Salmonella typhimurium. Transmission by fiberoptic upper gastrointestinal endoscopy
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Abstract:
During a four-month period, Salmonella typhimurium developed in seven persons within five days of fiberoptic upper gastrointestinal (GI) endoscopy. A retrospective cohort study confirmed the association between S typhimurium infection and fiberoptic upper GI endoscopy. Salmonella typhimurium was cultured from the endoscopic equipment and the accessory suction equipment. The Salmonella isolated from the endoscopic and accessory suction equipment was identical to that recovered from the seven patients with salmonellosis by serotype, antimicrobial susceptibility pattern, and bacteriophage lysis pattern. Salmonella transmission was attributed to inadequate disinfection of the endoscope and accessory equipment between procedures. The original source of the contamination was not discovered.
Insights
Fiberoptic upper endoscopy procedures were linked to Salmonella typhimurium infections in seven patients. Inadequate disinfection of endoscopic equipment likely caused this outbreak of salmonellosis.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Medical Device Contamination
Background:
- Fiberoptic upper gastrointestinal (GI) endoscopy is a common diagnostic procedure.
- Nosocomial infections can arise from contaminated medical equipment.
- Salmonella typhimurium is a significant cause of bacterial gastroenteritis.
Observation:
- Seven cases of Salmonella typhimurium infection occurred within five days of fiberoptic upper GI endoscopy over a four-month period.
- A retrospective cohort study identified a significant association between S. typhimurium infection and the procedure.
- Salmonella was isolated from both the endoscopes and accessory suction equipment used.
Findings:
- The Salmonella strains from the equipment and patients were indistinguishable based on serotype, antimicrobial susceptibility, and bacteriophage lysis patterns.
- Inadequate disinfection of endoscopic and accessory equipment was identified as the transmission route.
- The initial source of Salmonella contamination remains undetermined.
Implications:
- Highlights the critical importance of stringent disinfection protocols for endoscopic equipment to prevent healthcare-associated infections.
- Underscores the potential for gastrointestinal endoscopy equipment to act as a vector for bacterial transmission.
- Suggests a need for enhanced surveillance and validation of cleaning procedures in endoscopy units.