An update on gastrointestinal endoscopy-associated infections and their contributing factors

Area of Science:

• Infectious Diseases
• Gastroenterology
• Medical Device Reprocessing

Background:

• Gastrointestinal endoscopes are contaminated during clinical use, necessitating reprocessing to prevent patient-to-patient infectious transmission.
• Endoscopy-associated infections and outbreaks have been documented, with a growing concern regarding multi-drug resistant organisms.
• This review provides an update on endoscopy-associated infections and their contributing factors.

Purpose of the Study:

• To review and update the current understanding of gastrointestinal endoscopy-associated infections and outbreaks.
• To identify factors contributing to the occurrence of these infections.
• To examine the outcomes of reported outbreaks.

Main Methods:

• A systematic literature search was conducted using PubMed, ScienceDirect, and CINAHL.
• Articles published between 2008 and 2018 focusing on gastrointestinal endoscopy-associated infections and outbreaks were included.
• Contributing factors and outbreak outcomes were analyzed.

Main Results:

• Eighteen articles were reviewed, with 16 detailing duodenoscope-associated infections and two reporting colonoscope- and gastroscope-associated infections.
• Outbreaks were reported globally, including the United States, France, China, Germany, the Netherlands, and the United Kingdom.
• Identified causative organisms included Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, and Salmonella enteritidis.

Conclusions:

• Factors contributing to endoscopy-associated infections include reprocessing lapses, biofilm formation, endoscope design flaws, and device damage.
• Enhancing endoscope reprocessing protocols is crucial for infection prevention.
• Implementing screening for contamination and evaluating endoscope integrity are vital strategies to mitigate future infections and outbreaks.