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Contamination of a fiberoptic bronchoscope with Proteus species
Abstract:
We have traced an episode of contamination of a fiberoptic bronchoscope with a Proteus species to an index patient. Bacterial cultures obtained by aspiration through the fiberoptic bronchoscope from 11 of 12 subsequent bronchoscopies in 8 additional patients grew a Proteus species with sensitivities similar to those of the initial isolate. Culture of the fiberoptic bronchoscopic specimen yielded an identical organism. There were no definitive ill effects in the patients. These findings necessitated a change in our fiberoptic bronchoscope disinfection protocol as well as development of culture surveillance mechanism to detect breaks in the cleaning procedure. The importance of this and avoiding potential outbreaks of fiberoptic bronchoscope-related infeciton is emphasized.
Insights
A contaminated fiberoptic bronchoscope transmitted Proteus bacteria to multiple patients. Enhanced disinfection protocols and surveillance are crucial to prevent fiberoptic bronchoscope-related infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Endoscopy
Background:
- Fiberoptic bronchoscopes are essential tools in diagnosing respiratory conditions.
- Improper disinfection of medical devices can lead to patient-to-patient transmission of pathogens.
- Proteus species are opportunistic bacteria that can cause healthcare-associated infections.
Purpose of the Study:
- To investigate a suspected outbreak of Proteus species contamination linked to a fiberoptic bronchoscope.
- To identify the source of contamination and the extent of bacterial transmission.
- To evaluate the effectiveness of existing disinfection protocols.
Main Methods:
- Bacterial cultures were performed on specimens aspirated through the fiberoptic bronchoscope.
- Cultures were obtained from an index patient and subsequent patients undergoing bronchoscopy.
- Microbial identification and antibiotic sensitivity testing were conducted on isolated Proteus species.
Main Results:
- Proteus species were isolated from 11 of 12 bronchoscopies in 8 patients following the index case.
- The isolated Proteus strains exhibited similar antibiotic sensitivities to the initial isolate.
- The fiberoptic bronchoscope itself was cultured and yielded the identical organism, confirming it as the source.
Conclusions:
- The fiberoptic bronchoscope was identified as the source of Proteus species contamination.
- Existing disinfection protocols were insufficient to prevent cross-contamination.
- Revised disinfection procedures and implementation of culture surveillance are necessary to prevent future outbreaks of fiberoptic bronchoscope-related infections.