Microbiological monitoring of endoscopes as an element of quality assurance at the Territorial Hospital of New Caledonia between 2012 and 2020

Background. Flexible endoscopes are complex, non-autoclavable devices that must undergo high-level disinfection. The presence of dirt and biofilms can cause infection and promote the spread of resistance to antibiotics. Microbiological monitoring of endoscopes is recommended in France but remains controversial internationally. The objective of this study is to assess the contribution of this surveillance as an element of quality assurance in New Caledonia. Method. We reviewed all the microbiological tests carried out on flexible endoscopes between January 1, 2012 and December 31, 2020 at the Centre -Hospitalier Territorial (CHT) in New Caledonia. We assessed the contamination rate and identified the main microorganisms isolated. Results. 605 microbiological endoscope controls were analyzed. A total of 87 samples (14.4%) did not reach the target level. The non-compliance rate varied from 25.0 % to 4.5 % depending on the year. Choledoscopes and echoendoscopes were the most contaminated devices (p = 0.0035). The main microorganisms identified were gram positive bacteria such as coagulase negative staphylococci (n = 122) and Micrococcus sp (n = 97), and gram negative bacteria including Moraxella sp (n = 31) and Pseudomonas (n = 17). Conclusion. This study evaluated the effectiveness of the disinfection of flexible endoscopes used at the CHT. The overall contamination rate (14.4%) is in line with the figures published in various studies. This monitoring makes it possible to identify deviations in the disinfection process and to take corrective measures that guarantee patient safety.