GI Unit Leadership: Optimizing Endoscopy Operations through Leadership (Virtual) | February 2025-ASGE guideline

ASGE guideline_infection control in GI endoscopy

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The American Society for Gastrointestinal Endoscopy (ASGE) has updated its guidelines for infection control during gastrointestinal (GI) endoscopy, reflecting recent insights into infection risks and control practices. This revision, led by the ASGE Quality Assurance in Endoscopy Committee, revises the original 2008 guidelines by incorporating findings from recent medical literature and expert consultations.<br /><br />GI endoscopies are common procedures, but instances of infection remain rare. However, infections linked to multidrug-resistant organisms, particularly with duodenoscope use, highlight the need to reassess infection control practices. These instruments, used in endoscopic retrograde cholangiopancreatography (ERCP), present specific challenges due to their complex design, which complicates effective cleaning and disinfection.<br /><br />The guideline focuses on minimizing infections transmitted through endoscopy, suggesting stringent reprocessing of endoscopes. This includes mechanical cleaning, high-level disinfection (HLD), rinsing, and drying. The ASGE emphasizes adherence to established protocols and enhanced training for personnel handling these instruments. The importance of leadership in ensuring adherence to these guidelines is underscored, with recommended routine assessments of reprocessing efficacy and reporting any reprocessing failures or associated infections.<br /><br />The document acknowledges various modes of transmission, including patient-to-patient infection, non-endoscopic transmission through improper equipment use, and potential staff infections from patient contact. It addresses the low to non-existent risk of viral transmission through endoscopes when guidelines are followed. Special considerations are noted for multi-drug resistant organisms associated with duodenoscopes and other complex endoscopes.<br /><br />Emphasis is placed on proper use, training, and assessment of infection control procedures, alongside routine monitoring. The guideline highlights the role of institutional leadership in implementing and enforcing infection control standards to ensure high-quality, safe care in endoscopic procedures. The goal is to improve endoscopy safety through strict adherence to updated reprocessing and infection prevention protocols.

Keywords

ASGE guidelines

infection control

GI endoscopy

multidrug-resistant organisms

duodenoscope

endoscopic retrograde cholangiopancreatography

reprocessing protocols

high-level disinfection

infection prevention

endoscopy safety