DDW 2020: Infection Risk From D Endoscopy Far Higher Than Previously E Reported R

DDW 2020: Infection Risk From Endoscopy Far Higher Than Previously Reported

The risk for infection associated with duodenoscopes may be as much as 180 times greater than indicated by previous estimates, Dutch researchers have found.

A team at Erasmus Medical Center, in Rotterdam, reported that between 2008 and 2018, 21 patients in the Netherlands who had undergone endoscopic retrograde cholangiopancreatography (ERCP) became infected with bacteria linked to the duodenoscopes used for the procedure. During that time, Dutch physicians performed roughly 203,500 ERCPs, leading to an infection rate of 0.01%, the researchers reported.

The new estimate is far greater than previous figures, which have ranged from a low of 0.00006% to 0.00036%, according to the researchers, led by Marco J. Bruno, MD, the director of endoscopy at Erasmus.

“The risk of developing a [duodenoscoperelated infection] is at least 30 to 180 times higher than the risks that were previously reported for all types of endoscopy-associated infections. Importantly, the current calculated Mission continued from page 43 Consider Reprocessing Space On a Par With Procedure Rooms

The best way to figure out the flaws in your reprocessing space design is to put yourself in your technicians’ shoes. “We take a lot of pictures when we visit a site, and explain to owners and administrators what they are asking their staff to do,” Mr. Davis said. “But it’s even better if you can walk through a day of their routine with them and understand what they are experiencing.”

If you are either expanding existing space or building a new location, consider your reprocessing rooms to be as important as your procedure rooms. “You really have to think about how

risk of 0.01% constitutes a bare minimum risk … because endoscope related infections are underreported,” they noted.

In addition to the direct risk for infection from endoscopy, Dr. Bruno’s group said, patients also may become colonized with bacteria via a contaminated endoscope but not develop symptoms of infection.

“These data call for consorted action of medical practitioners, industry and government agencies to minimize and ultimately ban the risk of exogenous endoscope associated infections and contamination,” they wrote. “As a first step, the FDA recently recommended health care facilities and manufacturers begin transitioning to duodenoscopes with disposable components.”

The study was presented as part of the 2020 virtual Digestive Disease Week (abstract Tu1036).

—Priority Report Staff much space it takes,” he added. “If you anticipate growth in the future, you’ll want to include space in the reprocessing room to accommodate additional techs. As we’re automating more and more processes and doing a lot more computerized tracking, do you have adequate space for the reprocessing staff to perform those tasks?”

Dr. Smith stressed that “this job requires a person who has great attention to detail. One thing that should never happen in our environment is transmission of an infection from a scope to a patient. That is almost always the result of human error,” he said. “So we need to establish a working environment for our technicians that enables them to perform at their best.” —Gina Shaw

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