Monthly endoscopy surveillance culture facilitates detection of breaches in the scope reprocessing procedure: 5 year-experience in an endoscopy center

Monthly endoscopy surveillance culture facilitates detection of breaches in the scope reprocessing procedure: 5 year-experience in an endoscopy center | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article Monthly endoscopy surveillance culture facilitates detection of breaches in the scope reprocessing procedure: 5 year-experience in an endoscopy center Hsu-Heng Yen, Shu-Hui Chen, Huei-Wen Lai, Hui-Lan Chang, Yu-Chun Hsu, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.2.19420/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract AIM To review the clinical impact of monthly microbiology surveillance culture for monitoring endoscope contamination after high-level disinfection. METHODS Monthly surveillance culture of the endoscopes was conducted from January 2014 to December 2018 at our endoscopy center. A total of 1931 cultures were collected, including 765 cultures from 16 gastroscopes, 730 cultures from 18 colonoscopes, 379 cultures from 8 duodenalscopes, 46 cultures from 1 echoscopes, and 11 cultures from 1 enterscope. Cultures were obtained from ready-to-use endoscopes after a full reprocessing cycle and storage. Samples were cultured to test for aerobic and anaerobic bacteria. RESULTS The positive culture rates for the endoscope were 2% (15/765) for gastroscopes, 1.9% (14/730) for colonoscopes, 0.8% (3/379) for duodenscopes, 4.3% (2/46) for echoscopes, and 9.1% (1/11) for enterscopes. These findings were predominantly attributed to human factors (71.4%, 25/35) followed by storage cabinet failure (14.3%, 5/35), automatic endoscope reprocessing failure (11.4%, 4/35), and endoscope channel damage (2.8%, 1/35). Multivariate analysis showed that the years 2015 [odds ratio (OR) 0.19, 0.04 to 0.91], 2016 (OR 0.21, 0.05 to 0.80), and 2017 (OR 0.22, 0.06 to 0.83) were associated with decreased risk of endoscope contamination. The age, type, and number of times the scope was used were not related to contamination. CONCLUSIONS A low risk of endoscope contamination was found over a 5-year period in our endoscopy center. The most common cause of contamination was human factor. Duodenalscopes showed the lowest scope contamination rate. We suggested the implantation of a systematic endoscope culture regardless of the type of scope to facilitate early detection of breaches in the scope reprocessing procedure in clinical practice. Gastroenterology & Hepatology General Microbiology endoscopy surveillance culture scope reprocessing procedure endoscope contamination Figures Figure 1 Introduction Modern endoscopes have delicate designs with long channels, valves, or elevators that are difficult to clean and are prone to damage. Endoscope reprocessing is a complex process that decontaminates endoscopes for subsequent reuse [ 1 – 3 ]. Failure of reprocessing can result in the transmission of pathogens. Endoscopy-associated infection has become an important issue since the outbreak of carbapenem-resistant Enterobacteriaceae (CRE) infection after endoscopic retrograde cholangiopancreatography in the USA between 2012 and 2015 [ 4 ]. These outbreaks resulted in efforts to investigate the quality and efficacy of endoscope reprocessing, as well as factors that influence transmission between endoscopes and patients [ 2 , 5 , 6 ]. Microbiological surveillance is a method used to evaluate the outcome of endoscopy reprocessing and is used for regular quality control in endoscopy units [ 1 , 7 ]. Rigorous culturing of all duodenoscopes after reprocessing of every instrument was reported to terminate an ongoing outbreak of transmission related to duodenoscopes [ 8 ]. In the so-called culture and quarantine approach, all instruments are sampled after reprocessing then stored for 48 h, pending the return of culture results verifying the absence of pathogenic organisms, before reuse [ 8 ]. Although this approach is ideal, it is not practical in busy daily practice and is expensive. The frequency of obtaining microbiology cultures varies from different international guidelines. The European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates guidelines recommend routine testing at intervals of no longer than 3 months [ 7 ]. The Australia guideline recommends that duodenoscopes and endoscopic ultrasound instruments are monitored every month, and other endoscopes are monitored every 3 months [ 9 ]. In the USA, microbiology testing of endoscopes after reprocessing, during storage, or before use is not advised [ 2 ]. The Digestive Endoscopy Society of Taiwan (DEST) recommends randomly testing at routine intervals [ 10 ].Surveillance culturing as a quality assurance measure is advised in these reprocessing guidelines but the optimal interval of surveillance remains controversial. In 2014, our institution began a monthly microbiology surveillance program for all endoscopy in use as a quality indicator due to lack of a reliable real-time indicator after endoscopy reprocessing. The present study reviewed the results of intensive microbiology surveillance, identifying risk factors related to scope contamination and its clinical impact on daily practice. Materials and methods Endoscope reprocessing cycles and storage The ESGE and DEST guidelines recommend that endoscope reprocessing cycle consists of bedside precleaning, manual leak testing, manual cleaning in the cleaning facility, and high-level disinfection in the automatic endoscope reprocessing (AER) [ 1 , 10 , 11 ]. Endoscopes were cleaned manually by qualified endoscopy technicians by brushing and rinsing with tap water and an enzymatic detergent. Manual cleaning was followed by decontamination by the technician using an AER (DSD EDGE Dual Basin AER, Medivators Inc., Minnesota, USA). The liquid disinfectant used was 0.55% ortho-phthalaldehyde solution, which was stored at 15 °C to 30 °C and tested using a test strip prior to each use to ensure the concentration was above the minimum effective concentration. Following AER reprocessing and drying, the scope was transported or stored in a temperature-controlled cabinet for clinical use. The endoscopy unit have a standard protocol for reprocessing and education for the staff. The study didn’t involve human material and the study was approved by the Institutional Research Board of the Changhua Christian Hospital (No. Y-108-0188). Endoscope sampling and culture methods In 2014, we began monthly sampling of the endoscope after high-level disinfection performed by two senior endoscopy technicians. Rinse samples were obtained by flushing the biopsy channels with 100 mL of sterile distilled water under highly aseptic conditions, distributing 50 mL into the working channel and 50 mL into the air/water channel. The distilled water was contained in an aseptic vial (20 mL/vial) manufactured for medical use. The total sample (100 mL) was recovered at the distal end of the endoscope and incubated at 30 °C on plate count agar after filtration of 100 mL through a 0.45 µm filter (Biosart100 Monitors 16401-47-06—ACK, Sartorius, Germany). The filter membrane obtained was aseptically removed, transferred to the total count broth (Biosart100 Nutrient Media 16400-02—TC-K, Sartorius, Germany), and incubated at 35 °C ± 1 °C for 48 ± 3 h. After incubation, results were expressed as the number of colony-forming units per 100 mL. After culturing was complete, the endoscope was reprocessed and returned for reuse, pending negative culture results. Each endoscope was tested by culture once monthly, and the schedule for culturing was based on a scheduled volume and was preferentially performed at a weekend as the endoscope would be out of circulation for approximately 48 h. Microbiology review process of the endoscopy units Positive cultures from the endoscope were followed up by a discussion with the infection control unit, followed by investigation into the source of contamination by the endoscopy center. The infection control unit identified and followed patients who underwent procedures using the contaminated device, reviewed the reprocessing process with staff, repeated the reprocessing of the endoscope, and only returned the endoscope to clinical use only after a repeat culture was found to be negative. In cases of persistent contamination, the scope was sent for ethylene oxide gas sterilization followed by a repeated reviewing process. The scope was sent to the manufacturer if permanent contamination occurred [ 2 , 12 ] . Statistical Analysis The extracted data were presented in Microsoft Excel software and analyzed using MedCalc Statistical Software version 18.11 (MedCalc Software bvba, Ostend, Belgium; https://www.medcalc.org ; 2018). Chi-square test or Fisher's exact test was used for categorical variables. Statistical significance was considered for values of P < 0.05. Results Microbiology surveillance results From January 2014 to December 2018, a total of 1931cultures, including 765 cultures from 16 gastroscopes, 730 cultures from 18 colonoscopes, 379 cultures from 8 duodenalscopes, 46 cultures from 1 echoscopes, and 11 cultures from 1 enterscope (Fig 1). The type, age, and monthly use of the scopes are summarized in Table 1. The overall positive culture rate was 1.8% (35/1931), with three positive culture results considered to be insignificant (<10 colonies of skin flora). The positive culture rates of the endoscopes were 2% (15/765) for gastroscopes, 1.9% (14/730) for colonoscopes, 0.8% (3/379) for duodenscopes, 4.3% (2/46) for echoscopes, and 9.1% (1/11) for enterscopes. The most frequently cultured pathogenic organism was Klebsiella pneumoniae (n = 13) followed by Pseudomonas aeruginosa (n = 11), Enterococcus spp. (n = 1), Candida spp. (n = 5), Alcaligenes faecalis (n = 1), and Acinetobacter baumannii (n = 1). Analysis of the year of microbiology sampling revealed a higher rate (3.9%) of scope contamination in 2018 (Table 2). There was no association between the age and type of scope and scope contamination rate (Tables 3 and 4). Multivariate analysis showed that the years 2015 [odds ratio (OR) 0.19, 0.04 to 0.91), 2016 (OR 0.21, 0.05 to 0.80), and 2017 (OR 0.22, 0.06 to 0.83) were associated with a decreased risk of endoscope contamination. The age, type, and monthly use of the scopes were not related to endoscope contamination. Risk factors for scope contamination A monthly meeting was held between the infection control center and endoscopy center for root cause analysis to investigate the cause of scope contamination (Table 5). The most common causes were found to be human factors (71.4%; 25/35), followed by storage cabinet damage (14.3%; 5/35), AER failure (11.4%; 4/35), and endoscope channel damage (2.8%; 1/35). In 2018, there were five incidents of Candida spp. contamination in the same month. An investigation found that all the contaminated scopes were placed in the same endoscope storage cabinet and the cabinet drying function was found to be damaged. There were four incidents of scope contamination, and a review of the reprocessing procedure identified damage to the AER endoscope connector. There was one incident of persistent scope contamination, despite repeated culturing and ethylene oxide gas sterilization. The scope was finally sent to the manufacturer, and damage to the internal channel was found. The contamination was resolved by changing the channel of the scope. Discussion The present study reviewed a 5-year monthly microbiology endoscopy surveillance and found a low risk of endoscope contamination in our endoscopy unit. Consistent with previous reports, the most common cause of scope contamination was found to be human factors [1, 5, 13, 14]. Despite the complex design of the duodenal scope and recent concerns about duodenal scope contamination [3, 5, 15, 16], duodenal scopes showed a lower scope contamination rate in our study compared with those in previous reports [7, 17, 18] and the frequency of microbiology surveillance should be the same regardless the type of endoscope. A monthly culture of all endoscopes in our unit helped to detect scope contamination and pinpoint the step in the endoscope reprocessing procedure in which contamination occurred. There are two main methods used to evaluate endoscope contamination after high-level disinfection: non-culture and culture-based methods. The former includes the use of ATP and bioburden testing for point-of-care testing for contamination to measure the performance of manual cleaning [4, 19, 20]. However, this method shows a poor correlation with cultures of fully reprocessed devices [4] and requires extra work, particularly in a high-volume unit. The microbiological culture of endoscopes is critical to understanding the efficacy of reprocessing and transmission of microorganisms during outbreak investigations [8, 17, 18, 21-23]. However, the existing guidelines are inconsistent in terms of the recommended frequency and method of microbiological monitoring [7, 9, 24] (Table 6). In Europe [7] and Australia [9, 10], endoscopy microbiology surveillance is regarded as a critical indicator of endoscope reprocessing quality. DEST recommend that microbiology surveillance is performed at a regular frequency [10]. In contrast, the US guidelines recommend against the use of endoscopy microbiology and require more data before a surveillance program should be implemented by healthcare facilities [2]. In the present study, a low risk of scope contamination from various etiologies was identified in the monthly endoscopy surveillance program. Although scope contamination may not be correlated with patient infection, we found this strategy helped early identification of the breach of the reprocessing process before the occurrence of outbreak of scope-related infection. Many studies have reported a higher rate of duodenal scope contamination [7, 17, 18, 25], and the ESGE recommends a close surveillance interval for duodenal scope compared with that for other types of scopes [1, 7]. Because of increased awareness of the high risk of duodenal scope reprocessing failure and the report of duodenal scope transmitted infection in 2014, our endoscopy staff were trained and audited for duodenal scope reprocessing [20]. The rate of inadequate manual cleaning decreased from 70.4% to 18.8% after auditing the reprocessing process [20]. The present study found a low rate of duodenal scope contamination compared with that of other types of scopes. This may be due to an increased awareness of reprocessing of this specific type of scope within the unit. As prompt identification of contaminated endoscopes is vital to prevent an outbreak of scope transmission, we suggest that monthly microbiology surveillance program should be performed, regardless of the type of endoscope, especially in this era of overemphasizing duodenal scope contamination. The present study found that human error was the most common cause of scope contamination [26, 27]. Despite established processing guidelines, high rates of non-compliance to the reprocessing process remain [13, 28]. A lack of regular evaluation of reprocessing staff competence (60%) and regular microbiological inspection (56%) [29, 30] in the endoscopy unit was previously shown to result in guideline non-compliance. Education of endoscopy staff was shown to decrease the rate of endoscope contamination after high-level disinfection [19, 27]. In our unit, we performed an annual competence evaluation of endoscopy staff and still failed to eliminate non-adherence to the reprocessing guidelines. In 2018, our unit introduced the Olympus 290 system, which has a different design than the previously used Olympus 260 system. Thus, in 2018, a lack of familiarity with the new system and a mixture of different endoscope modes (Olympus 260 model and Olympus 2290 model ) were attributed to the increased incidence of human error in our endoscopy unit. This obvious challenge in the current endoscopy reprocessing procedures [30-32] was not addressed in the recent endoscopy reprocessing guidelines [1, 2]. A wide variety of devices continually require reprocessing in the endoscopy unit, and technicians need to identify each type, brand, and model of endoscope and apply appropriate reprocessing procedure. Furthermore, complete reprocessing of each endoscope takes up to 40 min [33], and the technician may speed up the process due to high-volume loads, which may lead to an increased reprocessing error [26, 34]. Memory violation due to too many reprocessing steps, a lack of real-time feedback, and visibility violation were the most causes of human errors during endoscopy reprocessing [32, 35, 36]. Therefore, future studies into endoscopy reprocessing are required to identify the optimal workload for endoscopy technicians, improve the design of endoscopes to simplify and unify the reprocessing procedures, and improve the reprocessing environment to make a safer, more efficient, and more compatible workspace [32]. The present study has some limitations. Quality control is fundamental to the delivery of safe and efficient endoscopic procedures, and surveillance cultures are an important method; however, the optimal method for sampling and culture incubation periods vary among different countries [37]. We adopted the flush method for microbiology surveillance, as recommended by the DEST guidelines, and the culture recovery rate may be lower than using the flush–brush–flush methods [22, 37]. Furthermore, we did not perform cultures for slow-growing agents such as Mycobacterium . Low scope contamination was found in our study compared with that in previous reports of 12.9% to 71.4% [17, 18, 23, 25], although this may be an underestimation due to the culturing methods used and an incubation period of only 48 h. Since there were no outbreaks of endoscope-related transmission such as CRE infection at our institution, we are not able to evaluate the impact of monthly culturing to prevent scope-related transmission. As culture-negative endoscopes may have clinically significant biological residues, monthly culture monitoring should not replace other infection control methods in the unit. Culturing methods can help to detect flaws in the reprocessing procedure that could increase the risk of transmission of infectious agents in the unit. Conclusions A low risk of endoscope contamination was found over a 5 year period in our endoscopy center. Human factors were found to be the leading cause of scope contamination. We suggest the implementation of a systematic endoscope culture regardless of the type of scope for the early detection and etiology of scope contamination in daily practice. Declarations Acknowledgments The authors would like to thank Enago (www.enago.tw) for their English language review. Disclosure of interest The authors report no conflicts of interest. Ethic Statement The study didn’t involve human material and the study was approved by the Institutional Review Board of the Changhua Christian Hospital (No. Y-108-0188). Author contributions Hsu-Heng Yen: Designing the work; the acquisition, analysis and interpretation of the data and revising draft copies. E-mail: [email protected] ; [email protected] Shu-Hui Chen: analysis and interpretation of the data, plus drafting the work. Contributed equally to Dr. Hsu-Heng Yen. E-mail: [email protected] Huei-Wen Lai: interpretation of the data and revising draft copies. E-mail: [email protected] Hui-Lan Chang: interpretation of the data and revising draft copies. E-mail: [email protected] Yu-Chun Hsu: Interpretation of the data and revising draft copies. Contributed equally to Dr. Yen. E-mail: 77149 @cch.org.tw Fu-Yuan Siao: interpretation of the data, plus revising draft copies. E-mail: [email protected] Tables Table 1. Type of scope and scope contamination rate. Type of scope Number of scopes Age of scope (years; mean ± SD) Mean monthly usage (number of times; mean ± SD) Number of sampling Number of positive cultures Scope contamination rate (%) EGD 16 4.5 ± 2.11 45.54 ± 22.69 765 15 2 Colon 18 5.1 3.03 27.96 ± 17.02 730 14 1.9 ERCP 8 5.6 ± 2.58 15.12 ± 7.92 379 3 0.8 EUS 1 2.5 ± 1.13 9.39 ± 3.97 46 2 4.3 Balloon endoscope 1 1 ± 0 3.18 ± 2.09 11 1 9.1 EGD, esophagogastroduodenoscopy; ERCP, endoscopic retrograde cholangiopancreatography; EUS, endoscopic ultrasound Table 2. Scope culture and scope contamination rate by sampling year. Year Number of sampling cultures Number of positive cultures Scope contamination rate (%) 2014 316 9 2.8 2015 318 2 0.6 2016 416 3 0.7 2017 415 3 0.7 2018 466 18 3.9* * P = 0.0003 compared with year 2014 Table 3. Scope contamination rate by scope age. Age of endoscope Number of sampling cultures Number of positive cultures Scope contamination rate (%) 0 3 0 0 1 233 4 1.7 2 216 2 0.9 3 230 8 3.5 4 212 6 2.8 5 246 1 0.4 6 207 4 1.9 7 215 4 1.9 8 193 1 0.5 9 97 3 3.1 10 54 1 1.9 11 25 1 4.0 Table 4. Type of scope and microbiology culture results. Type of scope EGD Colon ERCP EUS Balloon Total Bacillus spp. 1 1 2 Corynebacterium spp. 1 1 Acinetobacter baumannii 1 1 Alcaligenes faecalis 1 1 Candida spp. 4 1 5 Enterococcus spp. 1 1 Klebsiella pneumoniae 5 4 2 1 1 13 Pseudomonas aeruginosa 5 6 11 EGD, esophagogastroduodenoscopy; ERCP, endoscopic retrograde cholangiopancreatography; EUS, endoscopic ultrasound Table 5. Scope contamination from 2014 to 2018. Type of scope Year CFU/mL Bacteria Monthly scope usage (times) Cause of scope contamination Need for Subsequent EO EGD 2014 12 Klebsiella pneumoniae 70 Human error No Colon 2014 10 Pseudomonas aeruginosa 29 Human error No EGD 2014 80 Pseudomonas aeruginosa 10 Human error No Colon 2014 40 Pseudomonas aeruginosa 22 Human error No Colon 2014 40 Pseudomonas aeruginosa 65 Human error No Colon 2014 10 Alcaligenes faecalis 15 Human error No Colon 2014 20 Pseudomonas aeruginosa 37 Human error Pass after EO Colon 2014 10 Pseudomonas aeruginosa 61 Scope breakdown Failed after EO, change scope channel Colon 2015 20 Klebsiella pneumoniae 52 Human error No EGD 2015 6 Klebsiella pneumoniae 62 Human error No EGD 2017 20 Klebsiella pneumoniae 9 Human error No Colon 2017 100 Klebsiella pneumoniae 4 Break of AER No EGD 2016 2 Pseudomonas aeruginosa 43 Human error No Colon 2016 200 Klebsiella pneumoniae 41 Human error No Colon 2016 10 Acinetobacter baumannii 2 Human error No EGD 2018 50 Pseudomonas aeruginosa 17 Break of AER connector No EGD 2018 200 Klebsiella pneumoniae 23 Break of AER connector No EGD 2018 80 Enterococcus spp. 19 Break of AER connector No EGD 2018 10 Klebsiella pneumoniae 19 Human error No DBE 2018 15 Klebsiella pneumoniae 3 Human error No EUS 2018 50 Klebsiella pneumoniae 11 Human error No ERCP 2018 80 Klebsiella pneumoniae 9 Human error Pass after ethylene oxide disinfection Colon 2018 5 Klebsiella pneumoniae 7 Human error No EGD 2018 1 Candida spp. 59 Storage cabinet damage No EGD 2018 5 Candida spp. 61 Storage cabinet damage No EGD 2018 120 Candida spp. 58 Storage cabinet damage No EGD 2018 25 Candida spp. 52 Storage cabinet damage No Colon 2018 5 Candida spp. 14 Storage cabinet damage No EGD 2018 10 Pseudomonas aeruginosa 57 Human error No ERCP 2018 2 Klebsiella pneumoniae 2 Human error No Colon 2018 5 Pseudomonas aeruginosa 8 Human error No EGD 2018 15 Pseudomonas aeruginosa 47 Human error No CFU, colony-forming units; DBE, double balloon enteroscopy; EGD, esophagogastroduodenoscopy; ERCP, endoscopic retrograde cholangiopancreatography; EUS, endoscopic ultrasound Table 6. Summary of current guideline recommendation about the frequency of microbiology surveillance of endoscope unit. Year of Publication Society Guidelines Frequency of Microbiology Surveillance 2007 ESGE–ESGENA [7] The frequency of microbiological surveillance and recommended test procedures differs across Europe. Monthly interval (Denmark, Monaco), 3-monthly interval (Croatia, Germany, Spain, Sweden, Switzerland ), yearly-interval (Austria, France), and UK ( no tests of endoscopes). 2016 Multisociety guideline on reprocessing flexible GI endoscopes (USA) [2] Microbiologic testing of endoscopes after reprocessing, during storage, or before use, has not been advised in current U.S. standard 2017 Gastroenterological Society of Australia [38] Surveillance frequency depends on types of endoscopes. Monthly interval (ERCP and EUS scope), and 3- monthly ( other gastrointestinal scopes ) 2017 World Endoscopy Organization [10] Endoscopes should be randomly tested at routine intervals. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-10033","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":263547,"identity":"194bed44-1ca1-480b-824b-710b930c95cf","order_by":1,"name":"Hsu-Heng Yen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAxUlEQVRIiWNgGAWjYBACfmbmAwYfKhgYDIjWItnOllA44wxcCxE6Dc7zKHzmbCNJy2Eexs2M8+zkzRmYj338wvAnsYGgww7zHjYu3JZsuLOBLXm2DIMBYS18h/nSjGduO5BgcIDHmFmCwSCXoBaGwzzmv3nnkKJF4DCPgTFvA0QL4wditEg2syUYzjiWbLjhMFsyM4OBcT1BLfz8h4FRWWMnb3C8+TDjjwo5Y4JeQQBmIOIhPg1AAeMPUnWMglEwCkbBiAAAIJ05QGdYJesAAAAASUVORK5CYII=","orcid":"","institution":"Changhua Christian Hospital","correspondingAuthor":true,"prefix":"","firstName":"Hsu-Heng","middleName":"","lastName":"Yen","suffix":""},{"id":263548,"identity":"449c3900-3083-49c0-a70e-a13102f87531","order_by":2,"name":"Shu-Hui Chen","email":"","orcid":"","institution":"Changhua Christian Hospital","correspondingAuthor":false,"prefix":"","firstName":"Shu-Hui","middleName":"","lastName":"Chen","suffix":""},{"id":263549,"identity":"082edb5d-a99e-4409-abe4-dc258cc0cb99","order_by":3,"name":"Huei-Wen Lai","email":"","orcid":"","institution":"Changhua Christian Medical Foundation Changhua Christian Hospitalpital","correspondingAuthor":false,"prefix":"","firstName":"Huei-Wen","middleName":"","lastName":"Lai","suffix":""},{"id":263550,"identity":"abe28a79-febf-4ca3-8bf6-28617d1239db","order_by":4,"name":"Hui-Lan Chang","email":"","orcid":"","institution":"Changhua Christian Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hui-Lan","middleName":"","lastName":"Chang","suffix":""},{"id":263551,"identity":"0b2ca846-fb0f-4e65-b4f0-d4c3a6f0f135","order_by":5,"name":"Yu-Chun Hsu","email":"","orcid":"","institution":"Changhus Christian Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yu-Chun","middleName":"","lastName":"Hsu","suffix":""},{"id":263552,"identity":"f32d9c5f-0cd0-4894-bd21-01164bd34974","order_by":6,"name":"Fu-Yuan Siao","email":"","orcid":"","institution":"Changhua Christian Medical Foundation Changhua Christian Hospital","correspondingAuthor":false,"prefix":"","firstName":"Fu-Yuan","middleName":"","lastName":"Siao","suffix":""}],"badges":[],"createdAt":"2019-12-19 15:12:55","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.2.19420/v1","doiUrl":"https://doi.org/10.21203/rs.2.19420/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":289281,"identity":"97d8047e-7936-4c1b-8a84-885a32329122","added_by":"auto","created_at":"2019-12-20 19:02:23","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":13870,"visible":true,"origin":"","legend":"Endoscopy unit culture results from 2014 to 2018.","description":"","filename":"1.PNG","url":"https://assets-eu.researchsquare.com/files/a0e7fe4e-912e-4349-8466-cd10fddd0eb9/v1/1.PNG"},{"id":13482994,"identity":"94f3a50b-6448-4f1c-9ad6-635f1a51891a","added_by":"auto","created_at":"2021-09-16 21:51:44","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1139939,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-10033/v1/be200d0c-14d3-4cdb-9994-8e4e89bd8f45.pdf"}],"financialInterests":"","formattedTitle":"Monthly endoscopy surveillance culture facilitates detection of breaches in the scope reprocessing procedure: 5 year-experience in an endoscopy center","fulltext":[{"header":"Introduction","content":" \u003cp\u003eModern endoscopes have delicate designs with long channels, valves, or elevators that are difficult to clean and are prone to damage. Endoscope reprocessing is a complex process that decontaminates endoscopes for subsequent reuse [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Failure of reprocessing can result in the transmission of pathogens. Endoscopy-associated infection has become an important issue since the outbreak of carbapenem-resistant Enterobacteriaceae (CRE) infection after endoscopic retrograde cholangiopancreatography in the USA between 2012 and 2015 [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. These outbreaks resulted in efforts to investigate the quality and efficacy of endoscope reprocessing, as well as factors that influence transmission between endoscopes and patients [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMicrobiological surveillance is a method used to evaluate the outcome of endoscopy reprocessing and is used for regular quality control in endoscopy units [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Rigorous culturing of all duodenoscopes after reprocessing of every instrument was reported to terminate an ongoing outbreak of transmission related to duodenoscopes [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. In the so-called culture and quarantine approach, all instruments are sampled after reprocessing then stored for 48\u0026nbsp;h, pending the return of culture results verifying the absence of pathogenic organisms, before reuse [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Although this approach is ideal, it is not practical in busy daily practice and is expensive. The frequency of obtaining microbiology cultures varies from different international guidelines. The European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates guidelines recommend routine testing at intervals of no longer than 3 months [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The Australia guideline recommends that duodenoscopes and endoscopic ultrasound instruments are monitored every month, and other endoscopes are monitored every 3 months [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. In the USA, microbiology testing of endoscopes after reprocessing, during storage, or before use is not advised [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. The Digestive Endoscopy Society of Taiwan (DEST) recommends randomly testing at routine intervals [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].Surveillance culturing as a quality assurance measure is advised in these reprocessing guidelines but the optimal interval of surveillance remains controversial. In 2014, our institution began a monthly microbiology surveillance program for all endoscopy in use as a quality indicator due to lack of a reliable real-time indicator after endoscopy reprocessing. The present study reviewed the results of intensive microbiology surveillance, identifying risk factors related to scope contamination and its clinical impact on daily practice.\u003c/p\u003e "},{"header":"Materials and methods","content":" \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eEndoscope reprocessing cycles and storage\u003c/h2\u003e \u003cp\u003eThe ESGE and DEST guidelines recommend that endoscope reprocessing cycle consists of bedside precleaning, manual leak testing, manual cleaning in the cleaning facility, and high-level disinfection in the automatic endoscope reprocessing (AER) [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Endoscopes were cleaned manually by qualified endoscopy technicians by brushing and rinsing with tap water and an enzymatic detergent. Manual cleaning was followed by decontamination by the technician using an AER (DSD EDGE Dual Basin AER, Medivators Inc., Minnesota, USA). The liquid disinfectant used was 0.55% ortho-phthalaldehyde solution, which was stored at 15\u0026nbsp;\u0026deg;C to 30\u0026nbsp;\u0026deg;C and tested using a test strip prior to each use to ensure the concentration was above the minimum effective concentration. Following AER reprocessing and drying, the scope was transported or stored in a temperature-controlled cabinet for clinical use. The endoscopy unit have a standard protocol for reprocessing and education for the staff. The study didn\u0026rsquo;t involve human material and the study was approved by the Institutional Research Board of the Changhua Christian Hospital (No. Y-108-0188).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eEndoscope sampling and culture methods\u003c/h2\u003e \u003cp\u003eIn 2014, we began monthly sampling of the endoscope after high-level disinfection performed by two senior endoscopy technicians. Rinse samples were obtained by flushing the biopsy channels with 100\u0026nbsp;mL of sterile distilled water under highly aseptic conditions, distributing 50\u0026nbsp;mL into the working channel and 50\u0026nbsp;mL into the air/water channel. The distilled water was contained in an aseptic vial (20\u0026nbsp;mL/vial) manufactured for medical use. The total sample (100\u0026nbsp;mL) was recovered at the distal end of the endoscope and incubated at 30\u0026nbsp;\u0026deg;C on plate count agar after filtration of 100\u0026nbsp;mL through a 0.45\u0026nbsp;\u0026micro;m filter (Biosart100 Monitors 16401-47-06\u0026mdash;ACK, Sartorius, Germany). The filter membrane obtained was aseptically removed, transferred to the total count broth (Biosart100 Nutrient Media 16400-02\u0026mdash;TC-K, Sartorius, Germany), and incubated at 35\u0026nbsp;\u0026deg;C\u0026thinsp;\u0026plusmn;\u0026thinsp;1\u0026nbsp;\u0026deg;C for 48\u0026thinsp;\u0026plusmn;\u0026thinsp;3\u0026nbsp;h. After incubation, results were expressed as the number of colony-forming units per 100\u0026nbsp;mL. After culturing was complete, the endoscope was reprocessed and returned for reuse, pending negative culture results. Each endoscope was tested by culture once monthly, and the schedule for culturing was based on a scheduled volume and was preferentially performed at a weekend as the endoscope would be out of circulation for approximately 48\u0026nbsp;h.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eMicrobiology review process of the endoscopy units\u003c/h2\u003e \u003cp\u003ePositive cultures from the endoscope were followed up by a discussion with the infection control unit, followed by investigation into the source of contamination by the endoscopy center. The infection control unit identified and followed patients who underwent procedures using the contaminated device, reviewed the reprocessing process with staff, repeated the reprocessing of the endoscope, and only returned the endoscope to clinical use only after a repeat culture was found to be negative. In cases of persistent contamination, the scope was sent for ethylene oxide gas sterilization followed by a repeated reviewing process. The scope was sent to the manufacturer if permanent contamination occurred [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] .\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eThe extracted data were presented in Microsoft Excel software and analyzed using MedCalc Statistical Software version 18.11 (MedCalc Software bvba, Ostend, Belgium; \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.medcalc.org\u003c/span\u003e\u003c/span\u003e; 2018). Chi-square test or Fisher's exact test was used for categorical variables. Statistical significance was considered for values of \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u0026thinsp;\u0026lt;\u003c/span\u003e\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e "},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eMicrobiology surveillance results\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFrom January 2014 to December 2018, a total of 1931cultures, including 765 cultures from 16 gastroscopes, 730 cultures from 18 colonoscopes, 379 cultures from 8 duodenalscopes, 46 cultures from 1 echoscopes, and 11 cultures from 1 enterscope (Fig 1). The type, age, and monthly use of the scopes are summarized in Table 1. The overall positive culture rate was 1.8% (35/1931), with three positive culture results considered to be insignificant (\u0026lt;10 colonies of skin flora). The positive culture rates of the endoscopes were 2% (15/765) for gastroscopes, 1.9% (14/730) for colonoscopes, 0.8% (3/379) for duodenscopes, 4.3% (2/46) for echoscopes, and 9.1% (1/11) for enterscopes. The most frequently cultured pathogenic organism was \u003cem\u003eKlebsiella pneumoniae\u003c/em\u003e (n\u0026nbsp;=\u0026nbsp;13) followed by \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e (n\u0026nbsp;=\u0026nbsp;11), \u003cem\u003eEnterococcus \u003c/em\u003espp. (n\u0026nbsp;=\u0026nbsp;1), \u003cem\u003eCandida \u003c/em\u003espp. (n\u0026nbsp;=\u0026nbsp;5), \u003cem\u003eAlcaligenes faecalis\u003c/em\u003e (n\u0026nbsp;=\u0026nbsp;1), and \u003cem\u003eAcinetobacter baumannii\u003c/em\u003e (n\u0026nbsp;=\u0026nbsp;1).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; Analysis of the year of microbiology sampling revealed a higher rate (3.9%) of scope contamination in 2018 (Table 2). There was no association between the age and type of scope and scope contamination rate (Tables 3 and 4). Multivariate analysis showed that the years 2015 [odds ratio (OR) 0.19, 0.04 to 0.91), 2016 (OR 0.21, 0.05 to 0.80), and 2017 (OR 0.22, 0.06 to 0.83) were associated with a decreased risk of endoscope contamination. The age, type, and monthly use of the scopes were not related to endoscope contamination.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRisk factors for scope contamination\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA monthly meeting was held between the infection control center and endoscopy center for root cause analysis to investigate the cause of scope contamination (Table 5). The most common causes were found to be human factors (71.4%; 25/35), followed by storage cabinet damage (14.3%; 5/35), AER failure (11.4%; 4/35), and endoscope channel damage (2.8%; 1/35). In 2018, there were five incidents of \u003cem\u003eCandida \u003c/em\u003espp. contamination in the same month. An investigation found that all the contaminated scopes were placed in the same endoscope storage cabinet and the cabinet drying function was found to be damaged. There were four incidents of scope contamination, and a review of the reprocessing procedure identified damage to the AER endoscope connector. There was one incident of persistent scope contamination, despite repeated culturing and ethylene oxide gas sterilization. The scope was finally sent to the manufacturer, and damage to the internal channel was found. The contamination was resolved by changing the channel of the scope.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present study reviewed a 5-year monthly microbiology endoscopy surveillance and found a low risk of endoscope contamination in our endoscopy unit. Consistent with previous reports, the most common cause of scope contamination was found to be human factors [1, 5, 13, 14]. Despite the complex design of the duodenal scope and recent concerns about duodenal scope contamination [3, 5, 15, 16], duodenal scopes showed a lower scope contamination rate in our study compared with those in previous reports [7, 17, 18] and the frequency of microbiology surveillance should be the same regardless the type of endoscope. \u0026nbsp;A monthly culture of all endoscopes in our unit helped to detect scope contamination and pinpoint the step in the endoscope reprocessing procedure in which contamination occurred.\u003c/p\u003e\n\u003cp\u003eThere are two main methods used to evaluate endoscope contamination after high-level disinfection: non-culture and culture-based methods. The former includes the use of ATP and bioburden testing for point-of-care testing for contamination to measure the performance of manual cleaning [4, 19, 20]. However, this method shows a poor correlation with cultures of fully reprocessed devices [4] and requires extra work, particularly in a high-volume unit. The microbiological culture of endoscopes is critical to understanding the efficacy of reprocessing and transmission of microorganisms during outbreak investigations [8, 17, 18, 21-23]. However, the existing guidelines are inconsistent in terms of the recommended frequency and method of microbiological monitoring [7, 9, 24] (Table 6). In Europe [7] and Australia [9, 10], endoscopy microbiology surveillance is regarded as a critical indicator of endoscope reprocessing quality. DEST recommend that microbiology surveillance is performed at a regular frequency [10]. In contrast, the US guidelines recommend against the use of endoscopy microbiology and require more data before a surveillance program should be implemented by healthcare facilities [2]. In the present study, a low risk of scope contamination from various etiologies was identified in the monthly endoscopy surveillance program. Although scope contamination may not be correlated with patient infection, we found this strategy helped early identification of the breach of the reprocessing process before the occurrence of outbreak of scope-related infection.\u003c/p\u003e\n\u003cp\u003eMany studies have reported a higher rate of duodenal scope contamination [7, 17, 18, 25], and the ESGE recommends a close surveillance interval for duodenal scope compared with that for other types of scopes [1, 7]. Because of increased awareness of the high risk of duodenal scope reprocessing failure and the report of duodenal scope transmitted infection in 2014, our endoscopy staff were trained and audited for duodenal scope reprocessing [20]. The rate of inadequate manual cleaning decreased from 70.4% to 18.8% after auditing the reprocessing process [20]. The present study found a low rate of duodenal scope contamination compared with that of other types of scopes. This may be due to an increased awareness of reprocessing of this specific type of scope within the unit. As prompt identification of contaminated endoscopes is vital to prevent an outbreak of scope transmission, we suggest that monthly microbiology surveillance program should be performed, regardless of the type of endoscope, especially in this era of overemphasizing duodenal scope contamination.\u003c/p\u003e\n\u003cp\u003eThe present study found that human error was the most common cause of scope contamination [26, 27]. Despite established processing guidelines, high rates of non-compliance to the reprocessing process remain [13, 28]. A lack of regular evaluation of reprocessing staff competence (60%) and regular microbiological inspection (56%) [29, 30] in the endoscopy unit was previously shown to result in guideline non-compliance. Education of endoscopy staff was shown to decrease the rate of endoscope contamination after high-level disinfection [19, 27]. In our unit, we performed an annual competence evaluation of endoscopy staff and still failed to eliminate non-adherence to the reprocessing guidelines. In 2018, our unit introduced the Olympus 290 system, which has a different design than the previously used Olympus 260 system. Thus, in 2018, a lack of familiarity with the new system and a mixture of different endoscope modes (Olympus 260 model and Olympus 2290 model ) were attributed to the increased incidence of human error in our endoscopy unit. This obvious challenge in the current endoscopy reprocessing procedures [30-32] was not addressed in the recent endoscopy reprocessing guidelines [1, 2]. A wide variety of devices continually require reprocessing in the endoscopy unit, and technicians need to identify each type, brand, and model of endoscope and apply appropriate reprocessing procedure. Furthermore, complete reprocessing of each endoscope takes up to 40\u0026nbsp;min [33], and the technician may speed up the process due to high-volume loads, which may lead to an increased reprocessing error [26, 34]. Memory violation due to too many reprocessing steps, a lack of real-time feedback, and visibility violation were the most causes of human errors during endoscopy reprocessing [32, 35, 36]. Therefore, future studies into endoscopy reprocessing are required to identify the optimal workload for endoscopy technicians, improve the design of endoscopes to simplify and unify the reprocessing procedures, and improve the reprocessing environment to make a safer, more efficient, and more compatible workspace [32].\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The present study has some limitations. Quality control is fundamental to the delivery of safe and efficient endoscopic procedures, and surveillance cultures are an important method; however, the optimal method for sampling and culture incubation periods vary among different countries [37]. We adopted the flush method for microbiology surveillance, as recommended by the DEST guidelines, and the culture recovery rate may be lower than using the flush\u0026ndash;brush\u0026ndash;flush methods [22, 37]. Furthermore, we did not perform cultures for slow-growing agents such as \u003cem\u003eMycobacterium\u003c/em\u003e. Low scope contamination was found in our study compared with that in previous reports of 12.9% to 71.4% [17, 18, 23, 25], although this may be an underestimation due to the culturing methods used and an incubation period of only 48\u0026nbsp;h. Since there were no outbreaks of endoscope-related transmission such as CRE infection at our institution, we are not able to evaluate the impact of monthly culturing to prevent scope-related transmission. As culture-negative endoscopes may have clinically significant biological residues, monthly culture monitoring should not replace other infection control methods in the unit. Culturing methods can help to detect flaws in the reprocessing procedure that could increase the risk of transmission of infectious agents in the unit.\u003c/p\u003e"},{"header":"Conclusions","content":" \u003cp\u003eA low risk of endoscope contamination was found over a 5\u0026nbsp;year period in our endoscopy center. Human factors were found to be the leading cause of scope contamination. We suggest the implementation of a systematic endoscope culture regardless of the type of scope for the early detection and etiology of scope contamination in daily practice.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank Enago (www.enago.tw) for their English language review.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDisclosure of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors report no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthic Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study didn\u0026rsquo;t involve human material and the study was approved by the Institutional Review Board of the Changhua Christian Hospital (No. Y-108-0188).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHsu-Heng Yen: Designing the work; the acquisition, analysis and interpretation of the data and revising draft copies. E-mail: \u003ca href=\"mailto:[email protected]\"\[email protected]\u003c/a\u003e; \u003ca href=\"mailto:[email protected]\"\[email protected]\u003c/a\u003e\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eShu-Hui Chen: analysis and interpretation of the data, plus drafting the work. Contributed equally to Dr. Hsu-Heng Yen. E-mail: \u003ca href=\"mailto:[email protected]\"\[email protected]\u003c/a\u003e\u003c/p\u003e\n\u003cp\u003eHuei-Wen Lai: interpretation of the data and revising draft copies. E-mail: \u003ca href=\"mailto:[email protected]\"\[email protected]\u003c/a\u003e\u003c/p\u003e\n\u003cp\u003eHui-Lan Chang: interpretation of the data and revising draft copies. E-mail: \u003ca href=\"mailto:[email protected]\"\[email protected]\u003c/a\u003e\u003c/p\u003e\n\u003cp\u003eYu-Chun Hsu: Interpretation of the data and revising draft copies. Contributed equally to Dr. Yen. E-mail: 77149 @cch.org.tw\u003c/p\u003e\n\u003cp\u003eFu-Yuan Siao: interpretation of the data, plus revising draft copies. E-mail: \u003ca href=\"mailto:[email protected]\"\[email protected]\u003c/a\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"Tables","content":"\u003cp style=\"margin-bottom: 10.0pt;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eTable 1. Type of scope and scope contamination rate.\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"width: 461.85pt; border-collapse: collapse; border: none; margin-left: 6.75pt; margin-right: 6.75pt;\" width=\"616\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 78.6pt; border: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"105\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eType of scope\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.45pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"67\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNumber of scopes\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 52.8pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"70\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;Age of scope (years; mean\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026plusmn;\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eSD)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.85pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"113\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eMean monthly usage (number of times; mean\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u0026plusmn;\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eSD)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.2pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNumber of sampling\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 57.95pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"77\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNumber of positive cultures\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 70.0pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"93\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eScope contamination rate (%)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 78.6pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"105\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.45pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"67\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e16\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 52.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"70\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e4.5\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026plusmn;\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2.11\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"113\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e45.54\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026plusmn;\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e22.69\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e765\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 57.95pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"77\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e15\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 70.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"93\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 78.6pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"105\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.45pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"67\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e18\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 52.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"70\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e5.1\u0026nbsp;\u003c/span\u003e \u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e3.03\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"113\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e27.96\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026plusmn;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;17.02\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e730\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 57.95pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"77\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e14\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 70.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"93\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1.9\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 78.6pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"105\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eERCP\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.45pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"67\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e8\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 52.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"70\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e5.6\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026plusmn;\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2.58\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"113\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e15.12\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026plusmn;\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e7.92\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e379\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 57.95pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"77\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 70.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"93\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e0.8\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 78.6pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"105\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEUS\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.45pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"67\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 52.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"70\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2.5\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026plusmn;\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1.13\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"113\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e9.39\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026plusmn;\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e3.97\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e46\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 57.95pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"77\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 70.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"93\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e4.3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 78.6pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"105\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eBalloon endoscope\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.45pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"67\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 52.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"70\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026plusmn;\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"113\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e3.18\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026plusmn;\u0026nbsp;\u003c/span\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2.09\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e11\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 57.95pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"77\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 70.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"93\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e9.1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD, esophagogastroduodenoscopy; ERCP, endoscopic retrograde cholangiopancreatography; EUS, endoscopic ultrasound \u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eTable 2. Scope culture and scope contamination rate by sampling year.\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"width: 432.1pt; border-collapse: collapse; border: none;\" width=\"576\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eYear \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNumber of\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003esampling cultures\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNumber of\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003epositive cultures\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eScope contamination rate (%)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2014\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e316\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e9\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2.8\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2015\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e318\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e0.6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2016\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e416\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e0.7\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2017\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e415\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e0.7\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e466\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e18\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e3.9*\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e* \u003c/span\u003e\u003c/em\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eP\u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;=\u0026nbsp;0.0003 compared with year 2014\u003cbr style=\"page-break-before: always;\" /\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eTable 3. Scope contamination rate by scope age.\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"width: 432.1pt; border-collapse: collapse; border: none;\" width=\"576\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eAge of endoscope\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNumber of\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003esampling cultures\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNumber of\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003epositive cultures\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eScope contamination rate (%)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e233\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1.7\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e216\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e0.9\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e230\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e8\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e3.5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e212\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2.8\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e246\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e0.4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e207\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1.9\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e7\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e215\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1.9\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e8\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e193\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e0.5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e9\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e97\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e3.1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e54\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1.9\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 77.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"104\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e11\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 134.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"180\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e25\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 120.5pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"161\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e4.0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eTable 4. Type of scope and microbiology culture results.\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse: collapse; border: none;\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 95.3pt; border: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eType of scope\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 46.2pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"62\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eERCP\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEUS\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eBalloon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.55pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eTotal\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 95.3pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif; color: black;\"\u003eBacillus \u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif; color: black;\"\u003espp.\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 46.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"62\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif; color: black;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif; color: black;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.55pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif; color: black;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 95.3pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif; color: black;\"\u003eCorynebacterium \u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif; color: black;\"\u003espp.\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 46.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"62\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif; color: black;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.55pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif; color: black;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 95.3pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eAcinetobacter baumannii\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 46.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"62\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.55pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 95.3pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eAlcaligenes faecalis\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 46.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"62\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.55pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 95.3pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eCandida \u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003espp.\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 46.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"62\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.55pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 95.3pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eEnterococcus \u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003espp.\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 46.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"62\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.55pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 52.3pt;\"\u003e\n\u003ctd style=\"width: 95.3pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 52.3pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eKlebsiella pneumoniae\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 46.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 52.3pt;\" width=\"62\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 52.3pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 52.3pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 52.3pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 52.3pt;\" width=\"66\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.55pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 52.3pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e13\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 95.3pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003ePseudomonas aeruginosa\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 46.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"62\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 56.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"76\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp style=\"text-align: justify; text-justify: distribute-all-lines;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.55pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e11\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD, esophagogastroduodenoscopy; ERCP, endoscopic retrograde cholangiopancreatography; EUS, endoscopic ultrasound\u003cbr style=\"page-break-before: always;\" /\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eTable 5. Scope contamination from 2014 to 2018. \u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse: collapse; border: none;\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eType of scope\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eYear \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eCFU/mL\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eBacteria\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eMonthly scope usage (times)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eCause of scope contamination\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNeed for Subsequent \u003c/span\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eEO\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2014\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e12\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eKlebsiella pneumoniae\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e70\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2014\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003ePseudomonas aeruginosa\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e29\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2014\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003ePseudomonas aeruginosa\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2014\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e40\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003ePseudomonas aeruginosa\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e22\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2014\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e40\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003ePseudomonas aeruginosa\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e65\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2014\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eAlcaligenes faecalis\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e15\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2014\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e20\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003ePseudomonas aeruginosa\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e37\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003ePass after EO\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2014\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003ePseudomonas aeruginosa\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e61\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eScope breakdown\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eFailed after EO, change scope channel\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2015\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e20\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eKlebsiella pneumoniae\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e52\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2015\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eKlebsiella pneumoniae\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e62\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2017\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e20\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eKlebsiella pneumoniae\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e9\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2017\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e100\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eKlebsiella pneumoniae\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eBreak of AER\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2016\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003ePseudomonas aeruginosa\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e43\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2016\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e200\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eKlebsiella pneumoniae\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e41\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2016\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eAcinetobacter baumannii\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e50\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003ePseudomonas aeruginosa\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e17\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eBreak of AER connector\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e200\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eKlebsiella pneumoniae\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e23\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eBreak of AER connector\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eEnterococcus \u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003espp.\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e19\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eBreak of AER connector\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eKlebsiella pneumoniae\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e19\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eDBE\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e15\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eKlebsiella pneumoniae\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEUS\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e50\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eKlebsiella pneumoniae\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e11\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eERCP\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eKlebsiella pneumoniae\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e9\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003ePass after ethylene oxide disinfection\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eKlebsiella pneumoniae\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e7\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eCandida\u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e spp.\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e59\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eStorage cabinet damage\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eCandida \u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003espp.\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e61\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eStorage cabinet damage\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e120\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eCandida \u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003espp.\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e58\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eStorage cabinet damage\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e25\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eCandida \u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003espp.\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e52\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eStorage cabinet damage\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eCandida \u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003espp.\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e14\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eStorage cabinet damage\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003ePseudomonas aeruginosa\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e57\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eERCP\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eKlebsiella pneumoniae\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eColon\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003ePseudomonas aeruginosa\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e8\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.75pt;\"\u003e\n\u003ctd style=\"width: 34.9pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eEGD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e2018\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.15pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"47\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e15\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.0pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"112\"\u003e\n\u003cp\u003e\u003cem\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003ePseudomonas aeruginosa\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 42.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"57\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003e47\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95.25pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"127\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eHuman error\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 87.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.75pt;\" width=\"117\"\u003e\n\u003cp\u003e\u003cspan style=\"line-height: 200%; font-family: 'Calibri',sans-serif;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 115%;\"\u003e\u003cspan style=\"line-height: 115%; font-family: 'Calibri',sans-serif;\"\u003eCFU, colony-forming units; DBE, double balloon enteroscopy; EGD, esophagogastroduodenoscopy; ERCP, endoscopic retrograde cholangiopancreatography; EUS, endoscopic ultrasound\u003c/span\u003e \u003cbr style=\"page-break-before: always;\" /\u003e\u003cbr style=\"page-break-before: always;\" /\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 115%;\"\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt;\"\u003eTable 6. Summary of current guideline recommendation about the frequency of microbiology surveillance of endoscope unit.\u003c/p\u003e\n\u003ctable style=\"width: 480.3pt; border-collapse: collapse; border: none; margin-left: 6.75pt; margin-right: 6.75pt;\" width=\"640\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 70.65pt; border: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"94\"\u003e\n\u003cp style=\"text-align: center; line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eYear of Publication\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eSociety Guidelines\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 282.1pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"376\"\u003e\n\u003cp style=\"text-align: center; line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eFrequency of Microbiology Surveillance\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 70.65pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"94\"\u003e\n\u003cp style=\"text-align: center; line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003e2007\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eESGE\u0026ndash;ESGENA\u003c/span\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003e[7]\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 282.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"376\"\u003e\n\u003cp style=\"line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eThe frequency of microbiological surveillance and recommended test procedures differs across Europe. Monthly interval (Denmark, Monaco), 3-monthly interval (Croatia, Germany, Spain, Sweden, Switzerland ), yearly-interval (Austria, France), and UK ( no tests of endoscopes). \u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 70.65pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"94\"\u003e\n\u003cp style=\"text-align: center; line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003e2016\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eMultisociety guideline on reprocessing flexible GI endoscopes (USA)\u003c/span\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003e[2]\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 282.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"376\"\u003e\n\u003cp style=\"line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eMicrobiologic testing of endoscopes after reprocessing, during storage, or before use, has not been advised in current U.S. standard\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 70.65pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"94\"\u003e\n\u003cp style=\"text-align: center; line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003e2017\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eGastroenterological Society of Australia \u003c/span\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003e[38]\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 282.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"376\"\u003e\n\u003cp style=\"text-align: center; line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eSurveillance frequency depends on types of endoscopes. Monthly interval (ERCP and EUS scope), and 3- monthly ( other gastrointestinal scopes )\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 70.65pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"94\"\u003e\n\u003cp style=\"text-align: center; line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003e2017\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eWorld Endoscopy Organization \u003c/span\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003e[10]\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 282.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"376\"\u003e\n\u003cp style=\"text-align: center; line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003eEndoscopes should be randomly tested at routine intervals. Regular interval (Taiwan), quarterly (China), every 6 months ( Indonesia ), or institution specific (India)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"line-height: normal;\"\u003e\u003cspan style=\"font-family: 'Calibri',sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBeilenhoff U, Neumann CS, Rey JF, Biering H, Blum R, Cimbro M, Kampf B, Rogers M, Schmidt V, Committee EG\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eESGE-ESGENA Guideline: cleaning and disinfection in gastrointestinal endoscopy\u003c/strong\u003e. \u003cem\u003eEndoscopy \u003c/em\u003e2008, \u003cstrong\u003e40\u003c/strong\u003e(11):939-957.\u003c/li\u003e\n\u003cli\u003eReprocessing Guideline Task F, Petersen BT, Cohen J, Hambrick RD, 3rd, Buttar N, Greenwald DA, Buscaglia JM, Collins J, Eisen G: \u003cstrong\u003eMultisociety guideline on reprocessing 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2\u003c/strong\u003e:S27-39.\u003c/li\u003e\n\u003cli\u003eSoares JB, Goncalves R, Banhudo A, Pedrosa J: \u003cstrong\u003eReprocessing practice in digestive endoscopy units of district hospitals: results of a Portuguese National Survey\u003c/strong\u003e. \u003cem\u003eEur J Gastroenterol Hepatol \u003c/em\u003e2011, \u003cstrong\u003e23\u003c/strong\u003e(11):1064-1068.\u003c/li\u003e\n\u003cli\u003eJolly JD, Hildebrand EA, Branaghan RJ, Garland TB, Epstein D, Babcock-Parziale J, Brown V: \u003cstrong\u003ePatient safety and reprocessing: A usability test of the endoscope reprocessing procedure\u003c/strong\u003e. \u003cem\u003eHuman Factors and Ergonomics in Manufacturing \u0026amp; Service Industries \u003c/em\u003e2012, \u003cstrong\u003e22\u003c/strong\u003e(1):39-51.\u003c/li\u003e\n\u003cli\u003eHildebrand EA, Branaghan RJ, Neuman BL, Jolly J, Garland TB, Taggart M, Epstein DR, Babcock-Parziale J, Brown V: \u003cstrong\u003eAn Expert Perspective of Errors in Endoscope 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\u003cstrong\u003eThe importance of sampling technique and rinse water for assessing flexible gastrointestinal endoscope reprocessing: A 3-year study covering 59 centers\u003c/strong\u003e. \u003cem\u003eAm J Infect Control \u003c/em\u003e2019.\u003c/li\u003e\n\u003cli\u003eCALHN S, NALHN, CHSALHN, WCHN: \u003cstrong\u003eClinical Guideline Microbiological Testing of Endoscopes Clinical Guideline\u003c/strong\u003e. 2017.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"endoscopy surveillance culture, scope reprocessing procedure, endoscope contamination","lastPublishedDoi":"10.21203/rs.2.19420/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.2.19420/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eAIM To review the clinical impact of monthly microbiology surveillance culture for monitoring endoscope contamination after high-level disinfection.\u003c/p\u003e\u003cp\u003eMETHODS Monthly surveillance culture of the endoscopes was conducted from January 2014 to December 2018 at our endoscopy center. A total of 1931 cultures were collected, including 765 cultures from 16 gastroscopes, 730 cultures from 18 colonoscopes, 379 cultures from 8 duodenalscopes, 46 cultures from 1 echoscopes, and 11 cultures from 1 enterscope. Cultures were obtained from ready-to-use endoscopes after a full reprocessing cycle and storage. Samples were cultured to test for aerobic and anaerobic bacteria.\u003c/p\u003e\u003cp\u003eRESULTS The positive culture rates for the endoscope were 2% (15/765) for gastroscopes, 1.9% (14/730) for colonoscopes, 0.8% (3/379) for duodenscopes, 4.3% (2/46) for echoscopes, and 9.1% (1/11) for enterscopes. These findings were predominantly attributed to human factors (71.4%, 25/35) followed by storage cabinet failure (14.3%, 5/35), automatic endoscope reprocessing failure (11.4%, 4/35), and endoscope channel damage (2.8%, 1/35). Multivariate analysis showed that the years 2015 [odds ratio (OR) 0.19, 0.04 to 0.91], 2016 (OR 0.21, 0.05 to 0.80), and 2017 (OR 0.22, 0.06 to 0.83) were associated with decreased risk of endoscope contamination. The age, type, and number of times the scope was used were not related to contamination.\u003c/p\u003e\u003cp\u003eCONCLUSIONS A low risk of endoscope contamination was found over a 5-year period in our endoscopy center. The most common cause of contamination was human factor. Duodenalscopes showed the lowest scope contamination rate. We suggested the implantation of a systematic endoscope culture regardless of the type of scope to facilitate early detection of breaches in the scope reprocessing procedure in clinical practice.\u003c/p\u003e","manuscriptTitle":"Monthly endoscopy surveillance culture facilitates detection of breaches in the scope reprocessing procedure: 5 year-experience in an endoscopy center","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2019-12-20 19:02:23","doi":"10.21203/rs.2.19420/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d2f4badf-16ac-4e02-a7b7-16012deb1cc0","owner":[],"postedDate":"December 20th, 2019","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":44530,"name":"Gastroenterology \u0026 Hepatology"},{"id":44531,"name":"General Microbiology"}],"tags":[],"updatedAt":"2020-07-23T13:07:59+00:00","versionOfRecord":[],"versionCreatedAt":"2019-12-20 19:02:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-10033","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"identity":"rs-10033","version":["v1"]},"buildId":"J0_U0BvcaRcwD8yVFaRlm","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}