Infectious complications of gastrointestinal endoscopy.

The relationships of infectious disease and fiberoptic gastrointestinal endoscopy have been reviewed. After a decade of burgeoning fiberoptic use, endoscopically related infections have occurred, but with remarkable rarity, despite lack of uniformity in endoscopic cleansing techniques. Transmission of viral disease has not been demonstrated. Reported bacterial cross infections have occurred under variable cleansing conditions which did not include disinfection. Transient low level bacteremia occurs following gastrointestinal endoscopy, and is generally inconsequential. Prophylactic antibiotics against gram negative organisms are to be considered in the patient with a prosthetic valve, because of theoretical risks which have not been clinically observed. Problems of cross infection and bacteremia can be generally avoided by various measures, but can most certainly be precluded by use of disinfectants, which maximally suppress microorganisms. Endogenous infection, chiefly evident as aspiration pneumonia, is likely underreported but uncommon, and prevention is probably related in part to good endoscopic technique. Infections are not an important complication of gastrointestinal endoscopy.