Infacol and endoscopy

[Jennifer McCarthy]

Dear members
At the recent ACIPC conference in Melbourne there was some discussion
about using “infacol” during endoscopy and the risk of developing
biofilm in the channels.
Does anyone have any literature regarding this so I can show one of my
general surgeons – who doesn’t seem to think this is an issue!
Thanks
Jenny

Kind regards,
Jenny McCarthy
Operating Room Manger/Infection Prevention and Control Coordinator
Maryvale Private Hospital
PO Box 348, Morwell, 3840
286 Maryvale Rd. Morwell, 3840
T +61 3 5132 1283 | F +61 3 5132 1281
E jenny@maryvaleph.com.au
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[Joanna Harris]

As I was unfortunately unable to be at the conference I’d be interested to know what the issue with this is, and whether infection prevention and control concerns have been identified as theoretical or real issues.

Just this afternoon I have been asked to advise about the use of infacol by endoscopists. Apparently the intention is to reduce the development of mucus ‘bubbles’ that could obscure the field of vision.
Our endoscopy unit staff are concerned about a build-up of residue and possible biofilm in the CO2/water channels and on the tubing leading from the CO2 bottles to the ‘scope. They are also finding that insufflation seems to have been affected recently and think it might be due to a greasy coating affecting valves and seals etc.

Although there are clearly a few non-IPC issues here, I am hoping to be able to answer infection control-related concerns.

Has anybody had any experience of the use of infacol in CO2 and/or water channels confirmed as leading to the transmission of pathogens, or ineffective reprocessing?
Thanks in anticipation 🙂

Jo Harris

Nurse Manager, Illawarra Shoalhaven Local Health District Infection Management and Control Service (IMACS)

Telephone – mobile 0475 943494 / Wollongong office 02 4222 5898 / Warrawong office 02 4221 6820
Joanna.Harris@health.nsw.gov.au
http://www.health.nsw.gov.au

[http://www.health.nsw.gov.au/images/communications/e-signatures/images/NSW-Health-Master.jpg]

Dear members
At the recent ACIPC conference in Melbourne there was some discussion about using “infacol” during endoscopy and the risk of developing biofilm in the channels.

Does anyone have any literature regarding this so I can show one of my general surgeons – who doesn’t seem to think this is an issue!

Thanks
Jenny

Kind regards,
Jenny McCarthy
Operating Room Manger/Infection Prevention and Control Coordinator
Maryvale Private Hospital
PO Box 348, Morwell, 3840
286 Maryvale Rd. Morwell, 3840
T +61 3 5132 1283 | F +61 3 5132 1281
E jenny@maryvaleph.com.au

Maryvale Private Hospital Confidentiality and Privacy Notice

NOTICE – This e-mail is only intended to be read by the named recipient. It may contain information which is confidential or proprietary. If you are not the intended recipient please notify the sender immediately and delete this e-mail. If you are not the intended recipient you should not copy this e-mail or use the information contained in it for any purpose nor disclose its contents to any other person. Maryvale Private Hospital Pty Ltd accepts no responsibility for electronic viruses or damage caused as a result of this email or for changes made to this email or to any attachments after transmission from Maryvale Private Hospital. You should not distribute or publish the contents of this email or any attachment without the prior consent of Maryvale Private Hospital.
* Please consider the environment before printing this email
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health or any of its entities.

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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[Anonymous]

Hi Jo,

The simethicone issue was raised due to an article published in AJIC –
Ofstead et al. (2016) “Simethicone residue remains inside gastrointestinal
endoscopes despite reprocessing.” AJIC (44) 1237-40.

http://www.ajicjournal.org/article/S0196-6553(16)30581-8/pdf

So I purchased the paper by Ofstead and in it she indicated that the
endoscope manufacturers advise against the use routinely and usage be
restricted to circumstances “when clinically indicated”. Also – during my
own audits I have become aware that many endoscopy centres are now ROUTINELY
adding it to the air / water or the auxiliary water bottles and not just
using it when a bowel is found to be “bubbly”. The endoscopists want to use
it because they believe they have a clearer view and are less likely to miss
lesions.

So I did a little digging around and found that Olympus raised this issue
back in 2009

https://medical.olympusamerica.com/sites/default/files/pdf/SimethiconeCustom
erLetter.pdf

And Pentax have a warning in their reprocessing instructions

FYI – Below are two slides from the paper I presented at the Australasian
College for Infection Prevention and Control Conference in Melbourne.

So long story short – awareness has been raised. Questions are being asked.
However whether the findings of Ofstead are able to be linked to a real and
not theoretical risk of transmission remains to be seen.

As for a ‘where to from here’ I imagine the quickest way to find out if the
problem affecting your endoscopes is simethicone related is to purchase a
borescope and have a look in your endoscope channels for whitish fluid
residues.

Hope this helps.

Kind Regards

Terry McAuley

Sterilisation & Infection Prevention and Control Consultant

STEAM Consulting Pty Ltd ACN 604 439 698

E: terry@steamconsulting.com.au

W: http://www.steamconsulting.com.au

A: PO BOX 779

Endeavour Hills

VIC Australia 3802

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Of Joanna Harris

As I was unfortunately unable to be at the conference I’d be interested to
know what the issue with this is, and whether infection prevention and
control concerns have been identified as theoretical or real issues.

Just this afternoon I have been asked to advise about the use of infacol by
endoscopists. Apparently the intention is to reduce the development of mucus
‘bubbles’ that could obscure the field of vision.

Our endoscopy unit staff are concerned about a build-up of residue and
possible biofilm in the CO2/water channels and on the tubing leading from
the CO2 bottles to the ‘scope. They are also finding that insufflation seems
to have been affected recently and think it might be due to a greasy coating
affecting valves and seals etc.

Although there are clearly a few non-IPC issues here, I am hoping to be able
to answer infection control-related concerns.

Has anybody had any experience of the use of infacol in CO2 and/or water
channels confirmed as leading to the transmission of pathogens, or
ineffective reprocessing?

Thanks in anticipation 🙂

Jo Harris

Nurse Manager, Illawarra Shoalhaven Local Health District Infection
Management and Control Service (IMACS)

Telephone – mobile 0475 943494 / Wollongong office 02 4222 5898 /
Warrawong office 02 4221 6820

Joanna.Harris@health.nsw.gov.au

http://www.health.nsw.gov.au

mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Jenny McCarthy

Dear members
At the recent ACIPC conference in Melbourne there was some discussion about
using “infacol” during endoscopy and the risk of developing biofilm in the
channels.

Does anyone have any literature regarding this so I can show one of my
general surgeons – who doesn’t seem to think this is an issue!

Thanks
Jenny

Kind regards,
Jenny McCarthy
Operating Room Manger/Infection Prevention and Control Coordinator
Maryvale Private Hospital
PO Box 348, Morwell, 3840
286 Maryvale Rd. Morwell, 3840
T +61 3 5132 1283 | F +61 3 5132 1281
E jenny@maryvaleph.com.au

Maryvale Private Hospital Confidentiality and Privacy Notice

NOTICE – This e-mail is only intended to be read by the named recipient. It
may contain information which is confidential or proprietary. If you are not
the intended recipient please notify the sender immediately and delete this
e-mail. If you are not the intended recipient you should not copy this
e-mail or use the information contained in it for any purpose nor disclose
its contents to any other person. Maryvale Private Hospital Pty Ltd accepts
no responsibility for electronic viruses or damage caused as a result of
this email or for changes made to this email or to any attachments after
transmission from Maryvale Private Hospital. You should not distribute or
publish the contents of this email or any attachment without the prior
consent of Maryvale Private Hospital.
* Please consider the environment before printing this email

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is
discouraged by ACIPC. If you wish to discuss specific reference to products
or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives –
registration and login required.

Replies to this message will be directed back to the list. To create a new
message send an email to aicalist@aicalist.org.au

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aicalist-request@aicalist.org.au .

You can unsubscribe from this list be sending ‘signoff aicalist’ (without
the quotes) to listserv@aicalist.org.au

This message is intended for the addressee named and may contain
confidential information. If you are not the intended recipient, please
delete it and notify the sender.

Views expressed in this message are those of the individual sender, and are
not necessarily the views of NSW Health or any of its entities.

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is
discouraged by ACIPC. If you wish to discuss specific reference to products
or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives –
registration and login required.

Replies to this message will be directed back to the list. To create a new
message send an email to aicalist@aicalist.org.au

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aicalist-request@aicalist.org.au .

You can unsubscribe from this list be sending ‘signoff aicalist’ (without
the quotes) to listserv@aicalist.org.au

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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