Table 2

Infections associated with flexible upper gastrointestinal endoscopy

ReferenceMicroorganism(s)No. of contaminated patients after endoscopyNo. of infected patientsInfection type(s)Detection of endoscope contaminationCause(s) of contamination a
80 P. aeruginosa 32SepsisYesInappropriate cleaning and disinfection (benzalkonium chloride)
62 P. aeruginosa 43Pneumonia, lung abscessYesInappropriate cleaning and disinfection (cetrimide)
65 P. aeruginosa 44SepsisYesContaminated water bottle and water supply; inappropriate cleaning and disinfection
23 P. aeruginosa 99No dataBacteremia/sepsis, cholangitis, pneumoniaYesContaminated AER (a flaw in design, presence of biofilm); drying with no ethanol flushing
130 H. pylori 11GastritisNot testedBiopsy forceps not sterilized
128 H. pylori 22GastritisYesInappropriate disinfection between patients (ethanol); biopsy forceps not sterilized
131 H. pylori 11GastritisYesInappropriate cleaning and disinfection between patients
84 Salmonella Typhi11BacteremiaNot testedInappropriate cleaning and disinfection
82 Salmonella Typhimurium77Gastroenteritis, peritoneal abscessYesInappropriate cleaning and disinfection
28 Salmonella Typhimurium11Urinary tract infectionYesLack of manual cleaning; insufficient disinfectant exposure
88 Salmonella Agona55Gastroenteritis, bacteremia/sepsisYesInappropriate cleaning and disinfection (cetrimide)
86 Salmonella Kedougou1512GastroenteritisNoInappropriate cleaning and disinfection (cetrimide)
162 HBV11HBV infectionNot testedInappropriate cleaning and disinfection (cetrimide); no disinfection between patients
163 HBV11HBV infectionNot testedEndoscope reprocessing not described
161 HBV11HBV infectionNot testedLack of disinfection procedure
183 HCV99HCV infectionNot testedContaminated syringe or anesthetic vial; inappropriate cleaning and disinfection
150 Strongyloides stercoralis 44EsophagitisNot testedNot found
152 Trichosporon spp.90NoYesInappropriate cleaning and disinfection (cetrimide)
151 Trichosporon asahii 11EsophagitisYesBiopsy forceps not sterilized
  • a AER, automated endoscope reprocessor.