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https://www.readbyqxmd.com/read/28034537/duodenoscope-hang-time-does-not-correlate-with-risk-of-bacterial-contamination
#1
Riley Heroux, Michelle Sheppard, Sharon B Wright, Mandeep Sawhney, Elizabeth B Hirsch, Robin Kalaidjian, Graham M Snyder
BACKGROUND: Current professional guidelines recommend a maximum hang time for reprocessed duodenoscopes of 5-14 days. We sought to study the association between hang time and risk of duodenoscope contamination. METHODS: We analyzed cultures of the elevator mechanism and working channel collected in a highly standardized fashion just before duodenoscope use. Hang time was calculated as the time from reprocessing to duodenoscope sampling. The relationship between hang time and duodenoscope contamination was estimated using a calculated correlation coefficient between hang time in days and degree of contamination on the elevator mechanism and working channel...
December 26, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/28033284/endoscopic-retrograde-cholangiopancreatography-in-patients-with-surgically-altered-anatomy-one-single-center-s-experience
#2
Fei Wang, Boming Xu, Quanpeng Li, Xiuhua Zhang, Guobing Jiang, Xianxiu Ge, Junjie Nie, Xiuyun Zhang, Ping Wu, Jie Ji, Lin Miao
Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is challenging. Results of ERCP in those patients varied.The aim of our study was to evaluate the safety and effectiveness of various endoscopes-assisted ERCP in patients with surgically altered anatomy.Fifty-two patients with Billroth II reconstruction (group A), 20 patients with subtotal or total gastrectomy with Roux-en-Y anastomosis (group B), 25 patients with pancreatoduodenectomy or Roux-en-Y hepaticojejunostomy reconstruction (group C) were included...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27922516/advances-in-endoscope-reprocessing-technology-and-its-impact-on-pathogen-transmission
#3
Cathleen Shellnutt
Pathogen transmissions via flexible endoscopes have been documented in the literature and have been historically related to human error or omission of steps in the reprocessing cycle. The 2008 Centers for Disease Control and Prevention report challenged manufacturers of automated endoscope reprocessors to improve and advance technology to automate more of the reprocessing steps. A review and synthesis of the literature following the 2008 Centers for Disease Control and Prevention report was performed to evaluate whether advances in reprocessing technology have occurred and whether these have had an impact on pathogen transmission via flexible endoscopes...
November 2016: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/27853743/a-novel-adjunctive-cleansing-method-to-reduce-colony-forming-units-on-duodenoscopes
#4
Karl Kwok, Joseph Chang, Simon Lo, Andrew Giap, Brian Lim, Bechien Wu
Background and study aims: Endoscopic retrograde cholangiopancreatography-related infections are of increasing global concern due to the emergence of multidrug-resistant bacteria such as carbapenem-resistant enterobacteriaceae (CRE), with bacterial biofilm production postulated as one cause of persistent infection from such virulent organisms. Because N-acetylcysteine (NAC) has been shown to possess antibacterial and biofilm-disruption properties, we aimed to evaluate if NAC would demonstrate clinical utility in reducing the colony forming units (CFU) at the elevator end of a duodenoscope, one of the hardest areas to clean...
November 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27818222/adenosine-triphosphate-bioluminescence-for-bacteriologic-surveillance-and-reprocessing-strategies-for-minimizing-risk-of-infection-transmission-by-duodenoscopes
#5
Saurabh Sethi, Robert J Huang, Monique T Barakat, Niaz Banaei, Shai Friedland, Subhas Banerjee
BACKGROUND AND AIMS: Recent outbreaks of duodenoscope-transmitted infections underscore the importance of adequate endoscope reprocessing. Adenosine triphosphate (ATP) bioluminescence testing allows rapid evaluation of endoscopes for bacteriologic/biologic residue. In this prospective study we evaluate the utility of ATP in bacteriologic surveillance and the effects of endoscopy staff education and dual cycles of cleaning and high-level disinfection (HLD) on endoscope reprocessing. METHODS: ATP bioluminescence was measured after precleaning, manual cleaning, and HLD on rinsates from suction-biopsy channels of all endoscopes and elevator channels of duodenoscopes/linear echoendoscopes after use...
November 3, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27805536/-outbreaks-related-to-contaminated-duodenoscopes-causes-and-solutions
#6
A W Rauwers, M C Vos, J W Poley, J G Buijs-Hegeman, M J Bruno
Duodenoscopes for Endoscopic Retrograde Cholangiopancreatography (ERCP) are used for diagnostic and, presently predominantly, for minimally invasive therapeutic procedures involving the biliary tree and the pancreatic duct. In 2012, in the Erasmus MC in the Netherlands, a large outbreak of multidrug-resistant bacteria was caused by a contaminated duodenoscope; its design was such that thorough cleaning was not possible. Worldwide, an increasing number of outbreaks involving multidrug-resistant bacteria caused by contaminated duodenoscopes have been reported on...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27761747/endoclip-therapy-of-post-sphincterotomy-bleeding-using-a-transparent-cap-fitted-forward-viewing-gastroscope
#7
Hyung Ku Chon, Tae Hyeon Kim
BACKGROUND: The incidence of post-endoscopic sphincterotomy (ES) bleeding is reportedly 2.0-5.0 %. Among various hemostatic methods, endoclip therapy is an effective modality in gastrointestinal bleeding. However, endoclip application for post-ES hemorrhage has not been widely studied, partly because of the difficulty in placing of clips using a duodenoscope. A cap-fitted forward-viewing gastroscope can easily visualize the major papilla and overcome the technical difficulty in applying endoclips...
October 19, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27665262/endoscopic-ultrasonography-guided-drainage-combined-with-trans-duodenoscope-cyclic-irrigation-technique-for-walled-off-pancreatic-necrosis
#8
Ying-Chun Ren, Su-Min Chen, Xiao-Bo Cai, Bai-Wen Li, Xin-Jian Wan
BACKGROUND: Endoscopic ultrasonography-guided drainage has been established as a good treatment modality in the management of walled-off pancreatic necrosis, but the unmanageable infection of postoperation is still a thorny problem due to the poor drainage ability for solid necrotic debris only through transmural stent and nasocystic catheter. AIMS: Introduce a novel therapeutic method, namely endoscopic ultrasonography-guided drainage combined with cyclic irrigation technique in managing patients with walled-off pancreatic necrosis...
January 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27595583/current-practice-of-duodenoscope-reprocessing
#9
REVIEW
Stephen Kim, V Raman Muthusamy
Numerous outbreaks of duodenoscope-associated transmission of multi-drug resistant bacteria have recently been reported. Unlike prior episodes of endoscope-transmitted infections, the latest outbreaks have occurred despite strict adherence to duodenoscope reprocessing guidelines. The current standard for all flexible endoscope reprocessing includes pre-cleaning, leak testing, an additional manual cleaning step, and high-level disinfection. When these steps are strictly followed, the risk of infection transmission during endoscopy is exceedingly rare...
October 2016: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/27531563/technical-tips-for-peroral-transluminal-cholangioscopy-using-novel-single-operator-cholangioscope-with-videos
#10
Takeshi Ogura, Wataru Takagi, Yoshitaka Kurisu, Kazuhide Higuchi
Endoscopic retrograde cholangiopancreatography (ERCP) is the gold-standard modality for diagnosis and therapy of bilio-pancreatic disease. In particular, peroral cholangiography (POCS) is a useful modality not only for diagnosing biliary disease, but also for therapeutic procedures such as electrohydraulic lithotripsy. The SPY-DS single-operator cholangioscope has recently become available, and offers favorable visualization, a wide view, suction function and a larger accessory working channel. However, if the duodenoscope cannot be advanced into the ampulla of Vater for reasons such as surgical anatomy, POCS cannot be performed...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/27478029/risk-of-infection-transmission-in-curvilinear-array-echoendoscopes-results-of-a-prospective-reprocessing-and%C3%A2-culture-registry
#11
Christopher G Chapman, Uzma D Siddiqui, Maricarmen Manzano, Vani J Konda, Cynthia Murillo, Emily M Landon, Irving Waxman
BACKGROUND AND AIMS: The complex design of the elevator mechanism in duodenoscopes has been recognized as a challenge for disinfection and recently implicated as a potential source of persistent bacterial contamination. Curvilinear array (CLA) echoendoscopes also have an elevator mechanism; however, there are no recommendations or data regarding the risk of persistent bacterial contamination of echoendoscopes. Here we hoped to determine the yield of microbial growth with routine bacterial surveillance cultures of reprocessed CLA echoendoscopes...
July 28, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27469303/olympus-chose-not-to-alert-us-doctors-of-infections-linked-to-its-duodenoscopes
#12
Michael McCarthy
No abstract text is available yet for this article.
2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27437409/epidemiologic-review-of-carbapenem-resistant-enterobacteriaceae-and-duodenoscopes-in-the-department-of-veterans-affairs
#13
Russell Ryono, Patricia Schirmer, Cynthia Lucero-Obusan, Gina Oda, Jason Dominitz, Mark Holodniy
No abstract text is available yet for this article.
December 2015: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27425799/enhanced-methods-for-duodenoscope-reprocessing-answers-or%C3%A2-just-more-questions
#14
EDITORIAL
Andrew S Ross
No abstract text is available yet for this article.
August 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27310408/outbreaks-associated-with-duodenoscopes-new-challenges-and-controversies
#15
Zachary A Rubin, Rekha K Murthy
PURPOSE OF REVIEW: Recent outbreaks of carbapenem-resistant enterobacteriaceae related to duodenoscopes in the United States and Europe have gained international attention and resulted in new regulations, especially in the United States, affecting healthcare facilities. In this review, we summarize findings from recent duodenoscope-related outbreaks, highlight what is known about the risk of transmission from these devices and discuss controversies about current recommendations to prevent transmission...
August 2016: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/27179395/carbapenem-resistant-enterobacteriaceae-and-endoscopy-an-evolving-threat
#16
John C O'Horo, Ann Farrell, M Rizwan Sohail, Nasia Safdar
BACKGROUND: Several clusters of Carbapenem-resistant Enterobacteriaceae (CRE) infections associated with contaminated endoscopes have recently been reported. Interim guidelines for mitigating endoscope-associated transmission have been proposed, but there has not been a systematic appraisal of CRE prevention practices. METHODS: We conducted a systematic review of endoscope-associated CRE infection episodes, abstracting information on outbreak detection, mitigation, outcomes, and corrective steps taken to prevent recurrence...
September 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27131135/outbreaks-of-carbapenem-resistant-enterobacteriaceae-infections-associated-with-duodenoscopes-what-can-we-do-to-prevent-infections
#17
William A Rutala, David J Weber
Recent outbreaks with carbapenem-resistant Enterobacteriaceae (CRE) in patients who have undergone endoscopic retrograde cholangiopancreatography (ERCP) have raised concerns of whether current endoscope reprocessing guidelines are adequate to ensure a patient-safe endoscope. Unlike previous outbreaks, these CRE outbreaks occurred even though manufacturer's instructions and professional guidelines were followed correctly. This article reviews why outbreaks associated with endoscopes continue to occur; what alternatives exist that might improve the margin of safety associated with duodenoscope reprocessing; and how to prevent future outbreaks associated with ERCP procedures...
May 2, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27126621/single-stage-management-with-combined-tri-endoscopic-approach-for-concomitant-cholecystolithiasis-and-choledocholithiasis
#18
Fujing Lv, Shutian Zhang, Ming Ji, Yongjun Wang, Peng Li, Wei Han
OBJECTIVE: The aim of this study was to investigate the value of a single stage with combined tri-endoscopic (duodenoscopy, laparoscopy and choledochoscopy) approach for patients with concomitant cholecystolithiasis and choledocholithiasis. METHODS: Fifty-three patients with combined gallbladder stones and common bile duct stones from February 2014 to April 2015 were randomized assigned to two groups: 29 patients underwent single-stage surgery with combined duodenoscope, laparoscope and choledochoscope (combined tri-endoscopic group), and 29 patients underwent endoscopic sphincterotomy to remove common bile duct stones followed by laparoscopic cholecystectomy several days later (control group)...
December 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27053226/types-of-peroral-cholangioscopy-how-to-choose-the-most-suitable-type-of-cholangioscopy
#19
REVIEW
Yusuke Ishida, Takao Itoi, Yoshinobu Okabe
A number of case studies have described the usefulness of peroral cholangioscopy for diagnosis and therapy, performed by visualizing the inner cavity of the bile duct. Currently available types of peroral cholangioscopy include peroral videocholangioscopy (POCS) using a mother-baby scope system (MBSS), direct peroral videocholangioscopy (D-POCS), and SpyGlass™ Direct Visualization System (SGDVS). POCS started with cholangioscopy using MBSS, requiring two skilled endoscopists using two endoscopic systems. On the other hand, D-POCS and SGDVS were developed as single-operator techniques...
June 2016: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/27032883/surveillance-of-guideline-practices-for-duodenoscope-and%C3%A2-linear-echoendoscope-reprocessing-in-a-large-healthcare%C3%A2-system
#20
Jack J Brandabur, James E Leggett, Lian Wang, Rebecca L Bartles, Lynda Baxter, George A Diaz, Gary L Grunkemeier, Shannan Hove, Margret Oethinger
BACKGROUND AND AIMS: To assess the adequacy of currently recommended duodenoscope and linear echoendoscope (DLE) automatic endoscope reprocessing (AER) and high-level disinfection (HLD), we collected daily post-reprocessing surveillance cultures of 106 DLEs in 21 Providence and Affiliate Hospitals. METHODS: Daily qualitative surveillance of dried, post-HLD DLEs was conducted for a minimum of 30 days at each facility. Positivity rates for any microbial growth and growth of high-concern pathogens were reported...
September 2016: Gastrointestinal Endoscopy
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