Microorganisms are everywhere in the environment and a rich population of microbes (particularly bacteria) reside on and in the human body and is referred to as normal flora.
Gastrointestinal tract flora
The normal flora of the gastrointestinal tract (GIT) varies depending on the site due to the variety of conditions that occur from one end of this long tube to the other.
The diagram below gives you some idea of the types of bacteria that commonly live in the GIT and can contaminate endoscopy equipment after use.
Respiratory flora
Similarly there is a variety of organisms that commonly inhabit different sections of the respiratory tract as indicated in the diagram below. These organisms can contaminate bronchoscopy equipment after use.
Skin flora
The skin is constantly populated with microorganisms that reflect the contacts, habits, occupation and environment of the individual.
There are contaminants that are found transiently on the skin (particularly hands) and are greatly influenced by the personal hygiene of the individual.
There is also the resident flora of the skin that includes:
These organisms can find their way onto endoscopes from the hands and skin of endoscopy personnel or possibly the patient.
Environmental organisms
The environmental organisms that cause most concern in endoscopy are those found in water. Hospital tap water may normally contain a variety of organisms that can contaminate endoscopes during the final rinsing stage.
This may pose a risk to the patient if:
Organisms that may be found in potable water are Micrococcus, Flavobacterium, Serratia, Chromobacterium, Acinetobacter and Achromobacter, Pseudomonas and atypical mycobacteria (i.e. not M. tuberculosis). There may also be some enteric organisms such as E. coli and Klebsiella depending on the quality of the water supply.
The organisms that cause most of the problems are Pseudomonas and Mycobacterium. Automated reprocessors are particularly prone to colonisation with these organisms because of the complicated nature of their plumbing. If present on an endoscope these organisms have the potential to cause infection in susceptible patients or they may contaminate specimens collected at endoscopy that may result in a misdiagnosis.
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For more information about water quality required for reprocessing endoscopes see: Quality Assurance Module |
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© The State of Queensland (Queensland Health) 2008.
