Objectives
Endoscopic- ultrasound (EUS) aspiration needles are single-use devices. However, because of cost-constraints, these devices are reused multiple times in many centers. We studied microbiological contamination and bioburden on reprocessed needles, to evaluate if these devices can be sterilized.
Methods
We studied 10 EUS needles each, of 19G, 22G, and 25G size, and five 22G ProCore needles. Each needle was reprocessed by a standardized protocol, after the initial use. We used standard microbiological cultures, as well as adenosine-triphosphate (ATP) bioluminescence technique to quantify bioburden as relative light units (RLU). We defined significant soil contamination by RLU values >200. We also used extractant fluid to disrupt cell-membranes, in an attempt to enhance detection of ATP.
Results
We found culture positivity in 3(8.8%), and detectable bioburden on exposed surface of 33(94.3%), and inside lumen of 29(82.9%) reprocessed FNA needles. Significant bioburden was found in 3(8.6%) and 2(5.7%) needles on the surface and lumen, respectively. We found that use of extractant fluid enhanced the detection of bioburden. Larger (19G) needles had higher surface contamination (p = 0.016), but there was no relation of luminal contamination with the needle diameter (p = 0.138). Sheath design and presence of side bevel did not influence extent of contamination. There was a significant correlation between the surface and intra-luminal bioburden (p < 0.001).
Conclusions
There is significant bioburden in reprocessed EUS needles; standard microbiological cultures have low sensitivity for detection of needle contamination. We have provided objective evidence for futility of reprocessing attempts, and practice of EUS needle re-use should be discontinued.
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