Endoscopes May Pass on E. coli Despite Proper Cleaning
(HealthDay News) — An Escherichia coli outbreak at an Illinois hospital was caused by endoscopes that had bacterial contamination despite being disinfected in the recommended way, according to a study published in the October 8 issue of the Journal of the American Medical Association, a theme issue on infectious disease.
The outbreak occurred among patients who underwent procedures with duodenoscopes. "The complicated design of duodenoscopes makes cleaning difficult. It appears that these devices have the potential to remain contaminated with pathogenic bacteria even after recommended reprocessing is performed," Lauren Epstein, MD, of the U.S. Centers for Disease Control and Prevention, and colleagues write. "Facilities should be aware of the potential for transmission of antimicrobial-resistant organisms via this route and should conduct regular reviews of their duodenoscope reprocessing procedures to ensure optimal manual cleaning and disinfection."
A number of patients were infected with, or exposed to, a highly drug-resistant strain of E. coli through duodenoscope procedures at the teaching hospital between January and December 2013, according to the study. Investigators found that the hospital followed all manufacturer-recommended duodenoscope reprocessing instructions. After the hospital changed to a gas sterilization method, there were no more cases of this type of E. coli among patients who underwent duodenoscope procedures.
Health care providers should report and publish all cases of infectious diseases linked to endoscopy, particularly if recommended reprocessing procedures were followed, in order to determine whether this study "is the tip of the iceberg or an isolated occurrence," William Rutala, PhD, and David Weber, MD, from the University of North Carolina Health Care in Chapel Hill, write in an accompanying editorial. "If the former, then revision of the endoscope reprocessing guidelines will be necessary to ensure patient safety."