Post-Colonoscopy Infection Rates Much Higher Than Previously Believed

A new study conducted by Johns Hopkins University researchers found that the risk of infection following colonoscopies and upper-GI endoscopies may be up to 100 times higher than previously believed.

Published in Gut, the study’s researchers examined medical insurance data from 2014 to look at infection rates after colonoscopy and osophagogastroduodenoscopies (OGD) procedures done at selected outpatient facilities in six states. More than 15 million colonoscopies and 7 million OGDs are performed each year in the U.S.

The study tracked infection-related emergency department visits and unplanned inpatient admissions within seven and 30 days after the procedures, looked at infection sites and organisms, and analyzed predictors of infections. They were compared with screening mammography, prostate cancer screening, bronchoscopy, and cystoscopy procedures.

The rates of postendoscopic infection per 1,000 procedures within seven days were 1.1 for screening colonoscopy, 1.6 for non-screening colonoscopy, and 3.0 for OGD; they were all higher than screening mammography (0.6) but lower than bronchoscopy (15.6) and cystoscopy (4.4). The study noted that predictors of postendoscopic infection included recent history of hospitalization or endoscopic procedure; concurrence with another endoscopic procedure; low procedure volume or non-freestanding ASC; younger or older age; black or Native American race and male sex.

“We found that postendoscopic infections are more common than previously thought and vary widely by facility,” the researchers wrote. “Although screening colonoscopy is not without risk, the risk is lower than diagnostic endoscopic procedures.”