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https://www.readbyqxmd.com/read/29753038/inspection-of-endoscope-instrument-channels-after-reprocessing-using-a-prototype-borescope
#1
Adarsh M Thaker, Stephen Kim, Alireza Sedarat, Rabindra R Watson, V Raman Muthusamy
BACKGROUND AND AIMS: Visual inspection of the instrument channel has been proposed as a quality assurance step during endoscope reprocessing. However, the nature and severity of findings in a broad array of endoscopes (gastroscopes, colonoscopes, duodenoscopes, and echoendoscopes) after systemic implementation of an inspection protocol remain unknown. In addition, a study using borescope inspection in upper endoscopes and colonoscopes raised concerns about persistent simethicone residue despite full reprocessing...
May 9, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29684421/duodenoscopy-an-amplifier-of-cross-transmission-during-a-carbapenemase-producing-enterobacteriaceae-outbreak-in-a-gastroenterology-pathway
#2
Céline Bourigault, Florence Le Gallou, Nathalie Bodet, Nicolas Musquer, Marie-Emmanuelle Juvin, Stéphane Corvec, Nathalie Ferronniere, Sophie Wiesel, Jérôme Gournay, Gabriel Birgand, Marc Le Rhun, Didier Lepelletier
Carbapenemase-producing Klebsiella pneumoniae (OXA-48 CPE) were identified in five patients who underwent an endoscopy with the same duodenoscope in October 2015. The endoscope was the only epidemiological link between these cases. A transient contamination of the duodenoscope following a failure in the disinfection process may have been the cause of transmission.
April 20, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29684387/duodenoscope-reprocessing-practice-patterns-in-u-s-endoscopy-centers-a-survey-study
#3
Adarsh M Thaker, V Raman Muthusamy, Alireza Sedarat, Rabindra R Watson, Michael L Kochman, Andrew S Ross, Stephen Kim
BACKGROUND AND AIMS: After recent outbreaks of duodenoscope-related infections from multidrug-resistant organisms (MDRO), the United States Food and Drug Administration (FDA) recommended implementing one or more of four enhanced reprocessing measures in addition to updated manual cleaning methods and high-level disinfection (HLD). The implementation of these techniques in endoscopy facilities and provider opinions regarding reprocessing priorities remain unknown. METHODS: Physicians, nurse managers, nurses, and infection control staff at endoscopy units performing ERCP in the United States were surveyed to assess current institutional practices and individual opinions regarding future reprocessing solutions...
April 20, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29677288/duodenoscope-warning
#4
Rebecca Voelker
No abstract text is available yet for this article.
April 17, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29658650/endoscopic-management-of-bile-duct-stones-in-patients-with-surgically-altered-anatomy
#5
REVIEW
Yousuke Nakai, Hirofumi Kogure, Atsuo Yamada, Hiroyuki Isayama, Kazuhiko Koike
Bile duct stones in patients with surgically altered anatomy still pose a challenge to endoscopists. For successful endoscopic management of bile duct stones, there are multiple hurdles: Intubation to the afferent limb, biliary cannulation, ampullary intervention and stone extraction. The major advancement in this area is the development of dedicated device-assisted endoscopes for endoscopic retrograde cholangiopancreatography (ERCP). In patients with Billroth II reconstruction, a high technical success rate is reported using a duodenoscope but can be complicated by a potentially high perforation rate...
April 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29579235/duodenoscope-related-outbreak-of-a-carbapenem-resistant-klebsiella-pneumoniae-identified-using-advanced-molecular-diagnostics
#6
Romney M Humphries, Shuan Yang, Stephen Kim, Venkatara Raman Muthusamy, Dana Russell, Alisa M Trout, Teresa Zaroda, Quen J Cheng, Grace Aldrovandi, Daniel Zachary Uslan, Peera Hemarajata, Zachary Aaron Rubin
Background: Carbapenem-resistant Klebsiella pneumoniae infections are increasingly prevalent in North American hospitals. We describe an outbreak of carbapenem-resistant K. pneumoniae containing the blaOXA-232 gene transmitted by contaminated duodenoscopes during endoscopic retrograde cholangiopancreatography (ERCP) procedures. Methods: An outbreak investigation was performed when 9 patients with blaOXA-232 carbapenem-resistant K. pneumoniae infections were identified at a tertiary care hospital...
October 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29561976/the-use-of-the-forceps-biopsy-as-an-auxiliary-technique-for-the-visualization-of-the-major-duodenal-papilla-using-the-foward-viewing-upper-endoscopy
#7
Nathalia Saber de Andrade, Ana Maria Félix André, Victor Hugo Perches Ferreira, Lincoln Eduardo Villela Vieira de Castro Ferreira
BACKGROUND: - Conventional esophagogastroduodenoscopy is the best method for evaluation of the upper gastrointestinal tract, but it has limitations for the identification of the major duodenal papilla, even after the use of the straightening maneuver. Side-viewing duodenoscope is recommended for optimal examination of major duodenal papilla in patients at high risk for lesions in this region. OBJECTIVE: To evaluate the use of the biopsy forceps during conventional esophagogastroduodenoscopy as an additional tool to the straightening maneuver, in the evaluation of the major duodenal papilla...
January 2018: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/29560645/comparison-of-side-viewing-duodenoscope-and-single-balloon-enteroscope-to-perform-ercp-in-patients-with-billroth-ii-gastrectomy
#8
G Mbatshi, E J Macken, H U De Schepper, H Piessevaux, P H Deprez, T G Moreels
Endoscopic retrograde cholangiopancreatography (ERCP) in Billroth II patients is challenging and different endoscopes can be used. We retrospectively analysed 67 ERCP procedures in 38 Billroth II patients focussing on endoscope type and respective technical success and adverse event rate. 33 (49.2 %) ERCPs were performed using a duodenoscope, 87.9 % were successful and 3 were completed with the single-balloon enteroscope. 28 (41.8 %) ERCPs were performed with the single-balloon enteroscope, 82.1 % were successful and 2 were completed with a paediatric colonoscope...
October 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29506914/successful-replacement-of-a-metallic-hepaticogastrostomy-stent-dislocated-during-endoscopic-retrograde-cholangiography
#9
Hiroyuki Matsubayashi, Hirotoshi Ishiwatari, Toru Matsui, Kenichiro Imai, Kinichi Hotta, Hiroyuki Ono
In the present case with lower bile duct cancer, an endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) was placed because of repeated obstructions of biliary metallic stent. However, when the HGS was occluded, transpapillary duodenoscopic procedure was again required. During this transpapillary procedure, including biliary balloon cleaning and metallic stent deployment, the HGS stent was dislocated into the stomach. Fortunately, due to the complete fistulization, no bile peritonitis was recognized and an HGS stent could be replaced from the gastric wall three days later...
March 2018: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/29476847/a-randomized-trial-of-single-versus-double-high-level-disinfection-of-duodenoscopes-and-linear-echoendoscopes-using-standard-automated-reprocessing
#10
Rebecca L Bartles, James E Leggett, Shannan Hove, Catherine D Kashork, Lian Wang, Margret Oethinger, Lynda Baxter, Jack J Brandabur
BACKGROUND AND AIMS: In a pilot study, we demonstrated that current guidelines for duodenoscope and linear echoendoscope (DLE) reprocessing using a single cycle of high-level disinfection (HLD) in an automated reprocessor may be inadequate. In August 2015, the U.S. Food and Drug Administration offered double HLD as a possible response to address this concern. As a result, Providence Health and Services adopted double HLD as standard procedure for DLEs, but no rigorous clinical studies supported this practice...
February 21, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29476846/optimizing-duodenoscope-reprocessing-rigorous-assessment-of-a-culture-and-quarantine-protocol
#11
Jennifer T Higa, Jaehoon Choe, Deborah Tombs, Michael Gluck, Andrew S Ross
BACKGROUND AND AIMS: Iatrogenic infections related to duodenoscopes remain a top concern for medical centers where ERCP is performed. We assessed the long-term results and impact of key interventions in the optimization of a rigorous "culture and quarantine" program for duodenoscope reprocessing. METHODS: We reviewed a prospectively collected, quality assurance database of all duodenoscope cultures (n = 4307) obtained for the initial 3-year duration of culture and quarantine from 2014 to 2017 in a single U...
February 21, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29476844/impact-of-cleaning-monitoring-combined-with-channel-purge-storage-on-elimination-of-escherichia-coli-and-environmental-bacteria-from-duodenoscopes
#12
Harminder Singh, Donald R Duerksen, Gale Schultz, Carol Reidy, Pat DeGagne, Nancy Olson, Zoann Nugent, Kathryn A Bernard, Michelle J Alfa
BACKGROUND AND AIMS: We aimed to determine whether monitoring of duodenoscope cleaning by rapid adenosine triphosphate (ATP) combined with channel-purge storage could eliminate high-concern microorganisms. METHODS: In a simulated-use study, suction channels, as well as lever recesses, from 2 duodenoscopes models and the unsealed elevator guidewire (EGW) channel from 1 of these 2 duodenoscopes (the other model has a sealed EGW) were perfused with ATS2015 containing approximately 8 Log10 colony-forming units (CFU)/mL of both Enterococcus faecalis and Escherichia coli...
February 21, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29415264/regional-spread-of-an-outbreak-of-carbapenem-resistant-enterobacteriaceae-cre-through-an-ego-network-of-healthcare-facilities
#13
Michael J Ray, Michael Y Lin, Angela S Tang, M Allison Arwady, Mary Alice Lavin, Erica Runningdeer, Dejan Jovanov, William E Trick
Background: In 2013, New Delhi metallo-β-lactamase-producing Escherichia coli, a type of carbapenem-resistant Enterobacteriaceae uncommon in the United States, was identified in a tertiary care hospital (Hospital A) in northeastern Illinois. The outbreak was traced to a contaminated duodenoscope. Patient-sharing patterns can be described through social network analysis and ego networks, which could be used to identify hospitals most likely to accept patients from a hospital with an outbreak...
February 3, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29408276/high-quality-endoscope-reprocessing-decreases-endoscope-contamination
#14
P Decristoforo, J Kaltseis, A Fritz, M Edlinger, W Posch, D Wilflingseder, C Lass-Flörl, D Orth-Höller
OBJECTIVES: Several outbreaks of severe infections due to contamination of gastrointestinal (GI) endoscopes, mainly duodenoscopes, have been described. The rate of microbial endoscope contamination varies dramatically in literature. The aim of this multicentre prospective study was to evaluate the hygiene quality of endoscopes and automated endoscope reprocessors (AERs) in Tyrol/Austria. METHODS: In 2015 and 2016, a total of 463 GI endoscopes and 105 AERs from 29 endoscopy centres were analysed by a routine (R) and a combined routine and advanced (CRA) sampling procedure and investigated for microbial contamination by culture-based and molecular-based analyses...
February 24, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29395506/a-systematic-review-of-adenosine-triphosphate-as-a-surrogate-for-bacterial-contamination-of-duodenoscopes-used-for-endoscopic-retrograde-cholangiopancreatography
#15
REVIEW
Lovisa B Olafsdottir, Julia Whelan, Graham M Snyder
BACKGROUND: Bacterial culture is the accepted standard to measure the adequacy of high-level disinfection (HLD) of duodenoscopes. Adenosine triphosphate (ATP) bioluminescence assays have been suggested as an alternative method of evaluating the quality of reprocessing. We systematically reviewed published research describing the correlation between ATP and bacterial cultures. METHODS: The primary outcome was the correlation or concordance between concomitantly sampled ATP and bacterial contamination obtained from the instrument channel and/or elevator mechanism of the duodenoscope...
January 30, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29375742/bacterial-presence-on-flexible-endoscopes-vs-time-since-disinfection
#16
Katlin I Mallette, Peter Pieroni, Sonny S Dhalla
AIM: To correlate the length of endoscope hang time and number of bacteria cultured prior to use. METHODS: Prospectively, we cultured specimens from 19 gastroscopes, 24 colonoscopes and 5 side viewing duodenoscopes during the period of 2011 to 2015. A total of 164 results had complete data denoting date of cleansing, number of days stored and culture results. All scopes underwent initial cleaning in the endoscopy suite utilizing tap water, and then manually cleaned and flushed...
January 16, 2018: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29340299/prospective-study-of-the-feasibility-of-point-of-care-testing-strategy-for-carbapenem-resistant-organism-detection
#17
Rahul Pannala, Bruce Baldwin, Vijay Aluru, Thomas E Grys, Jordan Holmes, Laurence J Miller, M Edwyn Harrison, Cuong C Nguyen, Fred C Tenover, David Persing, Douglas O Faigel
Background/aims:  In an investigator-initiated, prospective study, we evaluated the feasibility of a five-gene sequence point-of-care (POC) testing strategy (Xpert CARBA-R Assay, Cepheid Inc., Sunnyvale, CA, USA), compared to reference laboratory PCR (48 - 72 hours turnaround time, two gene sequences), in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) and in a hospital outbreak investigation. Methods:  After informed consent, patients undergoing ERCP (September 2015 - April 2016, n = 191) at Mayo Clinic and potential hospital contacts (n = 9) of an index carbapenem-resistant organism (CRO)-positive inpatient were included...
January 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29237202/a-double-reprocessing-high-level-disinfection-protocol-does-not-eliminate-positive-cultures-from-the-elevators-of-duodenoscopes
#18
Douglas K Rex, Marnie Sieber, Glen A Lehman, Douglas Webb, Bryan Schmitt, Amy Beth Kressel, Ji Young Bang, Jeffery Easler, Lee McHenry, Ihab El-Hajj, Evan Fogel, James Watkins, Stuart Sherman
Background and study aim  Duodenoscopes have been the source of serious infection, despite correct performance of high-level disinfection (HLD). This study aimed to observe the impact of performing HLD twice on the rate of positive cultures from duodenoscope elevators. Methods  We performed double HLD (DHLD; i. e. complete manual cleaning followed by automated reprocessing, with the entire process repeated) and then randomly cultured the elevators of our duodenoscopes on about 30 % of occasions. Results  DHLD was associated with positive elevator cultures for any microorganism in 9...
December 13, 2017: Endoscopy
https://www.readbyqxmd.com/read/29164124/sterile-reverse-osmosis-water-combined-with-friction-are-optimal-for-channel-and-lever-cavity-sample-collection-of-flexible-duodenoscopes
#19
Michelle J Alfa, Harminder Singh, Zoann Nugent, Donald Duerksen, Gale Schultz, Carol Reidy, Patricia DeGagne, Nancy Olson
Introduction: Simulated-use buildup biofilm (BBF) model was used to assess various extraction fluids and friction methods to determine the optimal sample collection method for polytetrafluorethylene channels. In addition, simulated-use testing was performed for the channel and lever cavity of duodenoscopes. Materials and methods: BBF was formed in polytetrafluorethylene channels using Enterococcus faecalis, Escherichia coli , and Pseudomonas aeruginosa . Sterile reverse osmosis (RO) water, and phosphate-buffered saline with and without Tween80 as well as two neutralizing broths (Letheen and Dey-Engley) were each assessed with and without friction...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29118690/pneumoperitoneum-after-endoscopic-retrograde-cholangiopancreatography-due-to-rupture-of-intrahepatic-bile-ducts-and-glisson-s-capsule-in-hepatic-metastasis-a-case-report-and-review-of-literature
#20
Zubair Khan, Umar Darr, Mohamad Nawras, Muhammad Bawany, Jacob Bieszczad, Osama Alaradi, Ali Nawras
Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) has been proven to be a safe and effective method for diagnosis and treatment of biliary and pancreatic disorders. Major complications of ERCP include pancreatitis, hemorrhage, cholangitis, and duodenal perforation. We report a third case in literature of pneumoperitoneum after ERCP due to rupture of intrahepatic bile ducts and Glisson's capsule in a peripheral hepatic lesion. Case Report: A 50-year-old male with a history of metastatic pancreatic neuroendocrine tumor and who had a partially covered metallic stent placed in the biliary tree 1 year ago presented to the oncology clinic with fatigue, abdominal pain, and hypotension...
September 2017: Case Reports in Gastroenterology
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