Medical journal: Endosc Int Open 2015; 03: E259–E265.

Author affiliations:

  1. Albert Schweitzer Hospital, Department of Infection Prevention and Control, Dordrecht, Netherlands.
  2. Albert Schweitzer Hospital, Department of Medical Microbiology, Dordrecht, Netherlands.
  3. Rivierenland Hospital, Department of Infection Prevention and Control, Tiel, Netherlands.
  4. Canisius-Wilhelmina Hospital, Department of Medical Microbiology, Nijmegen, Netherlands ; Radboud University Medical Centre, Nijmegen, NL.

This article places important focus on disease transmissions due to bronchoscopes, providing a table of eight publications in which damaged bronchoscopes were involved in infections.

As pointed out in September (2015) by Bloomberg Business, my research and writings were the first to bring to the public’s attention (two months before the FDA) of the potential for bronchoscopes (and both cystoscopes and ureteroscopes) — not just duodenoscopes — to transmit deadly CRE during a flexible endoscopic procedure.

Automated endoscope reprocessors, or AERs, are also discussed in this article.


Quality and Safety Services and Case Reviews for Hospitals, Manufacturers, Patients: Click here to read about Dr. Muscarella’s quality and safety services committed to reducing the risk of healthcare-associated infections, including CRE outbreaks linked to contaminated endoscopes and other reusable medical equipment.


Flexible endoscopes are widely used to examine, diagnose, and treat medical disorders. While the risk of endoscopy-related transmission of infection is estimated to be very low, more health care-associated infections are related to contaminated endoscopes than to any other medical device. Flexible endoscopes can get highly contaminated with microorganisms, secretions and blood during use. The narrow lumens and multiple internal channels make the cleaning of flexible endoscopes a complex and difficult task. Despite the availability of international, national and local endoscope reprocessing guidelines, contamination and transmission of microorganisms continue to occur. These transmissions are mostly related to the use of defective equipment, endoscope reprocessing failures, and noncompliance with recommended guidelines. This article presents an overview of publications about case reports and outbreaks related to contamination of flexible endoscopes.

Posting by Lawrence F Muscarella, PhD on September 29, 2015, Rev A.

Email:; Twitter: @MuskiePhD

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