Lessons From Outbreaks Associated With Bronchoscopy

Weber, David J.; Rutala, William A.

doi:10.1086/501924

Cited by 75 publications

(38 citation statements)

References 63 publications

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“…La contamination de l'endoscope peut témoigner de procédures de traitement inadaptées ou défaillantes, de la qualité des eaux utilisées lors de l'entretien, ou encore, de problèmes de conception de l'appareil [9,10].…”

Section: Discussionunclassified

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Contamination microbiologique résiduelle des endoscopes digestifs

et al. 2008

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Les endoscopes sont des dispositifs médicaux qui ne peuvent faire l'objet de mesures de stérilisation en raison de leur caractère complexe et notamment de la sensibilité à la chaleur de certains de leurs constituants. La complexité de leur structure rend possible une accumulation de souillures organiques ou minérales qui peuvent elles-mêmes renfermer des agents infectieux. Une fré-quence ou une qualité insuffisante de la procédure de désinfection peut aboutir à la formation d'un biofilm.L'objectif de notre travail est de faire une évaluation de la contamination microbiologique des endoscopes après désinfection dans une unité d'endoscopie du service d'hé-pato-gastro-entérologie du CHU Hassan II de Fès, Maroc.Les prélèvements ont concerné 13 endoscopes. Ils ont été réalisés en deux phases : l'injection d'une solution de décrochage dans les canaux de l'endoscope, et l'écou-villonnage de l'embout distal, puis insufflation et aspiration. L'eau du rinçage terminal ainsi que la solution de désinfection ont également été contrôlées.Les résultats obtenus ont montré une contamination résiduelle de la flore mésophile aérobie totale (FMAT) de l'ordre de 3,6.10 3 UFC/endoscope. Nous avons identifié 60 micro-organismes. Pseudomonas sp. est la bactérie la plus fréquemment rencontrée dans nos prélèvements (35 %), Acinetobacter sp. (13 %), Micrococcus sp. (17,5 %), Escherichia sp. (15 %), Staphylococcus sp.et Streptococcus sp. (11 %), Bacillus sp. (6 %), et Candida sp. (3 %).La modification dans la procédure de désinfection adoptée dans le service a permis de ramener la contamination à un niveau cible (FMAT < 10 UFC/endoscope).Le respect des principes de bases de l'hygiène hospitalière et l'application de procédures de nettoyage et de désinfection rigoureuses sont des éléments majeurs dans la prévention et la lutte contre les infections nosocomiales.Abstract: Due to the nature of the materials, which they are made of, flexible endoscopes require disinfection at a cool temperature after their use. A poorly-executed disinfection procedure can lead to cases of infection of varying degrees of severity, from simple cases of fever to fatal septicemia.The objective of our study is to test the effectiveness of the disinfection procedure for digestive endoscopes. This will be done by evaluating the residual microbiological contamination after disinfection of digestive endoscopes in the gastroenterological unit of the Hassan II Teaching Hospital in Fez (Morocco).The sample included 13 digestive endoscopes. It was undertaken in two phases: the injection of an uncoupling solution in the endoscope channels, and the swabbing of different points of the endoscope structure, particularly its extremity, and its air inlet and outlet. The water used in the final rinsing and the disinfecting solution were also tested.The results obtained indicate a residual contamination of approximately 3,6 × 103 UFC/endoscope. We identified 60 micro-organisms. The most prevailing bacteria encountered in our samples are Pseudomonas sp. (35%), Acinetobacter sp. (13%)...

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Section: Discussionunclassified

“…The contamination of the endoscope can be a sign of improper or defective treatment processes, of the quality of the waters used in maintenance, or of problems with the device design [9,10].…”

Section: Discussionmentioning

confidence: 99%

Contamination microbiologique résiduelle des endoscopes digestifs

et al. 2008

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“…If not properly disinfected or sterilized, medical devices and surgical instruments used in invasive procedures may be the carrier of infectious organisms and may lead to infection. Failure to comply with disinfection and sterilization guidelines has contributed to outbreaks associated with contaminated medical devices and surgical instruments (215,310,340).…”

Section: Disinfection Sterilization and Cleaningmentioning

confidence: 99%

Hospital Epidemiology and Infection Control in Acute-Care Settings

2011

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SUMMARY Health care-associated infections (HAIs) have become more common as medical care has grown more complex and patients have become more complicated. HAIs are associated with significant morbidity, mortality, and cost. Growing rates of HAIs alongside evidence suggesting that active surveillance and infection control practices can prevent HAIs led to the development of hospital epidemiology and infection control programs. The role for infection control programs has grown and continues to grow as rates of antimicrobial resistance rise and HAIs lead to increasing risks to patients and expanding health care costs. In this review, we summarize the history of the development of hospital epidemiology and infection control, common HAIs and the pathogens causing them, and the structure and role of a hospital epidemiology and infection control program.

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“…Fleksibl endoskoplar, karmaşık iç yapıları nedeniyle ve yüksek ısıyla sterilizasyon yapılamadığı için infeksiyon kontrolünde zorluk oluşturur. İşlem sırasında bronkoskopa bulaşan hastalık etkenleri, taşınma ve saklama sıra-sında meydana gelen çevresel mikroorganizma bulaşması dezenfeksiyonla yok edilemezse gerçek veya yalancı salgınlar oluşabilir (8,11).…”

Section: İrdelemeunclassified

“…Bulaşma, kontamine aspirasyon valfleri, hasarlı biyopsi kanalları, kontamine topik anestezikler ve kontamine dezenfeksiyon makinelerinden kaynaklanmaktadır. Kontaminasyona bağlı olarak hem gerçek hem de yalancı salgınlar görülmektedir (7)(8)(9)(10).…”

Section: Introductionunclassified