{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:45:15Z","timestamp":1790095515809,"version":"4.0.1"},"reference-count":15,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T00:00:00Z","timestamp":1673827200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X22003191_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate variables that affect risk of contamination for endoscopic retrograde cholangiopancreatography and endoscopic ultrasound endoscopes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X22003191_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Observational, quality improvement study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X22003191_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>University medical center with a gastrointestinal endoscopy service performing \u223c1,000 endoscopic retrograde cholangiopancreatography and \u223c1,000 endoscopic ultrasound endoscope procedures annually.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X22003191_as4\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Duodenoscope and linear echoendoscope sampling (from the elevator mechanism and instrument channel) was performed from June 2020 through September 2021. Operational changes during this period included standard reprocessing with high-level disinfection with ethylene oxide gas sterilization (HLD\u2013ETO) was switched to double high-level disinfection (dHLD) (June 16, 2020\u2013July 15, 2020), and duodenoscopes changed to disposable tip model (March 2021). The frequency of contamination for the co-primary outcomes were characterized by calculated risk ratios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X22003191_as5\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The overall pathogenic contamination rate was 4.72% (6 of 127). Compared to duodenoscopes, linear echoendoscopes had a contamination risk ratio of 3.64 (95% confidence interval [CI], 0.69\u201319.1). Reprocessing using HLD-ETO was associated with a contamination risk ratio of 0.29 (95% CI, 0.06\u20131.54). Linear echoendoscopes undergoing dHLD had the highest risk of contamination (2 of 18, 11.1%), and duodenoscopes undergoing HLD-ETO and the lowest risk of contamination (0 of 53, 0%). Duodenoscopes with a disposable tip had a 0% contamination rate (0 of 27).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X22003191_as6\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We did not detect a significant reduction in endoscope contamination using HLD-ETO versus dHLD reprocessing. Linear echoendoscopes have a risk of contamination similar to that of duodenoscopes. Disposable tips may reduce the risk of duodenoscope contamination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2022.319","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T05:37:28Z","timestamp":1673847448000},"page":"1485-1489","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":12,"title":["Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound endoscope reprocessing: Variables impacting contamination risk"],"prefix":"10.1017","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8476-9770","authenticated-orcid":false,"given":"Ashley M.","family":"Ayres","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Wozniak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"O\u2019Neil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John St.","family":"Leger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5540-2056","authenticated-orcid":false,"given":"A. William","family":"Pasculle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"McGrath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Slivka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5562-8880","authenticated-orcid":false,"given":"Graham M","family":"Snyder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,1,16]]},"reference":[{"key":"S0899823X22003191_ref5","unstructured":"5. FDA recommends healthcare facilities and manufacturers begin transitioning to duodenoscopes with disposable components to reduce risk of patient infection. US Food and Drug Administration webiste. https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-recommends-health-care-facilities-and-manufacturers-begin-transitioning-duodenoscopes-disposable. Published 2019. Accessed January 3, 2023."},{"key":"S0899823X22003191_ref2","unstructured":"2. Preventable tragedies: superbugs and how ineffective monitoring of medical device safety fails patients. US Senate Committee on Health, Education, Labor, and Pensions website. https:\/\/www.help.senate.gov\/ranking\/newsroom\/press\/preventable-tragedies-superbugs-and-how-ineffective-monitoring-of-medical-device-safety-fails-patients. Published January 13, 2016. Accessed January 3, 2023."},{"key":"S0899823X22003191_ref3","unstructured":"3. Design of Endoscopic Retrograde Cholangiopancreatography (ERCP) duodenoscopes may impede effective cleaning: FDA safety communication. US Food and Drug Administration webiste. http:\/\/www.fda.gov\/MedicalDevices\/Safety\/AlertsandNotices\/ucm434871.htm. Published 2015. Accessed March 31, 2015."},{"key":"S0899823X22003191_ref4","unstructured":"4. Infections associated with reprocessed duodenoscopes. US Food and Drug Administration website. http:\/\/www.fda.gov\/MedicalDevices\/ProductsandMedicalProcedures\/ReprocessingofReusableMedicalDevices\/ucm454630.htm. Published 2016. Accessed January 5, 2017."},{"key":"S0899823X22003191_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2018.12.024"},{"key":"S0899823X22003191_ref15","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31819efac0"},{"key":"S0899823X22003191_ref11","unstructured":"11. Duodenoscope surveillance sampling and culturing. US Food and Drug Administration website. https:\/\/www.fda.gov\/downloads\/MedicalDevices\/ProductsandMedicalProcedures\/ReprocessingofReusableMedicalDevices\/UCM597949.pdf. Published 2018. Accessed March 1, 2018."},{"key":"S0899823X22003191_ref13","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-020-01200-7"},{"key":"S0899823X22003191_ref6","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.06.052"},{"key":"S0899823X22003191_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2018.02.016"},{"key":"S0899823X22003191_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2016.07.049"},{"key":"S0899823X22003191_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100451"},{"key":"S0899823X22003191_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.05.030"},{"key":"S0899823X22003191_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2016.03.1480"},{"key":"S0899823X22003191_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.12.033"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X22003191","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T03:36:52Z","timestamp":1711942612000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X22003191\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,16]]},"references-count":15,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["S0899823X22003191"],"URL":"https:\/\/doi.org\/10.1017\/ice.2022.319","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,16]]},"assertion":[{"value":"\u00a9 The Author(s), 2023. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is used to distribute the re-used or adapted article and the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}