Prevalence of Carbapenemase-producing organisms (CPO) colonization before and after endoscopic retrograde cholangiopancreatography (ERCP): A prospective observational study.

INTRODUCTION

Risk of transmission of carbapenemase-producing organisms (CPO) from duodenoscopes has been widely described and is now considered a well-known threat. Data on infection rates are limited to case series and confined to the setting of infection outbreaks. To date, data on universal screening for multidrug-resistant microorganisms of patients referring to the Endoscopy service are extremely scant.

AIM: to evaluate the overall incidence of CPO colonization after endoscopic retrograde cholangiopancreatography (ERCP).

METHODS

All consecutive patients undergoing ERCP at our Service were evaluated. All enrolled patients underwent rapid rectal swab for KPC genes 2-24 h before the endoscopic procedure, with Xpert Carba-R rapid detection swabs. 72 h after ERCP, patients underwent a second rapid rectal swab for CPO.

RESULTS

from July 2022 to 15th November 2023 539 patients referring to the Endoscopy Unit for ERCP were evaluated. Of these, 16 had already a known colonization for MDR. The other 523 patients were screened: 10 resulted positive for CPO. Of the remaining 513 patients, 355 underwent post-procedural swab, and 9 (2,5 %) had a rectal colonization from CPO.

CONCLUSIONS

duodenoscope-related infections are an open issue. Routine screening with anal swabs could provide early recognition of infection outbreaks and identification of high-risk cases to drive proper resource allocation.