Pseudomonas aeruginosa sepsis following retrograde cholangiopancreatography (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP) has become a routine examination in a number of medical centers within the past several years. We report a life-threatening case of acute pancreatitis with Pseudomonas aeruginosa sepsis immediately following ERCP. Cultures of the blood, the inner channel of the duodenoscope, and irrigating water bottles all were positive for Pseudomonas aeruginosa. The Pseudomonas aeruginosa isolated from the blood and endoscope both reacted to three common antisera: serotypes 2, 15, and 16, suggesting a common source of infection. Although it is obvious that the ERCP procedure cannot be sterile, attempts should be made to prevent transmission of nosocomial pathogens by this procedure.