Duodenoscope-Associated Bacterial Infections: A Review and Update

  • Jennifer T. Higa
  • Michael Gluck
  • Andrew S. RossEmail author
Endoscopy (I Waxman, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Endoscopy

Opinion Statement

Physicians depend on the use of flexible endoscopes for delivery of vital care that is morbidity sparing compared to surgical alternatives. Iatrogenic infection is a well-documented complication of therapeutic endoscopy. Recent emergence of unique antimicrobial resistance patterns and molecular “fingerprinting” of bacteria harken a new era in duodenoscope-related infections which occur in spite of compliance with device manufacturer-recommended protocols for high-level disinfection (HLD). Further studies suggest that these protocols are likely inadequate. Endoscopic retrograde cholangiopancreatography (ERCP) remains critical in the provision of minimally invasive diagnostic, therapeutic, and palliative care for patients with pancreaticobiliary disease. This manuscript reviews the history of duodenoscope-related infections, current challenges to scope reprocessing, and recommendations from regulatory agencies.


Duodenoscope ERCP CRE MDRO Infection Reprocessing 


Compliance with Ethical Standards

Conflict of Interest

Jennifer T. Higa, Michael Gluck, and Andrew Ross declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC 2016

Authors and Affiliations

  • Jennifer T. Higa
    • 1
  • Michael Gluck
    • 2
  • Andrew S. Ross
    • 2
  1. 1.Division of GastroenterologyUniversity of Washington School of MedicineSeattleUSA
  2. 2.Division of GastroenterologyVirginia Mason Medical CenterSeattleUSA

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