Risk-assessment-based approach to patients exposed to endoscopes contaminated with Pseudomonas spp

Area of Science:

• Infectious Diseases
• Medical Device Safety
• Public Health

Background:

• Bronchoscope contamination with Pseudomonas aeruginosa poses a risk of pseudomonal infection.
• Optimal strategies for managing and mitigating this risk are not well-established.
• Routine surveillance is crucial for detecting contamination events.

Purpose of the Study:

• To describe a two-phase risk assessment protocol following endoscope contamination.
• To evaluate the clinical outcomes of patients exposed to contaminated bronchoscopes.
• To inform best practices for managing endoscope reprocessing failures.

Main Methods:

• A contamination event involving 75 endoscopes was identified via routine surveillance.
• An initial risk assessment prioritized 18 endoscopes based on lumen type (irrigation/biopsy).
• A subsequent clinical risk assessment was performed on exposed patients and their healthcare teams.

Main Results:

• No patients who were exposed to the contaminated bronchoscopes developed pseudomonal infection complications.
• The identified contamination was traced to a single endoscope washer-disinfector unit.
• The two-phase risk assessment and communication strategy were successfully implemented.

Conclusions:

• A systematic, two-phase risk assessment approach can effectively manage patient risk following bronchoscope contamination.
• Prompt identification and communication are vital for mitigating potential infectious complications.
• This study highlights the importance of robust surveillance and device reprocessing protocols.