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Bronchoscope-related Pseudomonas aeruginosa pseudo-outbreak attributed to contaminated rinse water

Yanjun Zhang1, Haijian Zhou2, Qianqian Jiang1

  • 1Department of Infection Control, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China.

American Journal of Infection Control
|July 31, 2019
PubMed
Abstract

Insights

A Pseudomonas aeruginosa outbreak linked to bronchoscopes was identified. Replacing the connecting tube effectively eliminated persistent bacteria, preventing further contamination and ensuring patient safety.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Healthcare Epidemiology

Background:

  • An increase in Pseudomonas aeruginosa (P. aeruginosa) infections was observed in patients, with isolates detected in bronchoalveolar lavage fluid, flexible bronchoscopes, and rinse water.
  • Microbiological surveillance in June 2016 indicated a potential link between P. aeruginosa and bronchoscope usage.

Purpose of the Study:

  • To investigate a pseudo-outbreak of P. aeruginosa associated with flexible bronchoscopes.
  • To identify the source of contamination and assess the effectiveness of reprocessing procedures.

Main Methods:

  • Reprocessing procedures for bronchoscopes were evaluated, and environmental samples were collected.
  • P. aeruginosa isolates from patients and the environment were characterized using multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE).

Main Results:

  • A novel MLST type, ST 2387, was identified alongside ST 671. Both were found in bronchoscopes and connecting tubes used in manual reprocessing.
  • Patient isolates were indistinguishable from P. aeruginosa strains found on bronchoscopes and connecting tubes, confirmed by PFGE.
  • Replacing the connecting tube successfully eradicated P. aeruginosa from bronchoscopes, connecting tubes, and final rinse water.

Conclusions:

  • The connecting tube served as a reservoir for P. aeruginosa, leading to bronchoscope contamination and a pseudo-outbreak.
  • Effective control measures for bacterial load in final rinsing water are crucial to prevent contamination of reusable medical equipment during reprocessing.
Keywords:
BronchoscopeConnecting tubeContamination

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