In the era of duodenoscopes with single-use endcaps, what is the role for single-use duodenoscopes?

Outbreaks of infection with multidrug-resistant organisms (MDROs) caused by standard fully reprocessable duodenoscopes have been highly publicized and identified as an issue of great concern. 1 Peery A.F. Crockett S.D. Murphy C.C. et al. Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2018. Gastroenterology. 2019; 156: 254-272 Abstract Full Text Full Text PDF PubMed Scopus (885) Google Scholar Harm resulting from a procedure intended to improve the health of a patient is both problematic and concerning. Still, it is worthwhile to note that these outbreaks are believed to represent extremely rare events, given that an estimated 500,000 to 600,000 ERCPs are performed annually in the United States and roughly 25 outbreaks of duodenoscope-transmitted MDRO infections were reported at the peak of these infections, between 2012 and 2015. 1 Peery A.F. Crockett S.D. Murphy C.C. et al. Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2018. Gastroenterology. 2019; 156: 254-272 Abstract Full Text Full Text PDF PubMed Scopus (885) Google Scholar , 2 Rutala W.A. Weber D.J. Reprocessing semicritical items: current issues and new technologies. Am J Infect Control. 2016; 44: e53-e62 Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar , 3 Petersen B.T. Chennat J. Cohen J. et al. ASGE Quality Assurance in Endoscopy CommitteeMultisociety guideline on reprocessing flexible gastrointestinal endoscopes: 2011. Gastrointest Endosc. 2011; 73: 1075-1084 Abstract Full Text Full Text PDF PubMed Scopus (143) Google Scholar