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Duodenoscope-Associated Bacterial Infections: A Review and Update

Jennifer T Higa1, Michael Gluck2, Andrew S Ross3

  • 1Division of Gastroenterology, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356424, Seattle, WA, 98105, USA.

Current Treatment Options in Gastroenterology
|March 30, 2016
PubMed
Abstract

Insights

Flexible endoscopes are vital for patient care, but infections can occur despite disinfection. New antimicrobial resistance patterns highlight challenges in preventing duodenoscope-related infections during procedures like ERCP.

Area of Science:

  • Gastroenterology and Infectious Diseases
  • Medical Device Reprocessing
  • Antimicrobial Resistance

Background:

  • Flexible endoscopes, particularly duodenoscopes, are essential for minimally invasive procedures like ERCP.
  • Iatrogenic infections are a known complication of endoscopic procedures.
  • Emerging antimicrobial resistance and novel bacterial strains complicate infection control.

Purpose of the Study:

  • To review the history and current challenges of duodenoscope-related infections.
  • To discuss the inadequacy of current high-level disinfection (HLD) protocols.
  • To present recommendations from regulatory agencies for improved reprocessing.

Main Methods:

  • Literature review of historical data on duodenoscope-related infections.
  • Analysis of current antimicrobial resistance patterns and bacterial "fingerprinting" data.
  • Examination of manufacturer-recommended HLD protocols and their effectiveness.

Main Results:

  • Despite adherence to HLD protocols, unique resistance patterns in bacteria have emerged.
  • Current HLD protocols may be insufficient to prevent transmission of multidrug-resistant organisms.
  • ERCP procedures remain critical for pancreaticobiliary disease management.

Conclusions:

  • Duodenoscope reprocessing requires re-evaluation due to evolving infectious threats.
  • Enhanced disinfection strategies and regulatory oversight are crucial.
  • Further research is needed to optimize reprocessing protocols and patient safety.
Keywords:
CREDuodenoscopeERCPInfectionMDROReprocessing

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