Clinicians and healthcare workers who staff intensive care units can expect to see rising numbers of infectious diseases.

Cases of infectious diseases are increasing both in the U.S. and globally due to war, multidrug resistance, climate change, new diseases and lower confidence in vaccines, according to Dr. Hannah Wunsch in a plenary address at the 2023 Critical Care Congress and chronicled in Anesthesiology News.

In the past, only about 20 percent of patients admitted to the ICU were there because of an infectious disease, but that is about to change dramatically. War is a major factor and is expected to lead to a surge of infectious diseases — HIV, tuberculosis, COVID-19 and others, said Wunsch, a professor of anesthesiology and critical care medicine at the University of Toronto.

Even in countries without war, infectious diseases are evident, and multidrug-resistant versions of TB and other diseases add to the challenge.

“We’ve lived through an era of noninfectious diseases being the predominant focus for much of our care in the ICU,” Wunsch said. “We are going to see infectious diseases again — much, much more of them over the next 20 to 50 years.”

In endoscopy, meanwhile, recent studies have underscored risks of infection from cross-contamination due to inadequate device reprocessing and other factors.

An analysis of medical device reports submitted to the U.S. Federal Food and Drug Administration (FDA) primarily by manufacturers, documents multidrug-resistant bacteria on six types of reusable flexible endoscopes, suggesting that current reprocessing practices may be coming up short.

That analysis by Dr. Lawrence Muscarella — a national authority on the causes and prevention of healthcare-associated infections (HAIs) and an Ambu consultant — found contamination on colonoscopes, duodenoscopes, gastroscopes, bronchoscopes, ear-nose-throat “(ENT)” scopes and urological endoscopes.

Although the risk of endoscopy-related infections remains low, more HAIs are linked to contaminated endoscopes than any other medical device.

“The risk of endoscopes transmitting diseases is no longer academic but at times, fortunately still with low frequency, can be a matter of life and death,” Muscarella told Infection Control Today.