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Pseudoepidemic of Legionella pneumophila serogroup 6 associated with contaminated bronchoscopes
D H Mitchell1, L J Hicks, R Chiew
1Centre for Infectious Diseases and Microbiology, Westmead Hospital, New South Wales, Australia.
Abstract:
An investigation of a pseudoepidemic of Legionella pneumophila serogroup 6 contaminating bronchoalveolar lavage specimens traced the source to contaminated tap water used to rinse disinfected bronchoscopes. The problem recurred despite plumbing changes and the installation of filters in the endoscopy unit water system because of inadequate maintenance of the filters.
Insights
A Legionella outbreak in bronchoalveolar lavage specimens was traced to contaminated tap water used for rinsing bronchoscopes. Inadequate filter maintenance caused the pseudoepidemic to recur despite plumbing and filter upgrades.
Area of Science:
- Infectious Diseases
- Microbiology
- Healthcare Epidemiology
Background:
- Legionella pneumophila serogroup 6 outbreaks pose significant risks in healthcare settings.
- Bronchoalveolar lavage (BAL) specimens can be sources of pseudoepidemics if contaminated.
- Endoscopic procedures require stringent disinfection protocols to prevent patient-to-provider transmission.
Purpose of the Study:
- To identify the source of a Legionella pneumophila serogroup 6 pseudoepidemic affecting BAL specimens.
- To determine the reasons for the recurrence of contamination despite interventions.
- To provide recommendations for preventing future Legionella contamination in endoscopy units.
Main Methods:
- Investigated a pseudoepidemic of Legionella pneumophila serogroup 6.
- Analyzed the water system used for rinsing bronchoscopes.
- Assessed the effectiveness of plumbing changes and filter installation.
- Evaluated the maintenance procedures for water filters.
Main Results:
- The source of contamination was identified as tap water used to rinse bronchoscopes.
- The pseudoepidemic recurred due to inadequate maintenance of installed water filters.
- Plumbing modifications and filter installation alone were insufficient to resolve the issue.
Conclusions:
- Contaminated tap water is a potential source for Legionella pseudoepidemics in BAL specimens.
- Rigorous and consistent maintenance of water filtration systems is crucial in preventing recurrent contamination.
- Effective control of Legionella requires a multi-faceted approach addressing both water quality and equipment disinfection.