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Pseudo-outbreak of pseudomonas aeruginosa in HIV-infected patients undergoing fiberoptic bronchoscopy
H J Kolmos1, A Lerche, K Kristoffersen
1Department of Clinical Microbiology, Hvidovre Hospital, University of Copenhagen, Denmark.
Abstract:
Pseudomonas aeruginosa was isolated from bronchoalveolar lavage fluid from 8 consecutive patients undergoing bronchoscopy at an infectious diseases unit. None of the patients developed signs of respiratory tract infection that could be ascribed to the organism. The source of contamination was the suction channels of 2 fiberoptic bronchoscopes which, due to a lapse in routine procedures, were not cleansed manually prior to disinfection with glutaraldehyde. Although rarely of pathogenetic importance, the possible presence of P. aeruginosa in lavage fluids should never be discounted, as it may indicate faulty disinfection of bronchoscopy equipment and thereby point to a risk of transmission of true respiratory pathogens such as mycobacteria.
Insights
Pseudomonas aeruginosa contamination in bronchoalveolar lavage fluid suggests faulty disinfection of bronchoscopy equipment. This highlights a potential risk for transmitting serious respiratory pathogens like mycobacteria.
Area of Science:
- Infectious Diseases
- Medical Microbiology
- Public Health
Background:
- Pseudomonas aeruginosa is an opportunistic pathogen.
- Bronchoscopy is a common diagnostic procedure.
- Contamination of medical equipment can lead to patient harm.
Purpose of the Study:
- To investigate the source of Pseudomonas aeruginosa found in bronchoalveolar lavage fluid.
- To assess the risk of infection transmission due to contaminated bronchoscopes.
- To emphasize the importance of proper disinfection protocols for medical devices.
Main Methods:
- Samples of bronchoalveolar lavage fluid were collected from patients undergoing bronchoscopy.
- Environmental sampling of bronchoscopes was performed.
- Microbiological cultures were used to identify bacterial contaminants.
Main Results:
- Pseudomonas aeruginosa was isolated from 8 patients' bronchoalveolar lavage fluid.
- The contamination source was identified as the suction channels of fiberoptic bronchoscopes.
- No patients developed Pseudomonas aeruginosa-related respiratory infections.
Conclusions:
- Faulty manual cleaning prior to glutaraldehyde disinfection of bronchoscopes can lead to Pseudomonas aeruginosa contamination.
- The presence of Pseudomonas aeruginosa in lavage fluid may indicate inadequate disinfection.
- This highlights a potential risk for transmitting other pathogens, such as mycobacteria.