Table 2 Duodenoscope sampling methods
From: A narrative review on current duodenoscope reprocessing techniques and novel developments
Method | Principle | Current status | Advantages | Disadvantages | References |
|---|---|---|---|---|---|
Flush | Release of bacteria through fluid flush | Clinically applied | Least complex sampling technique | Obsolete due to increased recovery with flush brush flush protocols | |
Flush Brush flush (CDC, FDA, ASM protocol)* | Release of bacteria through dual fluid flush and mechanical removal | Clinically applied | Can be considered as the current standard method of endoscope sampling | Requires two persons for sampling and is too laborious for general implementation | |
Flush brush flush (other protocols) | Release of bacteria through dual fluid flush and mechanical removal, uses different brushes and/or flushing fluid | Only applied in experimental models | The CDC, FDA and ASM protocol is outperformed in regard of Gram-negative bacteria recovered | Not tested in a clinical setting and a uniform protocol is still lacking | |
Pump assisted | Uses a peristaltic pump to increase shear stress at the lumen surface to remove bacteria | Clinically applied | More bacterial recovery compared to the flush method | Requires a peristaltic pump | [66] |
Turbulent fluid flow | Adds turbulent air droplets to the flushing fluid to achieve high shear stress at the lumen surface to remove bacteria | Only applied in experimental models | More bacterial recovery compared to the flush method and the CDC flush brush flush method | Requires a device to generate turbulent flow | [67] |
Tensioactive agents | A tensioactive agents is added to decrease surface tension of the sampling fluid thus aiding bacterial removal | Only applied in experimental models | Only requires addition of a tensioactive agent to the sampling fluid | Limited data are available and have reported conflicting results in regards of efficacy |