SpyGlass application for duodenoscope working channel inspection: Impact on the microbiological surveillance

Table 1 Duodenoscope characteristics, inspection findings, ATP test, and microbiological surveillance

Number	Duodenoscope (model)	Age (mo)	Usages(n)	Inspection abnormal findings (Severity degree/location)											ATP test (RLU)	Microbiological surveillance
				Scratches	Peel	Buckling	Stains	Debris					Fluid
								Dark color		Light color		Other	Clear	Opaque		Culture(n)	Positive(n)	Microorganism
1	JF-260V	87	1284	3/B	2/B	2/B	2/B	1/B	3/B		-		3/I	-	135	34	2	P. aeruginosa
2	JF-260V	2	18	-	-	1/B	2/I	-	-		-		-	-	185	2	1	P. aeruginosa
3	JF-260V	79	1267	-	-	-	2/B	2/I	-		-		-	-	117	27	0	-
4	JF-260V	64	825	3/B	1/B	2/B	2/B	1/I	-		-		3/I	3/I	45	24	0	-
5	JF-260V	1	15	-	-	-	-	2/I	1/ I&B		1/B		3/I	-	19	2	1	P. aeruginosa
6	TJF-260V	126	649	3/I&B	-	2/I&B	2/I&B	2/I	-		1/B		3/I&B	3/I&B	48	29	2	P. aeruginosa
7	TJF-260V	3	34	-	-	2/B	-	-	-		-		-	-	12	2	0	-
8	TJF-260V	12	135	-	-	2/B	2/I	2/I	-		-		3/I	1/I	108	2	0	-
9	TJF-260V	18	48	-	-	2/I&B	2/I	-	-		-		-	-	63	2	0	-
10	TJF-260V	93	164	1/B	2/B	2/B	2/I&B	2/I&B	-		-		-	-	39	1	0	-
11	TJF-260V	51	425	3/B	-	2/B	2/I	--	-		-		-	-	21	1	0	-
12	TJF-260V	38	251	1/B	-	2/B	2/B	3/I&B	-		-		-	-	114	2	0	-
13	TJF-260V	37	612	3/B	2/B	2/B	2/B	3/I&B	1/I&B		1/I&B		-	-	153	2	0	-
14	TJF-260V	12	217	1/B	-	2/I&B	1/B	1/I	-		-		-	-	40	2	0	-
15	TJF-260V	16	251	-	-	-	1B	1/I	-		-		-	-	48	0	0	-
16	TJF-260V	16	341	2/B	-	1/B	1/B	1/I	-		-		-	-	127	1	0	-
17	TJF-260V	2	50	-	-	1/B	-	2/ I&B	-		-		-	-	29	0	0	-
18	TJF-260V	4	80	1/B	-	1/B	-	2/I&B	-		-		-	-	191	1	0	-
19	TJF-260V	4	67	-	-	-	-	-	-		-		3/I&B	-	97	0	0	-
Summary		35 ± 38	356 ± 400	10	4	15	14	14	3		3		6	3	84 ± 57	134	6	-

Severity degree: None (0), mild (1), moderate (2), severe (3); location site: insertion tube (I) and bending section (B). Data in summary row are expressed as sum or mean ± SD. ATP: Adenosine tri-phosphate; RLU: Relative light units; P. aeruginosa: Pseudomonas aeruginosa.

Table 2 Multivariate regression analysis of abnormal visual inspection findings of the bending section and insertion tube

Variable	Adjusted odds ratio	95%CI	P value
Scratches	2.60	2.09-3.12	< 0.001
Buckling	2.00	1.68-2.39	< 0.001
Stains	1.72	1.16-2.56	0.008
Debris	1.88	1.50-2.36	< 0.001
Fluids	0.30	0.21-0.42	< 0.001

Reference: Insertion tube; CI: Confidence interval.

Table 3 Correlation between abnormal visual inspection findings and microbiological surveillance

Variable	Microbiological surveillance
	Spearman's correlation coefficient	P value
Scratches	0.088	0.694
Buckling	-0.080	0.746
Stains	0.133	0.587
Debris	0.423	0.029
Fluids	0.476	0.037
Debris + fluids	0.702	0.018

Table 4 Multivariate analysis of abnormal visual inspection findings and microbiological surveillance

Variable	Microbiological surveillance
	Partial correlation coefficient	P value
Debris	0.316	0.187
Fluids	0.462	0.046

Controlling for number of samples taken.

Table 5 Summary of studies on abnormal visual inspection findings in clinically used endoscopes

Study	Endoscopes (duodenoscopes), n (n)	Scratches (%)	Buckling (%)	Stains (%)	Debris (%)	Fluids (%)
Thaker et al[11], 2018	59 (14)	86	NR	59	22	8
Ofstead et al[19], 201819	45 (5)	NR	NR	NR	NR	47
Barakat et al[20], 2018	68 (7)	99	3	NR	96	43
This study	19 (19)	52.6	78.9	73.7	73.7	31.6

NR: Not reported.