Pseudomonas infection of the biliary system resulting from use of a contaminated endoscope

Allen, John I.; Allen, Melody O'Connor; Olson, Mary M.; Gerding, Dale N.; Shanholtzer, Carol J.; Meier, Peter B.; Vennes, Jack A.; Silvis, Stephen E.

doi:10.1016/0016-5085(87)90029-1

Cited by 149 publications

(83 citation statements)

References 14 publications

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“…24,25 In practice, a previous report has documented that Pseudomonas infection was common after ERCP of the bile duct. 26 Therefore, prophylactic antibiotics should be given to all patients even if they have no specific risk for infection. 27 A course of antibiotics as opposed to a single prophylactic dose may be more effective for the prevention of cholecystitis, if patients had these risk factors for cholecystitis.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction

Suk

Kim

et al. 2006

Gastrointestinal Endoscopy

142

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Section: Discussionmentioning

confidence: 99%

Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction

Suk

Kim

et al. 2006

Gastrointestinal Endoscopy

142

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“…Eighteen infections and 1 death were reported. 12 This cluster 3 outbreak was discussed in greater detail by Sorin et al 2 and Weber et al 3 Several questions and unresolved issues remain after reviewing these two articles. If, as Sorin et al 2 concluded, this cluster 3 outbreak was due at least in part to hospital personnel improperly connecting bronchoscopes to the AER, what does this reprocessing mishap portend for gastrointestinal endoscopes?…”

Section: To the Editormentioning

confidence: 97%

“…To what extent might the environment have contributed to this outbreak? During the investigations of the cluster 3 outbreak, 12 was the filtered rinse water (0.2 um rated) sampled microbiologically? And if so, was it immediately tested for P. aeruginosa?…”

Section: To the Editormentioning

confidence: 99%

Leading a Horse to Water: Are Crucial Lessons in Endoscopy and Outbreak Investigations Being Learned?

Muscarella

2002

Infect. Control Hosp. Epidemiol.

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“…An important cause of after-endoscopy infections was related to Ps. aeruginosa (2,3) . ALVARADO et al (3) reported an association of P. aeruginosa with sepses in individuals submitted to endoscopic examinations.…”

Section: Samplesmentioning

confidence: 99%

“…Endoscopes are routinely used in hospitals and clinics and they are potential sources of cross-infection when cleaning and disinfection are not effective (1,19,24) . Organisms isolated from these devices have been associated with pseudoepidemic infections and outbreaks (2,17,21) . In São Paulo (Brazil), the evaluation through questionnaires sent to public, private, and philanthropic hospitals showed that cleaning and disinfection procedures of endoscopes were inadequately performed in 38 of 39 analyzed institutions (10) .…”

Section: Introductionmentioning

confidence: 99%

Microbiologic profile of flexible endoscope disinfection in two Brazilian hospitals

Machado

Pimenta

Contijo

et al. 2006

Arq. Gastroenterol.

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BACKGROUD: Endoscopes are routinely used in hospitals and clinics of the world and they can be potential sources of cross-infection when the decontamination process is unsuitable AIM: The routines of flexible endoscope (bronchoscopes, esophagogastroduodenoscopes and colonoscopes) disinfection procedures used in two Brazilian university hospitals were evaluated during a 3-year period METHODS: Aleatory samples from internal channels of endoscopes were collected after patient examination and after cleaning/disinfection procedures RESULTS: A contamination >3 log10 was achieved in samples recovered from endoscopes after patient examination. These samples yielded gram-negative bacilli (n = 142: 56%), gram-positive cocci (n = 43: 17%), yeast cells (n = 43: 17%), and gram-positive bacilli (n = 26: 10%). Approximately, 72 out of 149 samples (48.32%) collected after undergoing the cleaning and disinfection procedures disclosed gram-negative bacilli (n = 55: 61%), gram-positive cocci (n = 21: 23%), gram-positive bacilli (n = 8: 9%) and yeast cells (n = 6: 7%). Esophagogastroduodenoscopes and colonoscopes were the most frequently contaminated devices. Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Enterobacter spp, Serratia marcescens, Proteus mirabilis, Citrobacter freundii, Staphylococcus aureus, Staphylococcus coagulase negative, Micrococcus luteus, Candida albicans, C. tropicalis, C. glabrata, C. guilliermondii, Bacillus spp and Corynebacterium spp were predominantly identified CONCLUSION: Inappropriate cleaning and low times of disinfection were respectively the major factors associated with the presence of microorganisms in colonoscopes and esophagogastroduodenoscopes. By analyzing the identified germs, hospital disinfection was considered of either intermediate or poor level. After this investigation, both university centers improved their previous protocols for disinfection and conditions for reprocessing endoscopes.

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Pseudomonas infection of the biliary system resulting from use of a contaminated endoscope

Cited by 149 publications

References 14 publications

Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction

Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction

Leading a Horse to Water: Are Crucial Lessons in Endoscopy and Outbreak Investigations Being Learned?

Microbiologic profile of flexible endoscope disinfection in two Brazilian hospitals

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