Duodenoscope-related infections: Overview and epidemiology

摘要

The duodenoscope, a complex endoscopic instrument, is frequently utilized to accomplish the increasing demand for minimally invasive treatments of pancreatic and biliary diseases. It is, in addition, the fundamental tool used to perform endoscopic retrograde cholangiopancreatography (ERCP). However, outbreaks of multi-drug resistance organism transmission have occurred in patients undergoing ERCP while adherent to current endoscope manufacturers' reprocessing guidelines. Evolving evidence suggests that implementation of the current protocols is inadequate to guarantee a pathogen-free duodenoscope. In spite of infection risk, ERCP remains a critical platform in the management of patients with pancreaticobiliary diseases. This manuscript reviews the history and epidemiology of recent duodenoscope-related infections, current challenges to scope reprocessing, and recommendations by regulatory agencies.