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Fig. 2 | Antimicrobial Resistance & Infection Control

Fig. 2

From: Uncovering the spread of drug-resistant bacteria through next-generation sequencing based surveillance: transmission of extended-spectrum β-lactamase-producing Enterobacterales by a contaminated duodenoscope

Fig. 2Fig. 2

Dismantling and sampling the ERCP duodenoscope. a, red-brown residue in groove (1) on the forceps elevator drive unit side and whitish-grey residue in the border above the white block around the instrument channel exit (2); white–gray residue (3) in groove on camera side; white deposit (4) on the bottom under the forceps elevator; white crystals (5) next to and below the forceps elevator; b, cutting and removing the cardan rubber, sampling the exposed surface; c, trimming the tip cover and the possible break (6) in the cementing around the arm cover.; d, brownish-red deposit and/or discoloration on the frame of the drive unit, with an apparent intrusion trace (7), corresponding to the previously observed possible interruption of cementing (8); f, sampling the instrument channel port; removed instrument channel port viewed from the entrance and port from the side; g, left half the piece of instrument channel with the brownish-yellow area; the ribbed scratch mark shows a kink where there is also a kink or dent in the tubing; Yellow discoloration of the tubing material with grey cloudy discoloration on the inner wall

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Antimicrobial Resistance & Infection Control

ISSN: 2047-2994

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