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Although multisociety guidelines detail steps for reliable, high-level disinfection (Gastrointest Endosc 2011; 73:1075), inadequately disinfected endoscopes have previously caused clusters of infections.
In a recent investigation of a single-hospital outbreak of carbapenem-resistant Enterobacteriaceae (CRE) producing New Delhi metallo-β-lactamase (NDM) — a pathogen that is rare in the U.S. and marked by high mortality and limited treatment options — the 39 infected patients had all been exposed to a duodenoscope, and 35 had been exposed to a single duodenoscope. An NDM-producing Escherichia coli strain identical to the patients' pathogen was recovered from this duodenoscope even after reprocessing.
A careful analysis identified no lapses in m…