Risk of infection transmission in curvilinear array echoendoscopes: results of a prospective reprocessing and culture registry

Chapman, Christopher G.; Siddiqui, Uzma D.; Manzano, Maricarmen; Konda, Vani J.; Murillo, Cynthia; Landon, Emily; Waxman, Irving

doi:10.1016/j.gie.2016.07.049

Cited by 34 publications

(28 citation statements)

References 10 publications

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“…In an analysis of linear echoendoscope cultures, Chapmen et al . reported that 4.2% of primary cultures were positive for pathogenic gram‐negative bacilli …”

Section: Methodsmentioning

confidence: 99%

“…31 In an analysis of linear echoendoscope cultures, Chapmen et al reported that 4.2% of primary cultures were positive for pathogenic gram-negative bacilli. 16 It is essential that the cleaning process commences immediately after completion of the endoscopic procedure. The greater the time interval an instrument is left uncleaned, the greater the possibility of organic material drying in the channels and tips.…”

Section: Cpe Infection Control Endoscopymentioning

confidence: 99%

“…[7][8][9][10][11][12][13][14][15] Further reports relate to linear echoendoscopes. 16,17 As discussed in Statement 2, this is related to the difficulties in cleaning the complex tips of these instruments. Despite reported outbreaks being sporadic, it is reasonable to conclude that the risk of transmission of a microorganism is present whenever these instruments are used.…”

Section: Evidence Level: IV Recommendation Grade: D Voting On Recommementioning

confidence: 99%

“…Evidence level: III Recommendation grade: C Voting on recommendation: Accept completely: 83%, Accept with some reservation: 17% It is accepted that the complex tips of duodenoscopes and linear echoendoscopes are a source of transmission of CPE due to difficulties in achieving adequate removal of biologic material. [7][8][9][10][11][12][13][14][15][16][17] Other endoscopes, without complex tips, have also been linked to patient-to-patient transmission of CPE. 15,[18][19][20][21] Six out of 10 screened patients were colonized with KPC K. pneumoniae, and two developed clinical infections following gastroscopies using a colonized instrument.…”

Section: Evidence Level: IV Recommendation Grade: D Voting On Recommementioning

confidence: 99%

“…[7][8][9] Whereas most attention has focused on transmission by duodenoscopes during endoscopic retrograde cholangiopancreatoscopy (ERCP), [7][8][9][10][11][12][13][14][15] positive (22/540 [4.2%]) microbiological cultures have been reported from linear echoendoscopes post-high-level disinfection. 16 There are also anecdotal reports of infectious transmission from linear echoendoscopes. 17 Duodenoscopes and linear echoendoscopes have complex instrument tips with an elevator mechanism.…”

Section: Introductionmentioning

confidence: 99%

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Australian infection control in endoscopy consensus statements on carbapenemase‐producing Enterobacteriaceae

Devereaux

Athan

Brown³

et al. 2018

J of Gastro and Hepatol

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Outbreaks of carbapenemase‐producing Enterobacteriaceae clinical infections related to endoscopic transmission are well documented. The high morbidity and mortality associated with these infections emphasizes the need to reassess endoscopic reprocessing protocols. The Gastroenterological Society of Australia established a multi‐society committee to formulate evidence‐based consensus statements on the prevention and management of endoscopic transmission of carbapenemase‐producing Enterobacteriaceae. A literature search was undertaken utilizing the MEDLINE database. Further references were sourced from published paper bibliographies. Nine statements were formulated. Using the Delphi methodology, the statements were initially reviewed electronically by the committee members and subsequently at a face‐to‐face meeting in Melbourne, Australia. After further discussion, four additional sub‐statements were added resulting in a total of 13 statements. Each statement was assessed for level of evidence, recommendation grade and the voting on recommendation was recorded. For a statement to be accepted, five out of six committee members had to “accept completely” or “accept with some reservation.” All 13 statements achieved consensus agreement. Eleven statements achieved 100% “accepted completely.” Two statements were 83% “accepted completely” and 17% “accepted with some reservation.” Of particular significance, automated flexible endoscope reprocessors were mandated for high‐level disinfection, and the use of forced‐air drying cabinets was mandated for endoscope storage. These evidence‐based statements encourage preventative strategies with the aim of ensuring the highest possible standards in flexible endoscope reprocessing thereby optimizing patient safety. They must be considered in addition to the broader published guidelines on infection control in endoscopy.

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“…In an analysis of linear echoendoscope cultures, Chapmen et al . reported that 4.2% of primary cultures were positive for pathogenic gram‐negative bacilli …”

Section: Methodsmentioning

confidence: 99%

Section: Cpe Infection Control Endoscopymentioning

confidence: 99%