40 WORLD GASTROENTEROLOGY NEWS JANUARY 2016 Gastro 2015: AGW-WGO | Expert Point of View | Gastro 2016: EGHS-WGO | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events WGO Guidelines Endoscope Disinfection 2016 Update At the Gastro 2015: AGW-WGO In-ternational Congress in September and October 2015 in Brisbane, Australia, the recent disinfection problems with certain endoscopes was a topic of discus-sion in the session on guidelines. The current WGO Endoscope Disinfection guideline, co-written with the World Endoscopy Organization in 2011, focuses on general disinfection procedures based on available resources through a cascade approach. It does not specifically mention issues with duodenoscopes or the recent documentation of infection transmission in multiple countries. We spoke with Professor David Bjorkman, President of the World Gastroenterology Organisation (WGO) and a co-author of the current WGO guideline on endo-scope disinfection. “While the most recent outbreaks of serious infections after gastro-, duodeno-, and bronchoscopy started in 2012 and the Dutch National Institute of Public Health and Envi-ronment commissioned a report into the outbreak at the Erasmus Hospital in Rotterdam, authorities in France and Germany have also investigated outbreaks. Similar documented infec-tion transmissions in the USA have prompted responses from American gastroenterology societies and a hear-ing by the U.S. Food and Drug Ad-ministration. The Gastroenterological Society of Australia has also distrib-uted information to their members on this issue. At the meeting in Brisbane the discussion concluded that infected material may remain after standard disinfection. It is also clear that there is still a lack of quality data for regula-tory bodies and advisory panels to make recommendations. At the meeting during our World Congress an update on the current evidence was presented and there was extensive discussion by the experts. Dr. Michelle Alfa from Canada presented data on the frequency of in-fectious material found in endoscopes after disinfection and emphasized the importance of how endoscopes are dried and stored. Dr. Tony Speer from Australia pointed out the important role of the endoscope design to allow easy cleaning and disinfection. We anticipate that the information pre-sented and the discussion will inform WGO’s addendum to the guideline in cooperation with other societies, such as the Australian society. This is clearly a worldwide issue that requires better information to make meaningful recommendations, including potential changes in the de-sign of endoscopes. We need to work with Member Societies and others to provide guidance to our Members. We are considering an addendum to our current guideline that could communicate the current status and what further steps should be taken to provide both short-term and long-term recommendations. In the long-term a new endoscope design may be needed, and we hope the industry will join efforts to deal with this serious problem.” Anton LeMair, MD WGO Guidelines Project Amsterdam, The Netherlands
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