OBJECTIVES

Multiple infection outbreaks have been linked to contaminated duodenoscopes worldwide. However, the rate of infections linked to contaminated duodenoscopes is unknown. We aimed to estimate the endoscope-related infection risk associated with patient-ready duodenoscopes used for endoscopic retrograde cholangio-pancreatography (ERCP).

METHODS

We searched the PubMed and Embase electronic databases, from 1 January 2010 to 5 March 2020, for citations related to either contamination rates or infection risks associated with duodenoscopes. We included studies related to both contamination rate and infection risk. The primary outcome was a pooled duodenoscope-related infection risk associated with ERCP. Estimates from each study were pooled using a random effects model.

RESULTS : We identified 21 studies that fulfilled the inclusion criteria; six studies investigating the risk of infection, and 15 studies investigating the rate of contamination. Studies related to contamination included 925 contaminated duodenoscopes from 13,112 samples. Studies related to infection included 1,239 patients; of these, 92 patients were infected. All patients had been infected due to outbreaks with multi-drug resistant organisms. The calculated total weighted endoscope-related infection risk was 1.21% ± 0.004 (95% confidence interval [Cl]: 0.46% - 2.11%).

CONCLUSIONS

To the best of our knowledge this is the first study to estimate the duodenoscope-related infection risk associated with contaminated patient-ready duodenoscopes used for ERCP. Based on the available literature, our analysis demonstrates that there is a 1.21% post-endoscopic duodenoscope-related infection risk due to contaminated patient-ready duodenoscopes.