Selection of Low Temperature Sterilization for the Prevention of Multidrug-Resistant Bacterial Infections During Flexible Endoscopy

Patient exposure to a duodenoscope emerged in 2012 as a recognized risk factor for transmissions of carbapenem resistant Enterobacteriaceae (CRE) and related multidrug-resistant organisms (MDROs). In several well-documented instances, outbreaks of these bacteria occurred despite apparent confirmation that the duodenoscope was being cleaned and high-level disinfected correctly.

This article provides guidance for healthcare facilities that have decided to replace high level disinfection with low-temperature sterilization of flexible endoscopes. Prevention of transmissions of CRE and related MDROs via these endoscopes, which is the focus of this article, has taken on heightened public awareness and regulatory focus, primarily because the patient mortality rate associated with these diseases can be as high as percent.

About the Author

Lawrence F. Muscarella, PhD
Founder, LFM Healthcare Solutions LLC

Founder of LFM Healthcare Solutions LLC, Lawrence F. Muscarella, PhD, has researched and authored more than 200 articles on the topics of disinfection, sterilization, instrument reprocessing, risk management, infection control and prevention, modes of disease transmission, and factors that pose an increased risk of healthcare-acquired infections (HAIs), with a focus in the fields of gastrointestinal endoscopy and critical care.

His articles have been published in such peer-reviewed medical journals as: The Journal of Hospital Infection, The American Journal of Infection Control, Gastrointestinal Endoscopy, Chest, Infection Control and Hospital Epidemiology, Endoscopy, and the World Journal of Clinical Infectious Diseases.

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