Introduction: During clinical use, gastrointestinal endoscopes are grossly contaminated with patient's native flora. These endoscopes undergo reprocessing to prevent infectious transmission upon future use. Endoscopy-associated infections and outbreaks have been reported, with a recent focus on the transmission of multi-drug resistant organisms. This review aims to provide an update on endoscopy-associated infections, and the factors contributing to their occurrence.
Methods: PubMed, ScienceDirect, and CINAHL were searched for articles describing gastrointestinal endoscopy-associated infections and outbreaks published from 2008 to 2018. Factors contributing to their occurrence, and the outcomes of each outbreak were also examined.
Results: This review found 18 articles, 16 of which described duodenoscope-associated infections, and the remaining two described colonoscope- and gastroscope-associated infection respectively. Outbreaks were reported from the United States, France, China, Germany, the Netherlands and the United Kingdom. The causative organisms reported were Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli and Salmonella enteritidis.
Conclusions: A number of factors, including lapses in reprocessing, biofilm formation, endoscope design issues and endoscope damage, contribute to gastrointestinal endoscopy associated infection. Methods of improving endoscope reprocessing, screening for contamination and evaluating endoscope damage may be vital to preventing future infections and outbreaks.
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| http://dx.doi.org/10.1186/s12941-018-0289-2 | DOI Listing |
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Article Synopsis
- * Out of 133 sampled endoscopes, 47% and 32% were found contaminated in two phases, with common bacteria including Pseudomonas aeruginosa and Escherichia coli, many of which were multidrug-resistant.
- * Molecular testing revealed that some endoscopes were contaminated with viruses like hepatitis B, C, and HIV, indicating a significant risk for endoscopy-associated infections and related health complications in the local population.
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