ECRI Institute advises on duodenoscope infection risk


ECRI Institute, a nonprofit that researches the best approaches to improving patient care, has issued a High Priority Hazard Report with recommendations to help reduce the risk of infections related to Endoscopic Retrograde Cholangiopancreatography (ERCP).

The hard-to-clean scopes are used to diagnose and treat a variety of conditions of the gall bladder and pancreas and are linked to of patient deaths caused by outbreaks of carbapenem-resistant Enterobacteriaceae (CRE) infections.

Scope culturing is a key step in reducing the risk of CRE infections, according to the report. The Hazard Report is free to the healthcare professional community at

“Our recommendations call for timely action and executive level attention,” said Dr Jeffrey Lerner, president and chief executive officer, ECRI Institute. “They will likely require additional costs and changes in workflow and processes.”

The report details ECRI’s recommendations on baseline and surveillance culturing. It recommends that hospitals consider instituting regular CRE surveillance through duodenoscope culturing regardless of which reprocessing method they use. Implementing surveillance culturing properly will not be trivial, but will provide a means to monitor duodenoscopes for CRE, say ECRI’s experts.

“Minimizing the risk of infections associated with ERCP scopes is extremely difficult and it will take multiple approaches to reduce the likelihood of contamination,” said James Keller, vice president of health technology evaluation and safety, ECRI Institute.

ECRI, Risk Management, ERCP, High Priority Hazard Report, Dr Jeffrey Lerner, James Keller, US