DETECT Study: Duodenoscopes and linear echo-endoscopes: efficacy of ATP tests compared to visual inspection

We aim to assess if the use of ATP tests in DLE, after manual cleaning combined with re-cleaning protocols, lowers the number of clinically relevant positive cultures. Therefore we will conduct a prospective single center intervention study using DLE in a single tertiary academic center: the Erasmus MC. In the intervention period DLE will be tested on ATP and manually cleaned again if the ATP value is above the cutoff. Efficacy of ATP tests will be assessed by the number of contaminated DLE, with special attention to clinically relevant positive cultures i.e. contaminated with indicator microorganisms.

Contaminated duodenoscopes can cause large-scale outbreaks. There is a need for rapid assessment methods to confirm the adequacy of the cleaning phase to improve the quality, safety and logistics of complex flexible endoscope reprocessing. The ATP test can give a rapid indication if organic residue is still present. Implementation of such an ATP test might reduce the number of contaminated duodenoscopes and linear echo-endoscopes (DLE). The primary objective of this study is to assess if the use of ATP tests in DLE, after manual cleaning combined with re-cleaning protocols, lowers the number of clinically relevant positive cultures.

Endoscopic procedure specifics: after procedure

ATP-test: after manual cleaning

Microbial sampling: after disinfection

To assess the primary study objective, baseline contamination rates will be determined during the control period and the effect of usage of ATP tests on the contamination rate will be evaluated in the intervention period. DLE will be tested on ATP and manually cleaned again if the ATP value is above the cutoff.