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An update on gastrointestinal endoscopy-associated infections and their contributing factors

机译:胃肠内镜相关感染及其影响因素的最新进展

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During clinical use, gastrointestinal endoscopes are grossly contaminated with patient’s native flora. These endoscopes undergo reprocessing to prevent infectious transmission upon future use. Endoscopy-associated infections and outbreaks have been reported, with a recent focus on the transmission of multi-drug resistant organisms. This review aims to provide an update on endoscopy-associated infections, and the factors contributing to their occurrence. PubMed, ScienceDirect, and CINAHL were searched for articles describing gastrointestinal endoscopy-associated infections and outbreaks published from 2008 to 2018. Factors contributing to their occurrence, and the outcomes of each outbreak were also examined. This review found 18 articles, 16 of which described duodenoscope-associated infections, and the remaining two described colonoscope- and gastroscope-associated infection respectively. Outbreaks were reported from the United States, France, China, Germany, the Netherlands and the United Kingdom. The causative organisms reported were Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli and Salmonella enteritidis. A number of factors, including lapses in reprocessing, biofilm formation, endoscope design issues and endoscope damage, contribute to gastrointestinal endoscopy associated infection. Methods of improving endoscope reprocessing, screening for contamination and evaluating endoscope damage may be vital to preventing future infections and outbreaks.
机译:在临床使用期间,胃肠道内窥镜严重污染了患者的天然菌群。这些内窥镜经过重新处理以防止将来使用时传染性传播。内镜相关的感染和暴发已有报道,最近的重点是耐多药生物的传播。这篇综述旨在提供有关内窥镜检查相关感染及其发生因素的最新信息。在PubMed,ScienceDirect和CINAHL上搜索了2008年至2018年发表的描述胃肠道内窥镜相关感染和暴发的文章。还检查了导致其发生的因素以及每次暴发的结果。这篇评论发现了18篇文章,其中16篇描述了十二指肠镜相关的感染,其余两篇分别描述了结肠镜和胃镜相关的感染。据报道有美国,法国,中国,德国,荷兰和英国的疫情暴发。报告的致病菌为肺炎克雷伯菌,铜绿假单胞菌,大肠杆菌和肠炎沙门氏菌。包括后处理失误,生物膜形成,内窥镜设计问题和内窥镜损坏在内的许多因素都导致胃肠道内窥镜相关感染。改善内窥镜后处理,污染筛查和评估内窥镜损坏的方法对于预防将来的感染和爆发可能至关重要。

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