Anesthesiologists provide anesthesia for numerous endoscopy procedures. They also perform bronchoscopy and other endoscopies. There are recent developments in mitigating endoscopy-associated infections.

Carbapenem-resistant Enterobacteriaceae (CRE) infections, which are resistant to multiple antibiotics, have been traced to duodenal endoscopy, cystoscopy, and ureteroscopy (Am J Infect Control 2016;44:1032-6). These cases had all followed standard disinfection protocols. The outbreaks were traced to difficulty sterilizing complex shapes or materials, such as the hinge of side-viewing duodenoscopes.

As a result of these outbreaks, new sterilization standards have been published by the American National Standards Institute (ANSI)/Association for the Advancement of Medical Instrumentation (AAMI) (ANSI/AAMI ST91:2021; Additionally, the FDA and the CDC published new surveillance antimicrobial surveillance guidelines (

The FDA recommends transitioning to fully disposable duodenoscopes (Clin Gastroenterol Hepatol 2020;18:2108-2117) or using endoscopes with disposable components.

This guidance includes developing schedules for routine inspection and...

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