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ERCP Side Effects: Superbugs Lead to Severe Illness

Terri Ackerman

Last updated: October 20, 2016 7:20 pm

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Researchers from Public Health England and the University of Edinburgh, among others, have discovered that around 30 years ago in the United Kingdom a strain of E. coli evolved to be able to become a “potentially fatal infection” when it “acquired a powerful toxin.” Their findings shed light on a series of severe food poisoning outbreaks that arose in the 1980s. 1

The startling results suggest that E. coli O157 is evolving and needs to be closely monitored. Although most strains of E. coli are found naturally in the intestines of both people and animals without causing harm, some strains are associated with serious human infections. The U.K. study also revealed that predecessors of E. coli O157 have been in existence since the mid-1800s. 2

For decades we’ve been able to count on antibiotics to kill bacteria that cause a variety of medical conditions and illnesses. Currently, however, we’re living in a time when certain bacteria have become resistant to today’s medications. 3

These new superbugs create ever-growing challenges for medical professionals. Superbugs are strains of bacteria that are resistant to several types of antibiotics.  “Every year these drug-resistant bacteria infect more than 2 million people nationwide and kill at least 23,000, according to the U.S. Centers for Disease Control and Prevention (CDC).” 4

“Drug-resistant forms of tuberculosis, gonorrhea, and staph infections are just a few of the dangers we now face.” 5 Researchers have been doing their best to stay at least one step ahead of these newly emerging superbug bacteria by manufacturing new drugs. 6

Antibiotic-Resistant Bacteria Transferred Through Duodenoscopes

According to the U.S. Food and Drug Administration (FDA), health care professionals need to use caution when using, cleaning, disinfecting, and sterilizing ERCP duodenoscopes, 7 which are endoscopic retrograde cholangiopancreatography (ERCP) endoscopes.

These reusable devices are used in the more than 500,000 procedures of the digestive tract performed each year in the U.S.  The procedure is the least invasive way of draining fluids from pancreatic and biliary ducts blocked by cancerous tumors, gallstones or other conditions. The intricate design of duodenoscopes presents challenges for cleaning and sterilizing all of their parts. 8

“In fall 2013, the Centers for Disease Control and Prevention (CDC) alerted the FDA to a potential association between multi-drug resistant bacteria and duodenoscopes. Upon further investigation, it became clear that these cases of infection were occurring despite confirmation that the users were following proper manufacturer cleaning and disinfection or sterilization instructions.” 9

FDA Warning of ERCP Procedure Complications

If duodenoscopes are not completely sterilized, tiny amounts of microbial-contaminated fluids or tissues may be left behind and then transmitted to other patients. One of the most serious ERCP procedure complications is the spread of serious infections that do not respond well to antibiotics. 10

From January 2013 through December 2014, the FDA received 75 reports of approximately 135 patients in the U.S. possibly involving “microbial transmission” from duodenoscopes that had not been thoroughly and completed disinfected in spite of healthcare providers “following proper manufacturer cleaning and disinfection or sterilization instructions.” 11

The FDA has provided health care professionals with a detailed list of additional duodenoscope “reprocessing measures.” 12

Patients who have undergone these types of procedures and have been ill may want to learn more about duodenoscopes and the possible risks associated with the use of this device.

  1. http://phys.org/news/2015-09-superbug-reveals-coli-strain-deadly.html 

  2. http://phys.org/news/2015-09-superbug-reveals-coli-strain-deadly.html  

  3. https://newsinhealth.nih.gov/issue/feb2014/feature1 

  4. https://newsinhealth.nih.gov/issue/feb2014/feature1; http://phys.org/news/2015-09-superbug-reveals-coli-strain-deadly.html 

  5. https://newsinhealth.nih.gov/issue/feb2014/feature1  

  6. https://newsinhealth.nih.gov/issue/feb2014/feature1 

  7. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ReprocessingofReusableMedicalDevices/ucm454630.htm 

  8. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm434871.htm 

  9. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm434871.htm 

  10. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm434871.htm 

  11. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm434871.htm

  12. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ReprocessingofReusableMedicalDevices/ucm454630.htm