Efficacy of ATP test compared to inspection (DETECT)

Rationale 
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.

Primary objective
To assess if usage of ATP tests in complex endoscopes, i.e. duodenoscopes and linear echo-endoscopes, after manual cleaning combined with re-cleaning protocols, lowers the number of clinically relevant positive cultures. 

Design
prospective single center intervention study in ERCP duodenoscopes and linear echo-endoscopes in a single tertiary academic center.

Intervention 
In the intervention group duodenoscopes will be tested on ATP. If the value is above the ATP cutoff, duodenoscopes will be recleaned. In the control group duodenoscopes will not be tested on ATP. 

ATP is an indicator of organic residue. Several studies indicate that use of ATP tests, after manual cleaning and prior to high level disinfection (HLD), can help to prevent that endoscopes with organic residue are subject to HLD. There are no adequate controlled studies in which the effect of ATP test compared to current practice is examined. Currently no statement can be made about the added value of ATP test in everyday practice. Therefore, the aim of the present study is to investigate if usage of ATP tests combined with re-cleaning protocols reduces the number of contaminated DLE.

3M

Dept of Gastroenterology and Hepatology

Prof Dr Margreet Vos:
m.vos@erasmusmc.nl

Prof Dr Marco Bruno
m.bruno@erasmusmc.nl

Drs Arjan Rauwers
a.rauwers@erasmusmc.nl