Evaluation of the Risk of Transmission of Bacterial Biofilms and Clostridium difficile During Gastrointestinal Endoscopy

Recent attention has focused on the potential for the transmission of bacterial biofilms, Clostridium difficile, and other types of pathogenic spore-forming bacteria during gastrointestinal (GI) endoscopy. This study investigates whether GI endoscopy is a risk factor for the transmission of bacterial biofilms and the endospores or vegetative cells of pathogenic spore-forming bacteria including C. difficile. The medical literature was reviewed to evaluate the risk of the transmission of these infectious agents during GI endoscopy. No cases of a GI endoscope transmitting the endospores or vegetative cells of C. difficile or another type of pathogenic spore-forming bacterium were identified during this review. Also, no studies were identified during this review that document a case of infection causally linked to a bacterial biofilm that formed on the internal surfaces of and was transmitted by a GI endoscope that was reprocessed in accordance with currently accepted and well-established reprocessing standards. Gastrointestinal endoscopy is not reported to be a risk factor for the transmission of bacterial biofilms, C. difficile, or the endospores (and vegetative cells) of any other type of pathogenic spore-forming bacterium (or any type of infectious agent). Strict adherence to currently accepted and well-established reprocessing standards is necessary to prevent transmission of biofilms, C. difficile, and other infectious agents during GI endoscopy.