Possible pseudotransmission of Enterobacter cloacae associated with an endobronchial ultrasound scope

Area of Science:

• Infectious Diseases
• Medical Device Contamination
• Microbiology

Background:

• Endobronchial ultrasound (EBUS) scopes are critical for diagnosing lung conditions.
• Proper reprocessing of medical instruments is essential to prevent patient-to-patient transmission of infections.
• Enterobacter cloacae is an opportunistic pathogen that can cause serious infections.

Purpose of the Study:

• To investigate a suspected case of pseudotransmission of Enterobacter cloacae between patients via an EBUS scope.
• To identify the source and mechanism of contamination despite adherence to reprocessing protocols.
• To explore the potential for bacterial transmission in EBUS scopes without elevator channels.

Main Methods:

• Environmental cultures were taken from an EBUS scope.
• Positive cultures for Enterobacter cloacae led to an investigation of patient records and scope handling.
• The original equipment manufacturer's quality control was engaged to assess the scope.

Main Results:

• A possible pseudotransmission event of Enterobacter cloacae was identified between two patients.
• Standard reprocessing procedures did not reveal the source of contamination.
• The scope's quality control assessment could not identify the root cause of the contamination.

Conclusions:

• This represents the first documented case of pseudotransmission linked to an EBUS scope.
• The findings suggest that bacterial transmission may occur even in endoscopes lacking an elevator channel.
• Further research is needed to understand transmission dynamics in duodenoscopes and other endoscopes.