were not practitioner-oriented. Therefore, this survey is significant for being the first to target actual participants in endoscope reprocessing in Korea. Methods This survey comprised 33 self-filled questions, and was personally delivered to nurses and nursing auxiliaries in the endoscopy departments of eight hospitals belonging to the society. The anonymous responses were collected after 1 week either by post or in person by committee members. Results The survey included 100 participants. In the questionnaire addressing compliance rates with the reprocessing guideline, the majority (98.9%) had a high compliance rate compared to 27% of respondents in 2002 and 50% in 2004. The lowest rate of compliance with a reprocessing procedure was reported for transporting the contaminated endoscope in a sealed container. Automated endoscope reprocessors were available in all hospitals. Regarding reprocessing time, more than half of the subjects replied that reprocessing took more than 15 minutes (63.2%). Conclusions The quality management of endoscope reprocessing has improved as since the previous survey. A national survey expanded to include primary clinics is required to determine the true current status of endoscope reprocessing.
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Affiliation(s)
- Jeong Bae Park
- Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea
| | - Jae Nam Yang
- Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea
| | - Yun Jeong Lim
- Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea
| | - Ja Seol Koo
- Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea
| | - Jae Young Jang
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sang Hoon Park
- Department of Internal Medicine, KEPCO Medical Center, Seoul, Korea
| | - Su Jin Hong
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sang-Woo Kim
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hoon Jai Chun
- Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea
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Affiliation(s)
- Young-Seok Cho
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
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