The Experts below are selected from a list of 279 Experts worldwide ranked by ideXlab platform
Petra Gastmeier - One of the best experts on this subject based on the ideXlab platform.
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An outbreak of carbapenem-resistant OXA-48 - producing Klebsiella pneumonia associated to Duodenoscopy.
Antimicrobial resistance and infection control, 2015Co-Authors: Axel Kola, Brar Piening, Ulrich-frank Pape, Wilfried Veltzke-schlieker, Martin Kaase, Christine Geffers, Bertram Wiedenmann, Petra GastmeierAbstract:Carbapenemase-producing Enterobacteriaceae (CPE) have become a major problem for healthcare systems worldwide. While the first reports from European hospitals described the introduction of CPE from endemic countries, there is now a growing number of reports describing outbreaks of CPE in European hospitals. Here we report an outbreak of Carbapenem-resistant K. pneumoniae in a German University hospital which was in part associated to Duodenoscopy. Between December 6, 2012 and January 10, 2013, carbapenem-resistant K. pneumoniae (CRKP) was cultured from 12 patients staying on 4 different wards. The amplification of carbapenemase genes by multiplex PCR showed presence of the bla OXA-48 gene. Molecular typing confirmed the identity of all 12 isolates. Reviewing the medical records of CRKP cases revealed that there was a spatial relationship between 6 of the cases which were located on the same wards. The remaining 6 cases were all related to endoscopic retrograde cholangiopancreatography (ERCP) which was performed with the same duodenoscope. The outbreak ended after the endoscope was sent to the manufacturer for maintenance. Though the outbreak strain was also disseminated to patients who did not undergo ERCP and environmental sources or medical personnel also contributed to the outbreak, the gut of colonized patients is the main source for CPE. Therefore, accurate and stringent reprocessing of endoscopic instruments is extremely important, which is especially true for more complex instruments like the duodenoscope (TJF Q180V series) involved in the outbreak described here.
Shing-kao Yueh - One of the best experts on this subject based on the ideXlab platform.
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double balloon enteroscopy application in biliary tract disease its therapeutic and diagnostic functions
Gastrointestinal Endoscopy, 2008Co-Authors: Yenchang Chu, Chi-chieh Yang, Chien-hua Chen, Yunghsiang Yeh, Shing-kao YuehAbstract:Background On occasion, it is impossible to perform ERCP with a traditional duodenoscope in patients who have had a Billroth II gastrectomy or hepatojejunostomy, and who now have biliary tract problems. Repeat surgery is not a suitable course of action in these patients. Therefore, finding alternative modalities to resolve these obstructions is of great importance. Objective To report successful endoscopic examination and treatment of difficult biliary obstructions by using double-balloon enteroscopy. Patients Five patients. Design Cases series. Intervention Double-balloon enteroscopy (DBE) for biliary tract examination and treatment. Results We report on 5 patients who underwent Billroth II gastrectomy or biliary tract Roux-en-Y surgery and who later had biliary tract obstruction from various causes. We were unable to perform ERCP with traditional Duodenoscopy but successfully completed ERCP with DBE. DBE was originally designed to examine the small intestine. The successful biliary tract cannulation rate when using DBE is lower than with duodenoscope. We performed ERCP by using DBE a total of 5 times, with a successful biliary cannulation rate of 60%. We performed a special-method papillotomy in 2 patients. This method entailed inserting an electric sphincterotome through the percutaneous transhepatic cholangiography and drainage (PTCD) route after performing DBE intubation to the ampulla of Vater. We then successfully completed a papillotomy with an electric sphincterotome under DBE guidance. Conclusions DBE appears to be a promising alternative in the examination and treatment of biliary tract disease in patients after GI operations such as Billroth II gastrectomy and choledochojejunostomy.
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Double-balloon enteroscopy application in biliary tract disease—its therapeutic and diagnostic functions
Gastrointestinal Endoscopy, 2008Co-Authors: Chi-chieh Yang, Chien-hua Chen, Shing-kao YuehAbstract:Background On occasion, it is impossible to perform ERCP with a traditional duodenoscope in patients who have had a Billroth II gastrectomy or hepatojejunostomy, and who now have biliary tract problems. Repeat surgery is not a suitable course of action in these patients. Therefore, finding alternative modalities to resolve these obstructions is of great importance. Objective To report successful endoscopic examination and treatment of difficult biliary obstructions by using double-balloon enteroscopy. Patients Five patients. Design Cases series. Intervention Double-balloon enteroscopy (DBE) for biliary tract examination and treatment. Results We report on 5 patients who underwent Billroth II gastrectomy or biliary tract Roux-en-Y surgery and who later had biliary tract obstruction from various causes. We were unable to perform ERCP with traditional Duodenoscopy but successfully completed ERCP with DBE. DBE was originally designed to examine the small intestine. The successful biliary tract cannulation rate when using DBE is lower than with duodenoscope. We performed ERCP by using DBE a total of 5 times, with a successful biliary cannulation rate of 60%. We performed a special-method papillotomy in 2 patients. This method entailed inserting an electric sphincterotome through the percutaneous transhepatic cholangiography and drainage (PTCD) route after performing DBE intubation to the ampulla of Vater. We then successfully completed a papillotomy with an electric sphincterotome under DBE guidance. Conclusions DBE appears to be a promising alternative in the examination and treatment of biliary tract disease in patients after GI operations such as Billroth II gastrectomy and choledochojejunostomy.
Axel Kola - One of the best experts on this subject based on the ideXlab platform.
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An outbreak of carbapenem-resistant OXA-48 - producing Klebsiella pneumonia associated to Duodenoscopy.
Antimicrobial resistance and infection control, 2015Co-Authors: Axel Kola, Brar Piening, Ulrich-frank Pape, Wilfried Veltzke-schlieker, Martin Kaase, Christine Geffers, Bertram Wiedenmann, Petra GastmeierAbstract:Carbapenemase-producing Enterobacteriaceae (CPE) have become a major problem for healthcare systems worldwide. While the first reports from European hospitals described the introduction of CPE from endemic countries, there is now a growing number of reports describing outbreaks of CPE in European hospitals. Here we report an outbreak of Carbapenem-resistant K. pneumoniae in a German University hospital which was in part associated to Duodenoscopy. Between December 6, 2012 and January 10, 2013, carbapenem-resistant K. pneumoniae (CRKP) was cultured from 12 patients staying on 4 different wards. The amplification of carbapenemase genes by multiplex PCR showed presence of the bla OXA-48 gene. Molecular typing confirmed the identity of all 12 isolates. Reviewing the medical records of CRKP cases revealed that there was a spatial relationship between 6 of the cases which were located on the same wards. The remaining 6 cases were all related to endoscopic retrograde cholangiopancreatography (ERCP) which was performed with the same duodenoscope. The outbreak ended after the endoscope was sent to the manufacturer for maintenance. Though the outbreak strain was also disseminated to patients who did not undergo ERCP and environmental sources or medical personnel also contributed to the outbreak, the gut of colonized patients is the main source for CPE. Therefore, accurate and stringent reprocessing of endoscopic instruments is extremely important, which is especially true for more complex instruments like the duodenoscope (TJF Q180V series) involved in the outbreak described here.
Gabriel Birgand - One of the best experts on this subject based on the ideXlab platform.
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Duodenoscopy an amplifier of cross transmission during a carbapenemase producing enterobacteriaceae outbreak in a gastroenterology pathway
Journal of Hospital Infection, 2018Co-Authors: Celine Bourigault, Le F Gallou, N Bodet, Nicolas Musquer, Marieemmanuelle Juvin, Stephane Corvec, N Ferronniere, S Wiesel, Jerome Gournay, Gabriel BirgandAbstract:Carbapenemase-producing Klebsiella pneumoniae (OXA-48 CPE) were identified in five patients who underwent an endoscopy with the same duodenoscope in October 2015. The endoscope was the only epidemiological link between these cases. A transient contamination of the duodenoscope following a failure in the disinfection process may have been the cause of transmission.
Brar Piening - One of the best experts on this subject based on the ideXlab platform.
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An outbreak of carbapenem-resistant OXA-48 - producing Klebsiella pneumonia associated to Duodenoscopy.
Antimicrobial resistance and infection control, 2015Co-Authors: Axel Kola, Brar Piening, Ulrich-frank Pape, Wilfried Veltzke-schlieker, Martin Kaase, Christine Geffers, Bertram Wiedenmann, Petra GastmeierAbstract:Carbapenemase-producing Enterobacteriaceae (CPE) have become a major problem for healthcare systems worldwide. While the first reports from European hospitals described the introduction of CPE from endemic countries, there is now a growing number of reports describing outbreaks of CPE in European hospitals. Here we report an outbreak of Carbapenem-resistant K. pneumoniae in a German University hospital which was in part associated to Duodenoscopy. Between December 6, 2012 and January 10, 2013, carbapenem-resistant K. pneumoniae (CRKP) was cultured from 12 patients staying on 4 different wards. The amplification of carbapenemase genes by multiplex PCR showed presence of the bla OXA-48 gene. Molecular typing confirmed the identity of all 12 isolates. Reviewing the medical records of CRKP cases revealed that there was a spatial relationship between 6 of the cases which were located on the same wards. The remaining 6 cases were all related to endoscopic retrograde cholangiopancreatography (ERCP) which was performed with the same duodenoscope. The outbreak ended after the endoscope was sent to the manufacturer for maintenance. Though the outbreak strain was also disseminated to patients who did not undergo ERCP and environmental sources or medical personnel also contributed to the outbreak, the gut of colonized patients is the main source for CPE. Therefore, accurate and stringent reprocessing of endoscopic instruments is extremely important, which is especially true for more complex instruments like the duodenoscope (TJF Q180V series) involved in the outbreak described here.
