[The transmission of mycobacteria through the fiberoptic bronchoscope]

Transmission of Mycobacterium tuberculosis by the flexible fiberoptic bronchoscope was suspected in two patients with positive cultures from bronchial washings but with negative cultures from sputum specimens and no clinical or radiological evidence of active tuberculosis, In both cases, a patient with sputum smear-positive pulmonary tuberculosis had been examined with the same bronchoscope the day before. In one case, mycobacteriophage typing of the cultures of the consecutively examined patients revealed the same phage type in both patients, suggesting transmission by the fiber bronchoscope. In the other case, however, transmission was ruled out by different phage types. Among the few previously reported cases of transmission of Mycobacterium tuberculosis by the flexible fiberoptic bronchoscope, one case of tuberculin conversion occurred. Without antituberculous therapy our patient had negative sputum cultures and no evidence of tuberculosis one year after bronchoscopy. Transmission of other microorganisms and possible causes of transmission by the fiberoptic bronchoscope are reviewed and discussed.