APPLIED MICROBIOLOGY · PRIMARIES SURGERY

Sterilisation Wave 2 → endoscope reprocessing outbreak audit

8 decision points ~18 min Difficulty 4/5 Primaries

Setting

You are joining an infection-control committee reviewing a cluster of carbapenem-resistant Enterobacteriaceae (CRE) infections after ERCP. You use the case to teach applied sterilisation biology to a Year-1 resident.

Patient

Six patients over four months developed CRE bloodstream infection after ERCP performed with the same duodenoscope. Routine automated endoscope reprocessing (AER) with high-level disinfection was documented on each occasion. The scope's elevator channel is under investigation.

Reference stack

Bailey & Love 28e Ch 5 · WHO 2018 SSI · FDA duodenoscope guidance · Rutala & Weber CDC HICPAC

Start cascade →

You'll be asked to decide what happens next at each step. There's no timer — take your time. The correct answer + evidence-anchored rationale is revealed after each choice.