Introduction and overview of endoscope-associated infections

摘要

Early in 2013, a report appeared in JAMA describing a multidrug resistant Escherichia coli infection in patients undergoing Endoscopic retrograde cholangiopancreatography at a Chicago hospital (Epstein, JAMA 2014;312:1447-55). National attention in the medical and lay press was muted as the Ebola epidemic in Africa, with concern of extension into the first world, dominated the news cycle at the time. However, by late 2013, with a presentation at a national infectious disease meeting, it became readily apparent that duodenoscopes were implicated in nosocomial transmission of highly resistant bacteria between patients. The story grew, and in short order a number of medical centers around the world had identified transmission of multidrug resistant bacteria by duodenoscopes to previously uninfected patients. Medical centers, endoscopists, and most importantly, patients were frightened that medical instruments used to alleviate or palliate diseases were in fact causing harm.