Correlation between Outbreaks of Multidrug-Resistant &lt;i&gt;Pseudomonas Aeruginosa&lt;/i&gt; Infection and Use of Bronchoscopes Suggested by Epidemiological Analysis

Machida, Hisako; Seki, Masafumi; Yoshioka, Nori; Yabuno, Kaori; Miyawaki, Koji; Yoshida, Hisao; Yamamoto, Naoki; Hamaguchi, Shigeto; Tomono, Kazunori

doi:10.1248/bpb.b13-00470

Cited by 12 publications

(9 citation statements)

References 16 publications

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“…Although relatively rare, 48 outbreaks of exogenous bronchoscopy‐related infections and cross‐contaminations involving 198 infected patients were reported in the literature between 1970 and 2012, and the problem is likely to be under‐reported . Outbreaks of bronchoscopy‐related transmission of multidrug‐resistant Pseudomonas aeruginosa and carbapenemase‐producing Klebsiella pneumoniae have also been published, along with news reports of cross‐contamination . This led the US Food and Drug Administration to publish a safety communication in September 2015 highlighting contamination of re‐usable bronchoscopes , and to the ECRI Institute (Emergency Care Research Institute) declaring ‘Inadequate cleaning of flexible endoscopes before disinfection can spread deadly pathogens’ as the top Health Technology Hazard for 2016 .…”

Section: Introductionmentioning

confidence: 99%

Contamination of single‐use bronchoscopes in critically ill patients

McGrath

Ruane

McKenna³

et al. 2016

Anaesthesia

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SummaryDisposable bronchoscopes such as the Ambu aScope TM 3 are marketed as 'single use' The risks of contamination from prolonged device storage before possible re-use are unknown. Following clinical bronchoscopy in patients whose lungs were mechanically ventilated, 20 aScope TM 3's bronchoscopes received a standard 'social clean' and were then stored. Subsequent paired saline flush and swab samples were taken at time zero, and at 24 h and 48 h. Positive microbiological cultures were obtained from at least one time point from 16 of the 20 bronchoscopes. Pathogens considered at high risk of causing pneumonia were isolated from seven bronchoscopes, with significant quantities from six of them. Our study demonstrates that aScope TM 3's should not be re-used on the same patient, as clinically significant growth of micro-organisms occurs frequently, despite adequate social cleaning. Culture of bronchoscopes themselves may be a potentially useful diagnostic tool in the context of pulmonary infection. Our data make it clear that these devices are single use and not single patient use.

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Section: Introductionmentioning

confidence: 99%

Contamination of single‐use bronchoscopes in critically ill patients

McGrath

Ruane

McKenna³

et al. 2016

Anaesthesia

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“…Many researchers (Kovaleva et al ; England et al ; Saliou et al ) showed that endoscopes after a complete cleaning and disinfection process were colonized by water‐borne pathogens, including P. aeruginosa (Wendelboe et al ; Bajolet et al ; Machida et al ; Guy et al ) and S. maltophilia (Guy et al ; Ofstead et al ; Visrodia et al ). In this study, L. pneumophila , P. aeruginosa and E. faecium were not found in the rinsing water and the final rinse water.…”

Section: Discussionmentioning

confidence: 99%

Assessment of endoscope cleaning and disinfection efficacy, and the impact of endoscope storage on the microbiological safety level

et al. 2020

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Aims:The aim of the study was microbiological evaluation of the efficacy of cleaning and disinfection of endoscopes carried out with the use of endoscope washer-disinfector EndoCleaner and evaluation of the endoscope storage cabinet providing a controlled environment. Methods and Results: The efficacy evaluation of endoscope cleaning and disinfection using the endoscope washer-disinfector EndoClener (AORT) was carried out in accordance with the PN-EN ISO 15883 standard, and the validity of endoscope storage cabinet (TRIBO LLC) was evaluated in accordance with the PN-EN 16442 standard. The micro-organism tested used in the study were as follows: Pseudomonas aeruginosa ATCC â 15442 TM , Enterococcus faecium ATCC â 12952 TM , Clostridium sporogenes ATCC â 19404 TM (spores), Candida albicans ATCC â 90028 TM and Aspergillus brasiliensis DSM â 1988 TM (surrogate for Asperigllus niger ATCC â 16404 TM ). It was demonstrated that the endoscope reprocessing carried out in the washer-disinfector EndoCleaner guaranteed the elimination of the micro-organism tested, and the tested endoscope storage cabinet met the microbiological criteria defined by the Polish standard PN-EN 16442 in the scope of tests. Conclusion: The obtained results showed that usage of washer-disinfector EndoCleaner and endoscope storage cabinet ensures the microbiological safety of using endoscopes. Significance and Impact of Study: The increase in the frequency of procedures applying endoscopes contributes to the increased risk of transmission of potentially pathogenic micro-organisms remaining after insufficient cleaning and disinfection of these devices. Research allows assessing the effectiveness of antimicrobial cleaning and disinfection of endoscopes and the safety of storing this equipment in an endoscope cabinet. A particularly innovative aspect is equipping the cabinet with a module generating the phenomenon of radiant catalytic ionization, which is a unique solution on the market. This is one of the very few works involving the assessment of each stage, that is contamination, washing and disinfection, drying and storage of endoscopes. IntroductionEndoscopes, as simple speculum, were constructed in the 1960s. Since then, they have been expanded and equipped with additional elements, that is cameras, suckers and pliers, therefore they have evolved into multi-channel, complex medical devices. However, as the modification and technological improvement in endoscopes occurred, difficulties in cleaning and disinfecting them initiated (Aumeran et al. 2010).

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“…Because outbreaks of Gramnegative bacteria are often caused by unsanitary medical devices, we initially focused on stopping the sharing of devices and on implementing standard precautions. 15 Since 2012 in Japan, co-operation among hospitals for infection control has been incentivized with additional reimbursement under the universal health insurance policy. This framework makes it possible for small-sized hospitals to obtain support from experienced infection control practitioners in large, wellresourced hospitals.…”

Section: Discussionmentioning

confidence: 99%