Koen van der Ploeg, Corné H W Klaassen, Saskia H J Renkens, Bibi C G C Mason-Slingerland, Juliëtte A Severin, Marco J Bruno, Margreet C Vos
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引用次数: 0
Abstract
Background and study aims: The risk of duodenoscope-associated colonisations (DAC) and infections (DAI) after endoscopic retrograde cholangiopancreatography (ERCP) with a contaminated duodenoscope remains unknown. Determining the incidence of these events is crucial for developing prevention strategies. This study aimed to assess the incidence of DACs and DAIs.
Methods: This prospective observational study included adult patients who underwent ERCP from January 2022 to December 2023. Duodenoscopes were sampled prior to each procedure. Contamination was defined as the presence of microorganisms of gut or oral origin (MGO). Post-ERCP, upon availability of culture results, patients exposed to contaminated duodenoscopes were asked to provide a stool sample and were followed for six months. Microorganisms isolated from patient samples and clinical cultures were compared with those found in the duodenoscopes. Whole-genome sequencing (WGS) was used to confirm DAC or DAI.
Findings: Among 341 ERCP patients, 73 (21.4%) procedures involved MGO-contaminated duodenoscopes. No duodenoscope-associated outbreaks occurred during the study. Stool samples were returned by 45 of the 73 patients (61.6%). Additionally, 80 MGOs from clinical cultures and 37 residual samples were stored. WGS was performed on eight duodenoscope-patient microorganism pairs from six patients. No DAC or DAI cases were detected.
Conclusion: In a non-outbreak setting, supported by monthly routine microbiological surveillance and a quarantine protocol for duodenoscopes, the risk of DAC and DAI appears low. These findings suggest limited value in intensive patient surveillance for DACs/DAIs. Further research is warranted to confirm these results and address knowledge gaps regarding risk factors for DACs and DAIs.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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