Table 4

Infections associated with endoscopic retrograde cholangiopancreaticography a

ReferenceMicroorganism(s)No. of contaminated patients after endoscopyNo. of infected patientsInfection(s)Detection of endoscope contaminationCause(s) of contamination
95 P. aeruginosa 11Cholangitis, sepsisYesInappropriate cleaning and disinfection (ethanol)
96 P. aeruginosa 140NoYesInappropriate cleaning and disinfection (povidone-iodine/ethanol)
97 P. aeruginosa 77CholangitisYesInappropriate cleaning and disinfection (ethanol)
100 P. aeruginosa 11SepsisYesContaminated water bottles
53 P. aeruginosa 43SepsisYesInappropriate disinfection; rinsing with nonsterile tap water
91 P. aeruginosa 55Cholangitis, sepsis, urinary tract infectionYesInadequate cleaning and disinfection between uses in patients (tap water)
22 P. aeruginosa 105Cholecystitis, liver abscessYesContaminated AER; inappropriate cleaning and disinfection; drying with no ethanol flushing
328 P. aeruginosa 11Liver abscessNoNot found; endoscope reprocessing not described
98 P. aeruginosa 22SepsisYesInappropriate cleaning and disinfection (cetrimide)
90 P. aeruginosa 77Bacteremia/sepsis, cholangitis, pancreatitisYesContaminated water bottle; inadequate manual cleaning and disinfection between patients (isopropanol)
99 P. aeruginosa 55SepsisYesContaminated water bottle (not disinfected)
23 P. aeruginosa 16No dataBacteremia/sepsis, cholangitis, pneumoniaYesContaminated AER (a flaw in design, presence of biofilm); drying with no ethanol flushing
75 P. aeruginosa 2525Bacteremia/sepsisYesFailure to disinfect elevator channel in AER; drying with no ethanol flushing
101 P. aeruginosa 53Cholangitis, sepsisNoNot found; endoscope reprocessing not described
29 P. aeruginosa 33SepsisYesContaminated water bottle; inadequate manual cleaning; insufficient disinfectant exposure
2 P. aeruginosa 33SepsisYesPresence of biofilm in intact endoscope channels
83 Salmonella Oslo32Gastroenteritis, sepsisNot testedInappropriate cleaning and disinfection (povidone-iodine/ethanol)
141 Serratia marcescens 10NoYesInappropriate cleaning and disinfection (povidone-iodine)
52 M. chelonae 140NoNo dataContaminated AER; inappropriate disinfection; rinsing with tap water; lack of drying procedure
147 Methylobacterium mesophilicum 11BacteremiaYesContaminated endoscope channels
144 ESBL-producing K. pneumoniae 1612Bacteremia/sepsis, cholangitisYesContaminated endoscope channels; insufficient drying procedure
145 KPC-producing K. pneumoniae 72BacteremiaYesContaminated endoscope channels; insufficient drying procedure
184 HCV11HCV infectionNot testedInadequate disinfection (low concn, insufficient exposure); failure to perfuse elevator channel
  • a AER, automated endoscope reprocessor; ESBL, extended-spectrum β-lactamase; KPC, Klebsiella pneumoniae carbapenemase.