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Rhodotorula rubra contamination in fiberoptic bronchoscopy
W L Whitlock1, R A Dietrich, E H Steimke
1Eisenhower Army Medical Center, Fort Gordon, Ga.
Chest
|November 1, 1992
Summary
Contaminated bronchoscopes can lead to Rhodotorula rubra recovery in bronchoalveolar lavage (BAL) samples. Removing specific valves after cleaning effectively eradicates this contamination, improving patient safety.
Area of Science:
- Medical Microbiology
- Infection Control
- Pulmonology
Background:
- Rhodotorula rubra was frequently recovered from bronchoscopic specimens.
- This yeast is an opportunistic pathogen, particularly in immunocompromised patients.
Purpose of the Study:
- To investigate the source of Rhodotorula rubra contamination in bronchoscopic specimens.
- To implement and validate an effective decontamination protocol for bronchoscopes.
Main Methods:
- Retrospective analysis of bronchoscopy cases involving Rhodotorula rubra.
- Systematic evaluation of laboratory, bronchoscopy suite, and equipment cleaning procedures.
- Modification of the bronchoscope cleaning protocol by removing specific valves during non-use.
Main Results:
- Rhodotorula rubra was isolated from 18 bronchoscopic specimens (11 BAL, 4 bronchial washes, 3 transbronchial biopsies).
- No clinical infection was identified in any patient.
- Contamination was traced to moisture accumulation in the biopsy channel due to specific valve replacements.
- Removal of suction and biopsy valves during non-use eradicated contamination for over two years.
Conclusions:
- Inadequate cleaning procedures for fiberoptic bronchoscopes can lead to contamination with organisms like Rhodotorula rubra.
- A modified cleaning protocol, involving valve removal, effectively prevents contamination.
- Vigilant infection control surveillance is crucial in bronchoscopy, especially for immunocompromised patients.