A Comprehensive Review of Digestive Endoscopy-Associated Infections : Bacterial Pathogens, Host Susceptibility, and the Impact of Viral Hepatitis
(2025) In Microorganisms 13(9).- Abstract
Gastrointestinal (GI) interventional endoscopy has evolved into a cornerstone of modern gastroenterology, offering minimally invasive solutions for complex conditions. However, these procedures are not without risk, particularly with respect to post-procedural infections. While rare, such infections can have significant clinical consequences and are increasingly recognized as a public health concern. This narrative review provides a comprehensive overview of infections associated with GI endoscopy, focusing on transmission mechanisms, microbial agents involved, host susceptibility, preventive strategies, and diagnostic and therapeutic approaches. Infections following GI endoscopy remain infrequent but clinically significant,... (More)
Gastrointestinal (GI) interventional endoscopy has evolved into a cornerstone of modern gastroenterology, offering minimally invasive solutions for complex conditions. However, these procedures are not without risk, particularly with respect to post-procedural infections. While rare, such infections can have significant clinical consequences and are increasingly recognized as a public health concern. This narrative review provides a comprehensive overview of infections associated with GI endoscopy, focusing on transmission mechanisms, microbial agents involved, host susceptibility, preventive strategies, and diagnostic and therapeutic approaches. Infections following GI endoscopy remain infrequent but clinically significant, particularly in high-risk procedures such as endoscopic retrograde cholangiopancreatography and endoscopic ultrasound. Duodenoscopes represent a major vector for exogenous infection, often involving multidrug-resistant bacteria such as Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus spp. Host-related factors increase the risk of infection. Risk factors associated with post-endoscopic infections include advanced age, male sex, non-white ethnicity, immunosuppression, presence of cholangiocarcinoma, autoimmune diseases, liver cirrhosis of viral and/or alcoholic etiology, chronic kidney disease, high-risk cardiac conditions, or chemotherapy. New reprocessing methods, such as ethylene oxide gas sterilization, automated endoscope reprocessors, and selective use of single-use endoscopes and duodenoscopes, may contribute to lowering infection rates. Greater awareness of infection risks, improved infection control practices, and adherence to updated guidelines are crucial for enhancing patient safety in digestive endoscopy. Multidisciplinary strategies, including surveillance, device innovation, and personalized risk assessment, are needed to address this evolving challenge.
(Less)
- author
- author collaboration
- organization
- publishing date
- 2025-09
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- antibiotic prophylaxis, endoscope reprocessing, endoscopic ultrasound, endoscopy-associated infections, ERCP, MDR, viral hepatitis
- in
- Microorganisms
- volume
- 13
- issue
- 9
- article number
- 2128
- publisher
- MDPI AG
- external identifiers
-
- scopus:105026460787
- pmid:41011458
- ISSN
- 2076-2607
- DOI
- 10.3390/microorganisms13092128
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2025 by the authors.
- id
- 3347a977-7d3f-45c1-ba2e-7bdbb3e892b8
- date added to LUP
- 2026-02-23 16:45:09
- date last changed
- 2026-08-12 18:46:06
@article{3347a977-7d3f-45c1-ba2e-7bdbb3e892b8,
abstract = {{<p>Gastrointestinal (GI) interventional endoscopy has evolved into a cornerstone of modern gastroenterology, offering minimally invasive solutions for complex conditions. However, these procedures are not without risk, particularly with respect to post-procedural infections. While rare, such infections can have significant clinical consequences and are increasingly recognized as a public health concern. This narrative review provides a comprehensive overview of infections associated with GI endoscopy, focusing on transmission mechanisms, microbial agents involved, host susceptibility, preventive strategies, and diagnostic and therapeutic approaches. Infections following GI endoscopy remain infrequent but clinically significant, particularly in high-risk procedures such as endoscopic retrograde cholangiopancreatography and endoscopic ultrasound. Duodenoscopes represent a major vector for exogenous infection, often involving multidrug-resistant bacteria such as Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus spp. Host-related factors increase the risk of infection. Risk factors associated with post-endoscopic infections include advanced age, male sex, non-white ethnicity, immunosuppression, presence of cholangiocarcinoma, autoimmune diseases, liver cirrhosis of viral and/or alcoholic etiology, chronic kidney disease, high-risk cardiac conditions, or chemotherapy. New reprocessing methods, such as ethylene oxide gas sterilization, automated endoscope reprocessors, and selective use of single-use endoscopes and duodenoscopes, may contribute to lowering infection rates. Greater awareness of infection risks, improved infection control practices, and adherence to updated guidelines are crucial for enhancing patient safety in digestive endoscopy. Multidisciplinary strategies, including surveillance, device innovation, and personalized risk assessment, are needed to address this evolving challenge.</p>}},
author = {{Günșahin, Deniz and Șandru, Vasile and Constantinescu, Gabriel and Ilie, Mădălina and Cabel, Teodor and Popescu, Ramona Ștefania and Ungureanu, Bogdan Silviu and Miron, Victor Daniel and Balan, Gheorghe G. and Cotigă, Diana and Miutescu, Bogdan and Özkaya Şahin, Gülşen and Săndulescu, Oana}},
issn = {{2076-2607}},
keywords = {{antibiotic prophylaxis; endoscope reprocessing; endoscopic ultrasound; endoscopy-associated infections; ERCP; MDR; viral hepatitis}},
language = {{eng}},
number = {{9}},
publisher = {{MDPI AG}},
series = {{Microorganisms}},
title = {{A Comprehensive Review of Digestive Endoscopy-Associated Infections : Bacterial Pathogens, Host Susceptibility, and the Impact of Viral Hepatitis}},
url = {{http://dx.doi.org/10.3390/microorganisms13092128}},
doi = {{10.3390/microorganisms13092128}},
volume = {{13}},
year = {{2025}},
}