Endoscopy 2020; 52(S 01): S77
DOI: 10.1055/s-0040-1704233
ESGE Days 2020 oral presentations
Friday, April 24, 2020 08:30 – 10:30 ERCP complications Liffey Meeting Room 2
© Georg Thieme Verlag KG Stuttgart · New York

DUODENOSCOPE-RELATED INFECTIONS: AN ITALIAN PICK IN 2019

A Fugazza
1   Humanitas Research Hospital, Rozzano, Italy
,
L Lamonaca
1   Humanitas Research Hospital, Rozzano, Italy
,
C Alvisi
2   Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
,
G Aragona
3   AUSL Piacenza, Piacenza, Italy
,
M Ayoubi
4   Ospedale Gradenigo, Torino, Italy
,
M Bassi
5   AUSL Bologna, Bologna, Italy,
,
A Benedetti
6   Ospedali Riuniti di Ancona, Ancona, Italy
,
P Beretta
7   Istituto Clinico Città Studi, Milano, Italy
,
MB Canani
8   ASST Vimercate, Vimercate, Italy
,
C Calcara
9   Ospedale SS. Trinità, Borgomanero, Italy
,
A Cambareri
10   Ospedale San Giovanni, Cinisello Balsamo, Italy
,
L Camellini
11   ASL5 Spezzino, La Spezia, Italy
,
ML Canfora
12   AOU Cagliari, Cagliari, Italy
,
P Cantù
13   Fondazione IRCCS Ca’ Granda - Ospedale Maggiore, Milano, Italy
,
G Cengia
14   Spedali Civili, Brescia, Italy
,
F Cereatti
15   Istituti Ospitalieri, Cremona, Italy
,
G Costamagna
16   Policlinico A. Gemelli, Roma, Italy,
,
L Cugia
17   AOU Sassari, Sassari, Italy
,
CD Angelis
18   Città della Salute e della Scienza, Presidio Le Molinette, Torino, Italy
,
FD Grazia
2   Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
,
GDV Blanco
19   Fondazione Policlinico Tor Vergata, Roma, Italy
,
ED Giulio
20   Ospedale Sant’Andrea, Roma, Italy
,
G Diamantis
21   Azienda ULSS 6 Euganea, Padova, Italy
,
M Dinelli
22   ASST Monza, Monza, Italy,
,
C Fabbri
23   Ospedale di Forlì e Cesena, Forlì, Italy
,
G Feliciangeli
24   ASUR Marche AV3 Macerata, Macerata, Italy
,
A Gabbrielli
25   Ospedale di Verona, Verona, Italy
,
P Gambitta
26   ASST Ovest Milanese, Milano, Italy
,
C Luigiano
27   Ospedale Santi Paolo e Carlo, Milano, Italy
,
G Macarri
28   Ospedale Civile Murri, Fermo, Italy
,
G Manes
29   ASST Rhodense, Rho, Italy,
,
G Manfredi
30   ASST Crema, Crema, Italy,
,
M Manno
31   Ospedale di Carpi, Carpi, Italy,
,
N Mantovani
32   Ospedale Carlo Poma, Mantova, Italy
,
A Mariani
33   Ospedale San Raffaele, Milano, Italy
,
E Masci
34   Istituto Nazionale Tumori, Milano, Italy,
,
G Missale
14   Spedali Civili, Brescia, Italy
,
P Mosca
35   Ospedali Riuniti, Ancona, Italy
,
A Mussetto
36   Ospedale Santa Maria delle Croci, Ravenna, Italy
,
M Mutignani
37   Ospedale Niguarda, Milano, Italy,
,
P Occhipinti
38   AOU Maggiore della Carità, Novara, Italy,
,
M Paganelli
39   Azienda Ospedaliera Mellino Mellini, Chiari, Italy,
,
MC Parodi
40   Policlinico San Martino, Genova, Italy,
,
F Radaelli
41   Ospedale Valduce, Como, Italy,
,
R Salerno
42   ASST FBF-Sacco, Milano, Italy,
,
M Traina
43   Ismett IRCCS, Palermo, Italy,
,
A Tringali
44   Ospedale di Conegliano, Conegliano, Italy,
,
G Venezia
45   Ospedale Santa Croce e Carle, Cuneo, Italy
,
A Anderloni
1   Humanitas Research Hospital, Rozzano, Italy
,
A Repici
46   Humanitas Research Hospital & Humanitas University, Rozzano, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 
 

    Aims ERCP is performed with reusable duodenoscopes after manual and automated reprocessing. Recently, multidrug-resistant infection outbreaks associated with infected duodenoscopes have been reported. Our aim was to investigate the current Italian experience with duodenoscope-related infections and assess the criticality of the risk.

    Methods Sixty-one Italian centers who perform ERCP were invited to complete a questionnaire about various aspects of duodenoscope-associated infection over the past 3 years.

    Results Most centers (52, 85.2%) responded, 39 from Northern Italy (75.0%), 19 (36.6%) academic. Median number of duodenoscopes in use was 3.7/center with 39 (75.0%) using Olympus, 11 (21.2%) Pentax, 10 (19.2%) Fujifilm and 1 Storz (1.9%). Twenty-four (24, 46.2%) centers affirmed adopting reusable accessories, mainly Dormia baskets. Median number of ERCP/year was 300, with 38 (73.1%) reporting< 5% rate of ERCP-related complications, mostly pancreatitis. Thirty-six (69.2%) centers reported at least one episode of duodenoscope-related infection, with up to 25 patients/center contaminated. Isolated pathogens were Klebsiella pneumoniae (KP) (18, 50%), Pseudomonas aeruginosa (10, 27.7%) and Escherichia coli (8, 22.3%). Six cases of KP infection were due to carbapenemase-producing strain, while only one patient was infected with ESBL E. coli. In all cases but six the infective episode prolonged hospitalization. Only 1 center reported 1 death. Major problems reported by centers in reviewing duodenoscopes and local policies after the evidence of ERCP-related infections were damaged working channel and non-compliance with reprocessing procedures according to local and international guidelines. Forty-one (41, 78.9%) participants responded that duodenoscope-related infections are relevant for their daily practice and 49 (94.2%) stated that their center would agree to participate in a study on duodenoscope-related infections.

    Conclusions These data represent the first Italian report pertaining to duodenoscope-associated infection with majority of Italian centers having experienced at least one case of ERCP-related infection. The rising number of cases reported worldwide makes it urgent to find a solution.


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