Endoscope-associated infections: A microbiologist's perspective on current technologies

In the wake of several highly publicized endoscope-associated multidrug-resistant organism (MDRO) outbreaks, healthcare providers have focused on understanding and improving endoscope reprocessing practices. Microbiological culture of endoscopes has emerged as a critical tool in support of these efforts. As healthcare providers increasingly rely on microbiological culture results to make decisions that impact patient safety, it is important to understand the limitations of the methodology as well as the factors that may impact results. The use of traditional cultures in combination with molecular methods has enabled the investigation of disease transmission during outbreaks. With increased prevalence of MDROs, advanced molecular techniques like whole-genome sequencing provide high resolution data and information on the entire bacterial genome that are needed for thorough investigations and management of transmission events. Elucidation of the true burden of postprocedure patient colonization and infection would benefit from improved clinical lab access to molecular biology tools. Molecular biology tools would facilitate detection of emerging MDROs and ever-increasing diversity of antibiotic resistance genes. Implementation of postprocedure surveillance programs aimed at early recognition of colonized and infected patients could improve appropriate management of endoscope infected patients and guide infection prevention measures to prevent the spread of MDROs.