Superbugs & Endoscopy

“The most comprehensive series of articles ever written about the risk of ‘superbug’ outbreaks during gastrointestinal endoscopy.”

“The series that started the national discussion about the risk of ‘superbug’ infections following GI endoscopy.”


Click here to read a free copy of Dr. Muscarella’s peer-reviewed article, which foresaw the deadly outbreaks that soon followed:

  • Risk of transmission of carbapenem-resistant Enterobacteriaceae and related ‘superbugs’ during gastrointestinal endoscopy” (World J Gastrointest Endosc 2014; 6[10]:457-474).

The following series of more than two dozen articles by Dr. Muscarella discuss a number of recent outbreaks of “CRE” — or, carbapenem-resistant Enterobacteriaceae — following gastrointestinal (GI) endoscopy:

1. Executive Summary: “‘Updated’ Guidance for the Prevention of Multidrug-Resistant ‘Superbugs’ Following Endoscopy” [Free temporarily]

2. “FDA Recalls All Custom Ultrasonics System 83 Plus Automated Endoscope Reprocessors” [Free temporarily]

3.A ‘Trickle-Down Effect’: The Potential Impact of the FDA’s Warning About Endoscope Safety on Automated Endoscope Reprocessors” [Free temporarily]

4. Contaminated Bronchoscopes Linked in 2014 to A Potential ‘Superbug’ Outbreak: An Under-recognized Risk?” [Free temporarily]

5. “FDA Investigation of ‘Superbug’ Outbreaks Now Includes Automated Endoscope Reprocessors

6.FDA Orders Endoscope Manufacturers to Preform Safety Studies

7.Risk of “Superbug” Outbreaks Linked to Two Types of Gastrointestinal Endoscopes: Pittsburgh (PA), 2012

8. A ‘Test-and-Hold’ Surveillance Policy to Prevent ‘Superbug’ Infections Following Endoscopy

9.Wrongful Death Suit Blames a Chicago-Area Hospital and Endoscope Manufacturer for a Fatal ‘Superbug’ Infection

10. Deadly ‘Superbug’ Outbreak Linked to GI Endoscopes At UCLA’s Ronald Reagan Medical Center

11.Another Potentially Deadly ‘Superbug’ Outbreak Suspected at a Pasadena Hospital

12. FDA Warns Three Endoscope Manufacturers for Safety Violations Following Deadly ‘Superbug’ Outbreaks

13.Four Types of Medical Endoscopes Now Linked to Deadly ‘Superbug’ Infections

14. “A 2015 Outbreak of CRE in North Carolina: Were Contaminated Duodenoscopes to Blame?

15. Congressman Lieu Asks Questions of Endoscope Manufacturers in the Wake of Several Deadly ‘Superbug’ Outbreaks

16.Considerations Not Addressed in the FDA’s Communication Discussing Olympus’ New Instructions for Reprocessing the TJF-Q180V Duodenoscope

17.Important Lessons Taught by Recent ‘Superbug’ Outbreaks Linked to GI Endoscopes

18. Superbugs, Contaminated Gastrointestinal Endoscopes, and a Growing Number of Hospital Infections: Is an FDA Action Imminent?

19.Questions the FDA May Soon Address in Response to Recent ‘Superbug’ Outbreaks Linked to GI Endoscopes” 

20.At Least Seven Deaths Linked to GI Endoscopes in Seattle: Start of a National Discussion

21.Alert: Association of GI Endoscopy with Two Patient Deaths: Illinois, 2013

22.  Multiple CRE Outbreaks Linked to Contaminated Endoscopes in the U.S and Europe: Has a Smoking Gun been Found?

23. “Overlooked Outbreaks of the Superbug ‘CRE’ Following Gastrointestinal Endoscopy: An Epidemic in Our Midst?

24. GI Endoscopy: Pushed Beyond its Reprocessing Limits?” — click here. [2013]

25. Response to a News Report about a ‘Superbug’ Outbreak in 2013 at an Illinois Hospital

26. Investigation and Prevention of Bacterial Outbreaks during Endoscopic Retrograde Cholangiopancreatography

27. Early Identification and Control of Carbapenemase-Producing Klebsiella pneumoniae Originating from a Contaminated GI Endoscope

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