Bronchoscopy-related outbreaks and pseudo-outbreaks: A systematic review

Area of Science:

• Infectious Diseases
• Medical Device Safety
• Public Health

Background:

• Bronchoscopy is a common procedure, but outbreaks and pseudo-outbreaks of infection have been linked to it.
• Identifying pathogens and contamination sources is vital for patient safety.

Approach:

• A systematic review of 74 studies was conducted following PRISMA guidelines.
• Data on pathogens, contamination sources, and event types were extracted from eligible publications.
• Statistical analysis identified correlations between specific pathogens and contamination sources.

Key Points:

• Major pathogens include Pseudomonas aeruginosa, Mycobacterium tuberculosis, NTM, Klebsiella pneumoniae, Serratia marcescens, Stenotrophomonas maltophilia, Legionella pneumophila, and fungi.
• Contamination sources include water, anesthetics, bronchoscopes, reprocessing equipment, and inadequate disinfection.
• Bronchoscope defects correlated with P. aeruginosa and K. pneumoniae; contaminated water correlated with NTM and L. pneumophila.

Conclusions:

• Outbreaks and pseudo-outbreaks post-bronchoscopy pose a significant risk to patient care.
• Vigilance in bronchoscopy disinfection practices is essential.
• Stringent disinfection and quality control measures are paramount.