A bronchoscopy-associated pseudo-outbreak of Mycobacterium chelonae and Mycobacterium mucogenicum associated with...

Area of Science:

• Infectious Disease Epidemiology
• Healthcare-Associated Infections
• Microbiology

Background:

• Bronchoscopy procedures can be associated with pseudo-outbreaks of mycobacterial infections.
• Previous investigations have identified various sources for such pseudo-outbreaks.
• Maintaining sterility in medical equipment and supplies is critical for patient safety.

Purpose of the Study:

• To identify the source of a pseudo-outbreak of Mycobacterium chelonae and M. mucogenicum infections linked to bronchoscopy.
• To elucidate the transmission pathway of the identified microorganisms.
• To provide actionable recommendations for preventing future pseudo-outbreaks.

Main Methods:

• Retrospective case review and epidemiological investigation.
• Environmental sampling of the bronchoscopy suite, including ice machines and associated water.
• Microbiological cultures and identification of Mycobacterium species from clinical and environmental samples.

Main Results:

• The pseudo-outbreak was traced to contaminated water and ice from an ice machine.
• A nonsterile ice bath used for cooling sterile saline syringes was identified as the likely point of contamination.
• Mycobacterium chelonae and M. mucogenicum were isolated from both clinical specimens and the ice machine.

Conclusions:

• Contaminated ice machines pose a significant risk for pseudo-outbreaks of mycobacterial infections in healthcare settings.
• Strict adherence to sterile techniques and environmental controls is essential during bronchoscopy procedures.
• Recommendations for ice machine maintenance and sterile technique protocols are crucial for prevention.