Transmission of infection by gastrointestional endoscopy

A quarantine process for the resolution of duodenoscope-associated transmission of multidrug-resistant Escherichia coli

“…[3][4][5][6][7][8] Because of design complexities, the duodenoscope has been implicated as a vector for bacterial transmission since its introduction into clinical practice. [12][13][14][15][16] A recent report by the U.S. Food and Drug Administration 17 noted that the elevator mechanism might contain "microscopic crevices" (Fig. 1) that cannot be reached by brushes used to perform the manual component of the HLD process.…”

Transmission of Infection by Flexible Gastrointestinal Endoscopy and Bronchoscopy

“…Recommended chemical methods include a decontamination step with concentrated sodium hydroxide, sodium hypochlorite, or formic acid and prolonged steam sterilization (200,203,204). Most contemporary flexible endoscopes cannot be heat sterilized and disinfected with high concentrations of disinfectants without severe damage (1,9). Therefore, flexible endoscopes should be discarded after endoscopy in patients with CJD (205).…”

“…These instruments are difficult to clean and disinfect and easy to damage because of their complex design, with narrow lumens and multiple internal channels ( Fig. 1) (1). If the instruments are not properly cleaned, the disinfection and drying procedures can fail and increase the possibility of transmission of infection from one patient to another (2).…”

Usefulness of Bacteriological Monitoring of Endoscope Reprocessing

“…Accurate reprocessing of flexible endoscopes must involve cleaning, followed by high level disinfection with further rinsing and drying before storage. Most contemporary flexible endoscopes cannot be heat-sterilized and are designed with multiple channels and ports which are exposed to body fluids and are difficult to clean and disinfect (Nelson et al, 2001). Growth of biofilms inside endoscope channels can result in failure of the endoscope reprocessing and is an important factor in the pathogenesis of endoscopy-related infections (Buss et al, 2008;Kovaleva et al, 2009).…”