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Nosocomial infection and pseudoinfection from contaminated endoscopes and bronchoscopes--Wisconsin and Missouri
Abstract:
Flexible fiber-optic endoscopes are widely used in the United States for diagnostic and therapeutic procedures. Between uses, endoscopes should be cleaned and disinfected either manually or by using automated machines. However, outbreaks have occurred among patients exposed to contaminated endoscopes or to inadequately disinfected bronchoscopes (1-4). This report summarizes one outbreak of nosocomially acquired infection (Wisconsin) and one of pseudoinfection (Missouri) linked to endoscopes contaminated during cleaning and disinfection by automated reprocessing machines.
Insights
Automated reprocessing machines can contaminate flexible endoscopes, leading to patient infections and pseudoinfections. Proper cleaning and disinfection protocols are crucial to prevent the spread of nosocomial infections.
Area of Science:
- Medical device reprocessing
- Infection control
- Gastroenterology and pulmonology
Background:
- Flexible fiber-optic endoscopes are essential for numerous diagnostic and therapeutic procedures in the US.
- Inadequate cleaning and disinfection of endoscopes have been linked to patient outbreaks.
- Automated reprocessing machines are commonly used for endoscope disinfection between patient uses.
Purpose of the Study:
- To summarize outbreaks of nosocomially acquired infection and pseudoinfection.
- To identify the link between endoscope contamination and automated reprocessing machines.
- To highlight the risks associated with inadequate endoscope disinfection.
Main Methods:
- Review of outbreak investigations.
- Analysis of infection control breaches.
- Case study of nosocomial infection and pseudoinfection outbreaks.
Main Results:
- One outbreak of nosocomial infection was identified in Wisconsin.
- One outbreak of pseudoinfection was identified in Missouri.
- Both outbreaks were linked to endoscopes contaminated during automated reprocessing.
Conclusions:
- Automated reprocessing machines can be a source of endoscope contamination.
- Inadequate disinfection by automated machines poses a significant risk to patient safety.
- Strict adherence to and validation of cleaning and disinfection protocols are critical.