ECRI Institute Advises Culturing of Duodenoscopes to Help Reduce Risk of Deadly Infections

PLYMOUTH MEETING, Pa., March 3, 2015 /PRNewswire-USNewswire/ -- News of patient deaths caused by outbreaks of carbapenem-resistant Enterobacteriaceae (CRE) infections is fueling media attention and putting the healthcare community on high alert regarding appropriate disinfection practices for duodenoscopes. The hard-to-clean scopes are used to diagnose and treat a variety of conditions of the gall bladder and pancreas with Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures.

ECRI Institute, a nonprofit that researches the best approaches to improving patient care, today issued a High PriorityHazard Report with recommendations to help reduce the risk of ERCP endoscope-related patient infections. Scope culturing is a key step in reducing the risk of CRE infections, according to the report. The Hazard Report is free to the healthcare professional community at www.ecri.org/CRE.

"Our recommendations call for timely action and executive level attention," says Jeffrey C. Lerner, PhD, president and chief executive officer, ECRI Institute. "They will likely require additional costs and changes in workflow and processes."

The report details ECRI's recommendations on baseline and surveillance culturing. It recommends that hospitals consider instituting regular CRE surveillance through duodenoscope culturing regardless of which reprocessing method it uses (e.g., high-level disinfection using a liquid chemical germicide or sterilization using ethylene oxide). Implementing surveillance culturing properly will not be trivial, but will provide a means to monitor duodenoscopes for CRE, says ECRI's experts. 

"Minimizing the risk of infections associated with ERCP scopes is extremely difficult and it will take multiple approaches to reduce the likelihood of contamination," says James P. Keller, MS, vice president of health technology evaluation and safety, ECRI Institute.

ECRI's new recommendations build upon the organization's decades of experience investigating a variety of endoscope-related infections. The Hazard Report was developed by an ECRI Institute team of physicians, clinical specialists, infection control practitioners, biomedical engineers, and others who intensively researched and reviewed the best approaches to address this issue. Problems with reprocessing of endoscopes has appeared on ECRI Institute's annual Top 10 Health Technology Hazards list for the past six years. It is number four on the 2015 list.

"We believe that despite their infection risks, ERCP endoscopy procedures are vital and discontinuing them because of this risk would be more harmful to patients," says Lerner.

ECRI Institute continues to investigate this problem and will update its guidance and recommendations as new information becomes available. The Hazard Report and other technology management, patient safety, and risk management guidance articles and recommendations are publicly available in ECRI Institute's new CRE and Duodenoscope Resource Center, located at www.ecri.org/CRE. The website will be updated frequently.

For questions or additional information, contact ECRI Institute by telephone at (610) 825-6000; by e-mail at [email protected]; by fax at (610) 834-1275; or by mail at 5200 Butler Pike, Plymouth Meeting, PA 19462.

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About ECRI Institute
ECRI Institute (www.ecri.org), a nonprofit organization, dedicates itself to bringing the discipline of applied scientific research to healthcare to discover which medical procedures, devices, drugs, and processes are best to enable improved patient care. As pioneers in this science for more than 45 years, ECRI Institute marries experience and independence with the objectivity of evidence-based research. Strict conflict-of-interest guidelines ensure objectivity. ECRI Institute is designated an Evidence-based Practice Center by the U.S. Agency for Healthcare Research and Quality. ECRI Institute PSO is listed as a federally certified Patient Safety Organization by the U.S. Department of Health and Human Services. Find ECRI Institute on Facebook (www.facebook.com/ECRIInstitute) and on Twitter (www.twitter.com/ECRI_Institute).

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