title: Duodenoscope-Associated Bacterial Infections: A Review and Update.
abstract: Physicians depend on the use of flexible endoscopes for delivery of vital care that is morbidity sparing compared to surgical alternatives. Iatrogenic infection is a well-documented complication of therapeutic endoscopy. Recent emergence of unique antimicrobial resistance patterns and molecular "fingerprinting" of bacteria harken a new era in duodenoscope-related infections which occur in spite of compliance with device manufacturer-recommended protocols for high-level disinfection (HLD). Further studies suggest that these protocols are likely inadequate. Endoscopic retrograde cholangiopancreatography (ERCP) remains critical in the provision of minimally invasive diagnostic, therapeutic, and palliative care for patients with pancreaticobiliary disease. This manuscript reviews the history of duodenoscope-related infections, current challenges to scope reprocessing, and recommendations from regulatory agencies.
authors.affiliation: Division of Gastroenterology, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356424, Seattle, WA, 98105, USA.
authors.forename: Jennifer T
authors.initials: JT
authors.lastname: Higa
authors.affiliation: Division of Gastroenterology, Virginia Mason Medical Center, 1100 Ninth Ave, C3GAS, Seattle, WA, 98111, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Gluck
authors.affiliation: Division of Gastroenterology, Virginia Mason Medical Center, 1100 Ninth Ave, C3GAS, Seattle, WA, 98111, USA. andrew.ross@virginiamason.org.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Ross
keywords: CRE; Duodenoscope; ERCP; Infection; MDRO; Reprocessing