{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T13:44:48Z","timestamp":1779889488576,"version":"3.53.1"},"reference-count":27,"publisher":"The Korean Society of Gastrointestinal Endoscopy","issue":"1","license":[{"start":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T00:00:00Z","timestamp":1641168000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["e-ce.org"],"crossmark-restriction":true},"short-container-title":["Clin Endosc"],"published-print":{"date-parts":[[2022,1,31]]},"abstract":"<jats:p>Background\/Aims: Multiple outbreaks of multidrug-resistant organisms have been reported worldwide due to contaminated duodenoscopes. In 2015, the United States Food and Drug Administration recommended the following supplemental enhanced surveillance and reprocessing techniques (ESRT) to improve duodenoscope disinfection: (1) microbiological culture, (2) ethylene oxide sterilization, (3) liquid chemical sterilant processing system, and (4) double high-level disinfection. A systematic review and meta-analysis was performed to assess the impact of ESRT on the contamination rates.Methods: A thorough and systematic search was performed across several databases and conference proceedings from inception until January 2021, and all studies reporting the effectiveness of various ESRTs were identified. The pooled contamination rates of post-ESRT duodenoscopes were estimated using the random effects model.Results: A total of seven studies using various ESRTs were incorporated in the analysis, which included a total of 9,084 post-ESRT duodenoscope cultures. The pooled contamination rate of the post-ESRT duodenoscope was 5% (95% confidence interval [CI]: 2.3%\u201310.8%, inconsistency index [I2]=97.97%). Pooled contamination rates for high-risk organisms were 0.8% (95% CI: 0.2%\u20132.7%, I2=94.96).Conclusions: While ESRT may improve the disinfection process, a post-ESRT contamination rate of 5% is not negligible. Ongoing efforts to mitigate the rate of contamination by improving disinfection techniques and innovations in duodenoscope design to improve safety are warranted.<\/jats:p>","DOI":"10.5946\/ce.2021.212","type":"journal-article","created":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T05:52:32Z","timestamp":1641189152000},"page":"33-40","update-policy":"https:\/\/doi.org\/10.5946\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Contamination Rates in Duodenoscopes Reprocessed Using Enhanced Surveillance and Reprocessing Techniques: A Systematic Review and Meta-Analysis"],"prefix":"10.5946","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3324-9502","authenticated-orcid":true,"given":"Shivanand","family":"Bomman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3337-3140","authenticated-orcid":true,"given":"Munish","family":"Ashat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1697-3806","authenticated-orcid":true,"given":"Navroop","family":"Nagra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6394-6096","authenticated-orcid":true,"given":"Mahendran","family":"Jayaraj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6699-8174","authenticated-orcid":true,"given":"Shruti","family":"Chandra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9745-7538","authenticated-orcid":true,"given":"Richard A","family":"Kozarek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6587-7503","authenticated-orcid":true,"given":"Andrew","family":"Ross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1889-2129","authenticated-orcid":true,"given":"Rajesh","family":"Krishnamoorthi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3961","reference":[{"key":"ref1","volume-title":"Reducing the Risk of Infection from Reprocessed Duodenoscopes. [Internet]","year":"c2019"},{"key":"ref2","volume-title":"Health, Education, Labor, Pensions Committee. Preventable tragedies: superbugs and how ineffective monitoring of medical device safety fails patients. [Internet]","author":"Murray","year":"c2016"},{"key":"ref3","volume-title":"Design of endoscopic retrograde cholangiopancreatography (ERCP) duodenoscopes may impede effective cleaning: FDA safety communication [Internet]","year":"c2015"},{"key":"ref4","volume-title":"Supplemental measures to enhance duodenoscope reprocessing: FDA safety communication [Internet]","year":"c2015"},{"key":"ref5","volume-title":"522 Postmarket Surveillance Studies Database [Internet]","year":"c2016"},{"key":"ref6","volume-title":"522 Postmarket Surveillance Studies Database [Internet]","year":"c2016"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-315082"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.04.036"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2019.12.050"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2018.02.016"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.07.057"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2018.02.015"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2016.01.055"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-122378"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.06.052"},{"key":"ref16","volume-title":"","author":"Higgins","year":"c2011"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-010-9491-z"},{"key":"ref19","volume-title":"Duodenoscope Surveillance Sampling and Culturing Protocols [Internet]","year":"c2018"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.03.017"},{"key":"ref22","volume-title":"The FDA continues to remind facilities of the importance of following duodenoscope reprocessing instructions: FDA safety communication [Internet]","year":"c2019"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100451"},{"key":"ref24","volume-title":"The FDA is Recommending Transition to Duodenoscopes with Innovative Designs to Enhance Safety: FDA Safety Communication [Internet]","year":"c2019"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.03.001"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2019.08.032"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-321836"}],"container-title":["Clinical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-ce.org\/upload\/pdf\/ce-2021-212.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-ce.org\/journal\/view.php?doi=10.5946\/ce.2021.212","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-ce.org\/upload\/pdf\/ce-2021-212.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T04:39:32Z","timestamp":1644208772000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-ce.org\/journal\/view.php?doi=10.5946\/ce.2021.212"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,31]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"URL":"https:\/\/doi.org\/10.5946\/ce.2021.212","relation":{},"ISSN":["2234-2400","2234-2443"],"issn-type":[{"value":"2234-2400","type":"print"},{"value":"2234-2443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,31]]},"assertion":[{"value":"2021-08-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-03","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-31","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}