Last night, the ACG and other GI societies issued a public communication to respond to the Jan. 21 USA Today story, “Deadly bacteria on medical scopes trigger infections,” and clarify that this issue does not relate to endoscopes used in routine endoscopy. Read the release
What Physicians Should Know: Last year, a report in the mainstream press highlighted the spread of carbapenem-resistant Enterobacteriaceae (CRE) that was linked to a duodenoscope. This transmission of infection occurred despite the fact that endoscope reprocessing followed manufacturer’s directions. Additional patient infections after ERCP have now been reported in the medical literature and may cause concern for both patients and physicians.
The problem of infection transmission lies in the complex design of duodenoscopes where the elevator channel can allow bacteria to remain after cleansing, even if reprocessing follows accepted procedures.
ACG has been working with – and will continue to work with – the leadership of all other GI societies, the Centers for Disease Control & Prevention (CDC), the Food and Drug Administration (FDA), manufacturers and other groups to evaluate and address this complex issue.
What you can do:
Follow the endoscope manufacturer’s cleansing instructions and the societies-supported reprocessing guidelines, and understand the FDA-approved use of your automated reprocessor in order to minimize the risk of duodenoscope-associated infection. Have a process to track post-procedure complications, especially infections after ERCP.
- Read: Multisociety Guideline for Reprocessing Flexible Gastrointestinal Endoscopes
- Read: Standards of Infection Control
- Guidance from FDA is expected in 2015
What you should share with your patients:
ERCP stands for endoscopic retrograde cholangiopancreatography. It is an advanced highly technical endoscopic procedure.
The vast majority of people will never have an ERCP.
For patients who do need it, ERCP is a critical and potentially life-saving procedure. ERCP is performed using a special device called a duodenoscope. The duodenoscope is different from the device used in routine upper endoscopy or colonoscopy and these infections have not been associated with those other procedures.
The infectious complication rate for ERCP overall is in total only about 1 percent, but that includes all types of bacteria and these few CRE cases do not change the overall risk.
- Read: Multi-society statement for patients
- Read: USA Today article published Jan. 21, 2015, “Deadly bacteria on medical scopes trigger infections”
Remind patients that the therapeutic benefit of ERCP usually outweighs the potential low risk of infection.