ArticleEClinicalMedicine2020
Rate and impact of duodenoscope contamination: A systematic review and meta-analysis.
Article in EClinicalMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Prophylactic Antibiotics Reduce Infectious Complications After ERCP in Patients with Suspected Biliary Obstruction: A Meta-Analysis of Randomized Controlled Trials.Digestive diseases and sciences · 2026Pooled it
- [A systematic analysis of nosocomial outbreaks of nosocomial infections after gastrointestinal endoscopy].Zeitschrift fur Gastroenterologie · 2023Pooled it
- Gastrointestinal Endoscopy-Associated Infections: Update on an Emerging Issue.Digestive diseases and sciences · 2022Pooled it
- Technical and clinical feasibility of single-use gastroscopy with real-time AI-based quality monitoring and single-use colonoscopy: a prospective two-center study.Biomedical engineering online · 2026Trial
- Efficacy of duodenoscope with disposable distal cap in reducing microbial contamination: A systematic review and meta-analysis.World journal of methodology · 2026Article
- Implementation and assessment of a postreprocessing endoscope surveillance program at the University of Kentucky, 2019-2024.Infection control and hospital epidemiology · 2026Article
- Comprehensive Review of How Endoscope Channel Biofilm Differs from Hydrated and Dry Surface Biofilm and Its Implications.Endoscopy international open · 2026Review
- Single pediatric center experience with single-use duodenoscopes.Frontiers in pediatrics · 2026Article
- Preprocedural screening for multidrug-resistant organisms in endoscopic retrograde cholangiopancreatography: an international, multicentre, cross-sectional observational study.EClinicalMedicine · 2025Article
- Advancing Duodenoscope Reprocessing with Alginate-Coated Calcium Peroxide Nanoparticles.Life (Basel, Switzerland) · 2025Article
- Current status and trends of green endoscopy.Clinical endoscopy · 2025Review
- Efficacy and safety of single use duodenoscopes in comparison to reusable duodenoscopes for endoscopic retrograde cholangiopancreatography: A single center experience.World journal of gastrointestinal endoscopy · 2025Article
- Article
- A prospective, quasi-experimental study on the efficacy of a novel double-headed endoscope cleaning brush for cleaning flexible endoscopes.BMC gastroenterology · 2025Article
- Unfavorable microbiological impact of directly duodenal biliary drainage in patients with perihilar obstruction: a preliminary report.Frontiers in surgery · 2025Article
- From Screening to Strategy: Targeted Carbapenem-Resistant Enterobacteriaceae (CRE) Infection Prediction After Endoscopic Retrograde Cholangiopancreatography (ERCP).Infection and drug resistance · 2025Article
- Article
- Green endoscopy, one step toward a sustainable future: Literature review.Endoscopy international open · 2024Review
- Costs involved in compliance with new endoscope reprocessing guidelines.Clinical endoscopy · 2024Article
- Uncovering the spread of drug-resistant bacteria through next-generation sequencing based surveillance: transmission of extended-spectrum β-lactamase-producing Enterobacterales by a contaminated duodenoscope.Antimicrobial resistance and infection control · 2024Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMultiple infection outbreaks have been linked to contaminated duodenoscopes worldwide. However, the contamination rate of patient-ready duodenoscopes varies highly amongst published studies testing this subject. We aimed to estimate the contamination rate of reprocessed patient-ready duodenoscopes for endoscopic retrograde cholangio-pancreatography (ERCP) based on currently available data.
methodsWe searched the PubMed and Embase databases from January 1, 2010 until March 10, 2020, for citations investigating contamination rates of reprocessed patient-ready duodenoscopes. Studies not assessing other types of endoscopes than duodenoscopes were excluded from the analysis. Study eligibility and data extraction was evaluated by three reviewers independently. A random-effects model (REM) based on the proportion distribution was used to calculate the pooled total contamination rate of reprocessed patient-ready duodenoscopes. Subgroup analyses were carried out to assess contamination rates when using different reprocessing methods by comparing single high-level disinfection (HLD) with double HLD and ethylene oxide (EtO) gas sterilization. Additionally, we investigated the contamination rate between studies conducted following an outbreak compared to non-outbreak-initiated studies.
findingsWe identified 15 studies that fulfilled the inclusion, which included 925 contaminated duodenoscopes from 13,112 samples. The calculated total weighted contamination rate was 15.25% ± 0.018 (95% confidence interval [Cl]: 11.74% - 18.75%). The contamination rate after only using HLD was 16.14% ± 0.019 (95% Cl: 12.43% - 19.85%) and after using either dHLD or EtO the contamination rate decreased to 9.20% ± 0.025 (95% Cl: 4.30% - 14.10%). Studies conducted following an outbreak (n=4) showed a 5.72% ± 0.034 (95% Cl: 0.00% - 12.43%) contamination rate, and non-outbreak-initiated studies (n=11) revealed a contamination rate of 21.50% ± 0.031 (95% Cl: 15.35% - 27.64%).
interpretationThis is the first meta-analysis to estimate the contamination rate of patient-ready duodenoscopes used for ERCP. Based on the available literature, our analysis demonstrates that there is a 15.25% contamination rate of reprocessed patient-ready duodenoscopes. Additionally, the analysis indicates that dHLD and EtO reprocessing methods are superior to single HLD but still not efficient in regards to cleaning the duodenoscopes properly. Furthermore, studies conducted following an outbreak did not entail a higher contamination rate compared to non-outbreak-initiated studies.
fundingThe authors received no financial support for the research, authorship, and/or publication of this article.
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