Early identification and control of carbapenemase-producing Klebsiella pneumoniae, originating from contaminated endoscopic equipment

Alrabaa, Sally; Nguyen, Phung Kim Phi; Sanderson, Roger; Baluch, Aliyah; Sandin, Ramón L.; Kelker, Danashree; Karlapalem, Chaitanya; Thompson, Peggy; Sams, Kay; Martin, Sean P.; Montero, José; Greene, John N.

doi:10.1016/j.ajic.2012.07.008

Cited by 97 publications

(73 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Indeed, patient morbidity and mortality due to GI endoscopes contaminated with these antibiotic-resistant bacteria have been documented [13,[20][21][22]24,[26][27][28][29][30][31][32][33] . Reports of GI endoscopes transmitting other types of bacteria, too, as well as viruses and other infectious agents, also have been published during the past 30 years.…”

Section: Findings and Resultsmentioning

confidence: 99%

“…Further, HIV is not ordinarily transmitted from one patient to another due to poor hand hygiene, but rather is generally spread only through exposure to infected blood or other infectious fluids and materials (whereas CRE infections can be a consequence of poor hand hygiene). And, although outbreaks of CRE linked to contaminated GI endoscopes, with associated morbidity and mortality, have been reported and no longer are rare adverse events [13,[20][21][22]33,[36][37][38][39] , HIV transmission during GI endoscopy has not been documented.…”

Section: Muscarella Lf Risk Of Cre Transmissions During Gi Endoscopymentioning

confidence: 99%

“…Like the aforementioned report published in MMWR discussing the CDC's investigation of Hospital X's CRE outbreak in 2013 [25][26][27][28][29][30][31] , a number of other reports published in the medical literature since CRE's emergence similarly document infections and colonizations of CRE and their related superbugs due to a contaminated GI endoscope, most often (as prior to CRE's emergence, too) to an ERCP endoscope [13,[20][21][22]24,33,[36][37][38][39] .…”

Section: Transmission Of Cre and Related Superbugs During Gi Endoscopymentioning

confidence: 99%

“…These cases include infections of bacteria, including P. aeruginosa, and viruses, namely, the hepatitis B (HBV) or C virus (HCV). Like their emergence in the United States and globally, only during the past few years has the transmission of CRE been linked to GI endoscopy [13,[20][21][22]25,33,[36][37][38][39] . While for historical purposes, contextual insight, and important perspective a number of cases of disease transmission during GI endoscopy prior to CRE's emergence are discussed below, this section's primary focus in placed on outbreaks of CRE and their related superbugs due to a contaminated GI endoscope.…”

Section: Part 2: Gi Endoscopymentioning

confidence: 99%

“…And, with the recent emergence of the "superbug" known as carbapenem-resistant Enterobacteriaceae, or "CRE", infection control in this setting has taken on even more urgency and closer examination [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Risk of transmission of carbapenem-resistantEnterobacteriaceaeand related “superbugs” during gastrointestinal endoscopy

Muscarella¹

2014

WJGE

115

114

View full text Add to dashboard Cite

To evaluate the risk of transmission of carbapenemresistant Enterobacteriaceae (CRE) and their related superbugs during gastrointestinal (GI) endoscopy. Reports of outbreaks linked to GI endoscopes contaminated with different types of infectious agents, including CRE and their related superbugs, were reviewed. Published during the past 30 years, both prior to and since CRE's emergence, these reports were obtained by searching the peer-reviewed medical literature (via the United States National Library of Medicine's "MEDLINE" database); the Food and Drug Administration's Manufacturer and User Facility Device Experience database, or "MAUDE"; and the Internet (via Google's search engine). This review focused on an outbreak of CRE in 2013 following the GI endoscopic procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, performed at "Hospital X" located in the suburbs of Chicago (IL; United States). Part of the largest outbreak of CRE in United States history, the infection and colonization of 10 and 28 of this hospital's patients, respectively, received considerable media attention and was also investigated by the Centers for Disease Control and Prevention (CDC), which published a report about this outbreak in Morbidity and Mortality Weekly Report (MMWR), in 2014. This report, along with the results of an independent inspection of Hospital X's infection control practices following this CRE outbreak, were also reviewed. While this article focuses primarily on the prevention of transmissions of CRE and their related superbugs in the GI endoscopic setting, some of its discussion and recommendations may also apply to other healthcare settings, to other types of flexible endoscopes, and to other types of transmissible infectious agents. This review found that GI endoscopy is an important risk factor for the transmission of CRE and their related superbugs, having been recently associated with patient morbidity and mortality following ERCP. The CDC reported in MMWR that the type of GI endoscope, known as an ERCP endoscope, that Hospital X used to perform ERCP in 2013 on the 38 patients who became infected or colonized with CRE might be particularly challenging to clean and disinfect, because of the complexity of its physical design. If performed in strict accordance with the endoscope manufacturer's labeling, supplemented as needed with professional organizations' published guidelines, however, current practices for reprocessing GI endoscopes, which include high-level disinfection, are reportedly adequate for the prevention of transmission of CRE and their related superbugs. Several recommendations are provided to prevent CRE transmissions in the healthcare setting. CRE transmissions are not limited to contaminated GI endoscopes and also have been linked to other reusable flexible endoscopic instrumentation, including bronchoscopes and cystoscopes. In conclusion, contaminated GI endoscopes, particularly those used during ERCP, have been causally linked to outbreaks of CRE and their related su...

show abstract

Section: Findings and Resultsmentioning

confidence: 99%

Section: Muscarella Lf Risk Of Cre Transmissions During Gi Endoscopymentioning

confidence: 99%

Section: Transmission Of Cre and Related Superbugs During Gi Endoscopymentioning

confidence: 99%

Section: Part 2: Gi Endoscopymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Risk of transmission of carbapenem-resistantEnterobacteriaceaeand related “superbugs” during gastrointestinal endoscopy

Muscarella¹

2014

WJGE

115

114

View full text Add to dashboard Cite

show abstract

Single-setting endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy improve the rate of surgical site infection

et al. 2017

View full text Add to dashboard Cite

ERCP performed in the same setting as cholecystectomy carries no increased risk of SSI and should be the treatment of choice in patients with choledocholithiasis. ERCP performed separately within 60 days before cholecystectomy doubles the risk of SSI. Contaminated equipment might play a role, but other factors are likely at play, and should be taken into account when selecting treatment pathways for patients with choledocholithiasis.

show abstract

Duodenoscope-associated infections: a review

Bălan

Sfarti

Chiriac

et al. 2019

Eur J Clin Microbiol Infect Dis

View full text Add to dashboard Cite

Early identification and control of carbapenemase-producing Klebsiella pneumoniae, originating from contaminated endoscopic equipment

Cited by 97 publications

References 10 publications

Risk of transmission of carbapenem-resistantEnterobacteriaceaeand related “superbugs” during gastrointestinal endoscopy

Risk of transmission of carbapenem-resistantEnterobacteriaceaeand related “superbugs” during gastrointestinal endoscopy

Single-setting endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy improve the rate of surgical site infection

Duodenoscope-associated infections: a review

Contact Info

Product

Resources

About