A prospective, multicenter, clinical study of duodenoscope contamination after reprocessing.

OBJECTIVE: Several clinical procedures utilize duodenoscopes, which are processed for reuse after the procedures are completed. However, infection outbreaks due to improper duodenoscope processing occur frequently. To address this, we aimed to assess the contamination rates of duodenoscopes after reprocessing in nonoutbreak settings. DESIGN AND SETTING: Prospective study in 16 clinical sites in the United States. METHODS: We sampled and cultured reprocessed duodenoscopes following the FDA/CDC/ASM guideline; "Duodenoscope Surveillance Sampling and Culturing - Reducing the Risks of Infection." High-concern (HC) organisms were those highly associated with disease, including gram-negative rods, Staphylococcus aureus, Staphylococcus lugdunensis, ß-hemolytic Streptococcus, Enterococcus spp, and yeasts. We evaluated duodenoscopes with ≥1 CFU of organisms after reprocessing. The reprocessing environments were also sampled and cultured. RESULTS: We assessed 859 newer-model (NM) duodenoscopes (TJF-Q180V) and 850 older-model (OM) duodenoscopes (TJF-160F/VF); of these, 35 NM samples (4.1%) and 56 OM samples (6.6%) were contaminated with HC organisms. We detected and classified the HC organisms as gastrointestinal (45.4%), human origin (16.7%), environmental (24.1%), waterborne (13.0%), and unidentified (0.9%). CONCLUSIONS: We detected an overall HC contamination rate of 5.3% in nonoutbreak settings. Although the relationship between endoscopic contamination and the occurrence of infections remains unclear, attempts should continue to be made to further reduce contamination rates. Additional improvements to the manufacturer's instructions for use, human factors during the reprocessing procedure, ongoing training programs, cleanliness of reprocessing environments, and the design of the distal end of the duodenoscope should be considered.

[The impact of mindfulness meditation on anger].

This study explores the impact of mindfulness meditation on anger. A meditation group (N = 37) attended 5-10 minutes of mindfulness meditation daily for a week. They were assessed with self-report scales measuring three aspects of anger (rumination, arousal, and lengthiness) before, just after, and four weeks after their one-week participation. Their scores were compared to a control group (N = 27), which was assessed at the same intervals as the meditation group. The meditation group was also asked to evaluate their current mood using the Affect Grid before and after each meditation. The results indicated that participants in the meditation group who continued meditation voluntarily after the week of their participation had decreased anger rumination scores just after and four weeks after their participation. Additionally, the pleasant score on the Affect Grid increased after meditation for almost all the participation days. These findings suggest the efficacy of mindfulness meditation on improving the tendency to ruminate about anger episodes in the medium-term to long-term, and also on improving mood in the short-term.