Year 2022 / Volume 114 / Number 2
Editorial
Disposable duodenoscopes. Is healthcare system affordability the main hindrance?

70-72

DOI: 10.17235/reed.2022.8570/2021

Enrique Vázquez-Sequeiros, Juan Ángel González Martín, Agustín Albillos Martínez,

Abstract
The performance of an endoscopic procedure involves introducing an endoscope through the mouth or the anus, which may potentially lead to lethal infection. The risk increases when complex and difficult-to-clean scopes are used, as in the case of duodenoscopes. Side-viewing duodenoscopes are complex in design, with the camera and working channel exit located on one side of the endoscope’s distal end, and with an elevator nail also located at this point for catheter redirection. This complex design may facilitate the presence of blind areas not easy to access for cleaning, resulting in suboptimal disinfection of the duodenoscope and therefore a higher risk of bacterial infection. This is of particular importance in particularly vulnerable patients like those who are immunosuppressed (e.g., transplanted patients) or have a malignant disease and are receiving chemotherapy. Moreover, in the era of ¨superbugs¨, like carbapenem-resistant Enterobacteriaceae, infection outbreaks related to endoscopic retrograde cholangiopancreatography (ERCP) have been reported with a significant mortality rate.
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References
1. Ha J, Son BK. Current issues in duodenoscope-associated infections: now is the time to take action. Clin Endosc 2015;48:361-363. doi: 10.5946/ce.2015.48.5.361.
2. Aumeran C, Poincloux L, Souweine B, et al. Multidrug-resistant klebsiella pneumoniae outbreak after endoscopic retrograde cholangiopancreatography. Endoscopy 2010;42:895-899. doi: 10.1055/s-0030-1255647.
3. Epstein L, Hunter JC, Arwady MA, et al. New Delhi metallo-β-lactamase-producing carbapenem-resistant escherichia coli associated with exposure to duodenoscopes. JAMA 2014;312:1447-1455. doi: 10.1001/jama.2014.12720.
4. Naryzhny I, Silas D, Chi K. Impact of ethylene oxide gas sterilization of duodenoscopes after a carbapenem-resistant Enterobacteriaceae outbreak. Gastrointest Endosc 2016;84:259-262. doi: 10.1016/j.gie.2016.01.055.
5. Vickery K, Ngo Q-D, Zou J, Cossart YE. The effect of multiple cycles of contamination, detergent washing, and disinfection on the development of biofilm in endoscope tubing. Am J Infect Control 2009;37:470-475. doi: 10.1016/j.ajic.2008.09.016.
6. Verfaillie CJ, Bruno MJ, Voor in ’t Holt AF, et al. Withdrawal of a novel-design duodenoscope ends outbreak of a VIM-2-producing pseudomonas aeruginosa. Endoscopy 2015;47:493-502. doi: 10.1055/s-0034-1392080.
7. Trindale AJ, Copland A, Bhatt A, et al. Single-use duodenoscopes and duodenoscopes with disposable end caps. Gastrointest Endosc 2021;93:997-1005. doi: 10.1016/j.gie.2020.12.033.
8. Muthusamy VR, Bruno MJ, Kozarek RA, et al. Clinical evaluation of a single-use duodenoscope for endoscopic retrograde cholangiopancreatography. Clin Gastroenterol Hepatol 2020;18:2108-2117.e3. doi: 10.1016/j.cgh.2019.10.052.
9. Complexity of ERCP. Cotton PB, Eisen G, Romagnuolo J, et al. Grading the complexity of endoscopic procedures: results of an ASGE working party. Gastrointest Endosc 2011;73:868-874. doi: 10.1016/j.gie.2010.12.036.
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Vázquez-Sequeiros E, González Martín J, Albillos Martínez A. Disposable duodenoscopes. Is healthcare system affordability the main hindrance?. 8570/2021


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Publication history

Received: 03/01/2022

Accepted: 14/01/2022

Online First: 20/01/2022

Published: 07/02/2022

Article Online First time: 17 days

Article editing time: 35 days


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