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Related Experiment Videos

Bronchoscope-Related "Superbug" Infections.

Atul C Mehta1, Lawrence F Muscarella2

  • 1Respiratory Institute, Cleveland Clinic, Cleveland, OH.

Chest
|August 18, 2019
PubMed
Summary

Flexible bronchoscopes may transmit carbapenem-resistant Enterobacteriaceae (CRE) and other multidrug-resistant organisms (MDROs) despite reprocessing. Current cleaning and disinfection may not be enough to prevent infection transmission risks.

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Area of Science:

  • Medical device reprocessing
  • Infection control
  • Flexible endoscopy

Background:

  • Recent duodenoscope-associated outbreaks of carbapenem-resistant Enterobacteriaceae (CRE) and multidrug-resistant organisms (MDROs) raise concerns about flexible scope reprocessing.
  • Flexible bronchoscopes are increasingly recognized as potential vectors for transmitting serious infections.

Purpose of the Study:

  • To evaluate the effectiveness of current flexible bronchoscope reprocessing practices.
  • To investigate the risk of bronchoscopes transmitting CRE and related MDROs.

Main Methods:

  • Systematic literature search from 2012 onwards.
  • Review of US Food and Drug Administration adverse event databases.
  • Internet searches for relevant case reports.
Keywords:
cross-contaminationflexible bronchoscopeinfectionssuperbugs

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Main Results:

  • Several cases of CRE/MDRO transmission linked to reprocessed bronchoscopes were identified.
  • Current cleaning and high-level disinfection may be insufficient to eliminate transmission risks.
  • Factors like scope damage, inadequate servicing, and biofilm formation contribute to reprocessing failures.

Conclusions:

  • Flexible bronchoscopes pose an underrecognized risk for CRE/MDRO transmission.
  • Enhanced reprocessing measures, such as sterilization when indicated, are recommended.
  • Strict adherence to manufacturer guidelines for servicing and maintenance is crucial.