reprocessed, yet CRE-
contaminated duo-
denoscopes may have
contributed to the
deaths of 11 patients
and the sickening of 32
others at Virginia
Mason Medical Center
in Seattle between
2012 and 2014. The
hospital now cultures
and quarantines
reprocessed scopes for
48 hours, then checks them for bacterial growth. Because this length-
ens the time it takes to return a scope to the OR, the hospital has pur-
chased 20 new scopes.
In the October 2014 issue of JAMA, researchers who'd investigated a
2013 outbreak at Advocate Lutheran General Hospital in suburban
Chicago explained that EtO sterilization is the surest method of pre-
venting the transmission of multi-drug resistant organisms via diffi-
cult-to-disinfect duodenoscopes (tinyurl.com/ljeug8a). The same month,
researchers from UPMC Presbyterian in Pittsburgh, reflecting on a
2012 outbreak, presented similar findings at an epidemiology confer-
ence (tinyurl.com/qxj985j). Like UCLA, neither hospital has seen a
scope-driven CRE case since adopting the EtO sterilization tech-
niques.
The inability of standard, manufacturer-mandated reprocessing
practices to eliminate dangerous bacteria from the complex inner
workings of the duodenoscope has been a concern to some infection
prevention and GI professionals for decades.
"Historically, 1 in 1.8 million of all endoscopic procedures present a
cross-contamination risk or result in patient infection," says Charles
1 2 5
M A R C H 2 0 1 5 | O U T P A T I E N TS U R G E R Y. N E T
Carbapenem-resistant Enterobacteriaceae (CRE) can spark
fatal infections when it's cross-contaminated during
ERCP procedures. CRE is highly resistant to antibiotics
and can kill up to 50% of infected patients.
