Background and aim During the COVID-19 pandemic, health workers’ facial exposure to pathogens has been brought into focus. In this study, we aimed to determine the occurrence and degree of facial contamination to both endoscopists and their assistants during endoscopic procedures to help inform future safety measures.
Methods Non-sterile visors worn by endoscopist, assistant and room control visors from 50 procedures were swabbed post procedure for culture. Procedure type, therapy, duration and evidence of visible visor contamination were recorded. After 48-hour incubation, all bacterial colonies were identified using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry. Organisms were classified into skin/environmental, oronasal and enteric.
Results A total of 104 visors were available for assessment (93 staff; 11 control). In worn visors, skin/environmental flora were isolated from 70, oronasal flora from 8, and enteric flora from 3 with an average colony count of >9.5. Notably, bacteria of enteric origin (Escherichia coli and Enterobacter cloacae) were isolated from three worn visors. In room control, skin/environmental flora were isolated from seven and oronasal flora from one with average colony count of five. No room control visors grew enteric flora. Overall, 9.1% room control and 10.8% worn visors were contaminated with organisms that could possibly have originated from patients. However, enteric flora were only obtained from worn visors. No visors were visibly contaminated.
Conclusion This pilot study demonstrates risk of contamination to faces of endoscopists and assistants. Larger studies are required to determine degree of risk and to give guidance on facial protection during gastrointestinal endoscopy.
- diagnostic and therapeutic endoscopy
- intestinal bacteria
- gastrointesinal endoscopy
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. All data used in study are uploaded.
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Contributors DN came up with concept of study and wrote initial proposal and was endoscopist and lead in writing the manuscript and is the guarantor. DN, KWO and JL designed the study. MNarayanan and JP planned and carried out microbiological and bacteriological analysis and report and also provided critical feedback in bacterial results reporting on manuscript. JL carried out ad wrote statistical analysis of the results and wrote that section of the manuscript. KWO, JL, MG, CD, AS and MNayar all carried out endoscopy procedures and provided critical feedback in data analysis and the writing of the manuscript and were involved in finalising the manuscript for submission.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.