Microbiological monitoring of flexible bronchoscopes after high-level disinfection and flushing channels with alcohol: Results and costs

Gavaldà, Laura; Olmo, Ana Rosa; Hernández, R Sánchez; Domínguez, M. Ángeles; Salamonsen, Mathew Robert; Ayats, Josefina; Alcaide, Fernando; Soriano, Ana; Rosell, Antoni

doi:10.1016/j.rmed.2015.04.015

Cited by 21 publications

(17 citation statements)

References 17 publications

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“…Around one‐third of outbreaks were associated with a contaminated or defective endoscope reprocessor, with a further third associated with inadequate drying and storage. There is also variation and inconsistency between reprocessing guidelines . The potential for iatrogenic harm to multiple patients from contaminated bronchoscopes has led some authors to suggest additional cleaning measures, and that routine pre‐use ‘control’ BAL samples should be taken before clinical use of a re‐usable bronchoscope .…”

Section: Discussionmentioning

confidence: 99%

“…There is also variation and inconsistency between reprocessing guidelines . The potential for iatrogenic harm to multiple patients from contaminated bronchoscopes has led some authors to suggest additional cleaning measures, and that routine pre‐use ‘control’ BAL samples should be taken before clinical use of a re‐usable bronchoscope . This approach could alert departments that a scope is contaminated, and also ensure that positive clinical samples are true positives, preventing unnecessary treatment.…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Contamination of single‐use bronchoscopes in critically ill patients

McGrath

Ruane

McKenna³

et al. 2016

Anaesthesia

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“…[447] Furthermore, alcohol purging after machine disinfection of flexible bronchoscopes has shown to eliminate bacterial pseudo-outbreaks and reduced contamination rates from 4.7% to 0.6%. [448449450] However, it must be kept in mind that alcohol acts as a fixative and may promote biofilm formation.…”

Section: Equipment Disinfectionmentioning

confidence: 99%

Guidelines for diagnostic flexible bronchoscopy in adults: Joint Indian Chest Society/National College of chest physicians (I)/Indian association for bronchology recommendations

et al. 2019

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Flexible bronchoscopy (FB) is commonly performed by respiratory physicians for diagnostic as well as therapeutic purposes. However, bronchoscopy practices vary widely across India and worldwide. The three major respiratory organizations of the country supported a national-level expert group that formulated a comprehensive guideline document for FB based on a detailed appraisal of available evidence. These guidelines are an attempt to provide the bronchoscopist with the most scientifically sound as well as practical approach of bronchoscopy. It involved framing appropriate questions, review and critical appraisal of the relevant literature and reaching a recommendation by the expert groups. The guidelines cover major areas in basic bronchoscopy including (but not limited to), indications for procedure, patient preparation, various sampling procedures, bronchoscopy in the ICU setting, equipment care, and training issues. The target audience is respiratory physicians working in India and well as other parts of the world. It is hoped that this document would serve as a complete reference guide for all pulmonary physicians performing or desiring to learn the technique of flexible bronchoscopy.

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“…For this reason, it is necessary to take extreme care and precautions in the decontamination and cleaning of equipment. (2) Despite complex and advanced endoscope cleaning and disinfection systems, disinfection is often inadequate (3)(4)(5) , with the consequent risk of cross infection. (5-…”

Section: Introductionmentioning

confidence: 99%

Bronchoscopist's Perception of the Quality of the Single-use Fiberoptic Bronchoscope (Ambu Ascope4 ™) in Conventional Bronchoscopies. A Multicenter Study in 21 Spanish Pulmonology Services.

Aldeyturriaga

Giraldo

Alfayate

et al. 2020

Preprint

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Background:The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist's perception of its quality has not been evaluated. Methods: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of central tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis.Results:The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 minutes. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfied in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores> 70/100 from the first procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score.Conclusions:The aScope4 ™ scored well for ease of use, imaging, and aspiration. We found a learning curve with excellent scores from the 9th procedure. Bronchoscopists highlighted its portability, immediacy of use and the possibility of taking and storing images.

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Microbiological monitoring of flexible bronchoscopes after high-level disinfection and flushing channels with alcohol: Results and costs

Cited by 21 publications

References 17 publications

Contamination of single‐use bronchoscopes in critically ill patients

Contamination of single‐use bronchoscopes in critically ill patients

Guidelines for diagnostic flexible bronchoscopy in adults: Joint Indian Chest Society/National College of chest physicians (I)/Indian association for bronchology recommendations

Bronchoscopist's Perception of the Quality of the Single-use Fiberoptic Bronchoscope (Ambu Ascope4 ™) in Conventional Bronchoscopies. A Multicenter Study in 21 Spanish Pulmonology Services.

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