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Endoscopes: Does Disinfecting Absolutely Ensure Cleanliness?

A Missouri-based story does not yet prominently feature alongside other recent tales concerning frightening outcomes associated with endoscope use.

In time, though, that could change.

A “deadly pattern of illnesses” was recently noted in a media expose concerning the use of so-called duodenoscopes that are inserted down patients’ throats to probe for digestive disorders such as gallstones and cancerous tumors.

The use of scopes for that purpose is widely acknowledged as beneficial in a high number of cases, with the U.S. Food and Drug Administration noting the scopes’ “lifesaving” ability.

That efficacy in treatment has been tempered by a heavy price in some cases, though, as noted by a number of commentators who point to strong concerns regarding the difficulty with which some deadly strains of bacteria resist post-use disinfection efforts. Duodenoscopes are multi-use medical tools, and the implications for adverse medical outcomes are frighteningly clear when their disinfection efforts fail.

And they are failing, in a number of documented instances. In fact, outbreaks of endoscope-acquired bacteria have been traced to several hospitals across the country. Seven fatalities were associated with tainted scopes used in Seattle, and the presence of an especially virulent bacterial strain known as CRE was detected at hospitals in Chicago and elsewhere.

Such occurrences have triggered alarm bells, with the national Centers for Disease Control and Prevention issuing a warning last year and several infectious-disease specialists pointing to a tardy and even lackadaisical response from the FDA on the matter.

Duodenoscopes are intricately designed and difficult to clean. The FDA is consulting with scope manufacturers on possible design changes, and the agency state that a close examination of disinfection processes will be a high regulatory priority this year.