title: Exogenous endoscopy-related infections, pseudo-infections, and toxic reactions: clinical and economic burden.
abstract: OBJECTIVE
  The objective of this study was to analyze the characteristics and costs of exogenous endoscopy-related infections, pseudo-infections, and toxic reactions in the US.
  
  
  METHODS
  A systematic review of the scientific literature published between 1966 and 2005 was conducted in Medline. Data collection was based on a prospective protocol developed by the authors.
  
  
  RESULTS
  The literature review included 70 outbreaks described in 64 scientific articles. Bronchoscopy accounted for half of all reported outbreaks. Inadequate decontamination practices were the leading cause of contamination; equipment malfunction became the second leading cause of contamination during the period 1990-2004. More than 91% of the infections identified could be prevented by health care providers if quality control systems are improved and implemented. The available economic information concerning exogenous endoscope related events is very limited. A model for the analysis of the economic burden of exogenous endoscopy-related events is proposed.
  
  
  CONCLUSIONS
  Proper decontamination practices, the use of protective sheaths, and the improvement of surveillance systems could reduce the clinical and economic burdens associated with exogenous endoscopy-related events.
authors.affiliation: College of Pharmacy, The Ohio State University, Columbus, Ohio 43210, USA. pharmacoeconomics@osu.edu
authors.forename: Enrique
authors.initials: E
authors.lastname: Seoane-Vazquez
authors.forename: Rosa
authors.initials: R
authors.lastname: Rodriguez-Monguio
authors.forename: Jay
authors.initials: J
authors.lastname: Visaria
authors.forename: Angeline
authors.initials: A
authors.lastname: Carlson
mesh_terms: D003428:Cross Infection / Q000191:economics* / Q000453:epidemiology / Q000209:etiology*; D004724:Endoscopy / Q000009:adverse effects* / Q000191:economics*; D004866:Equipment Contamination; D006801:Humans; D017053:Infection Control; D007239:Infections / Q000191:economics* / Q000453:epidemiology / Q000209:etiology*; D018805:Sepsis / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D014481:United States