Stenotrophomonas maltophilia Pseudo-outbreak at a University Hospital Bronchoscopy Unit in Turkey

Ece, Gülfem; Eraç, Bayrı; Limoncu, MH; Baysak, Ayşegül; Oz, AT; Ceylan, KC

doi:10.7727/wimj.2013.005

Cited by 4 publications

(6 citation statements)

References 8 publications

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“…Antibiotic resistance is common in NF-GNB, resulting in inappropriate initial antibiotic treatment and poor outcomes 1,11,12,13 . Several outbreaks of infection have been described including a few reports of infections originating outside the hospital setting 14,15,16,17,18 .…”

Section: Discussionmentioning

confidence: 99%

Stenotrophomonas maltophilia isolates in a tertiary care hospital in Northeastern Brazil

Lemos

Paixão

Santos³

et al. 2019

BJHR

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Introduction: Stenotrophomonas maltophilia (S.maltophilia) has emerged as an important opportunistic, nosocomial pathogen capable of causing respiratory, bloodstream and urinary infections in a debilitated host. Prevention of acquisition and infection depends upon the application of modern infection-control practices. Methods: We conducted a retrospective and observational laboratory-based study on S. maltophilia to evaluate the distribution of these pathogen isolates between February 2008 and December 2012 in a 38-bed intensive care unit in northeastern Brazil. The study began by surveying all positive S. maltophilia cultures processed by the microbiology laboratory during the period of study. The cultures, originating from various types of biological material were processed by Vitek® System. The cultures were processed in protocol in accordance with CLSI-M100-S25. The incidence rate was calculated per 1,000 admissions. Results: A total of 100 sample isolates were tested positive for S. maltophilia. The isolates were obtained from 50.301 hospitalized patients (0.19%). A total of 8.572 positive cultures were detected in different biological materials. Ninety four (94%) isolates were from patients in adult intensive care. Seventy (70%) S. maltophilia isolates were from tracheal cultures. All S. maltophilia isolates were sensitive to Co-trimoxazole and levofloxacin. Conclusions: This study shows the importance of other analytical epidemiologic studies that correlate the presence of S. maltophilia incidence associated with the risk factor, and the outcomes, in our region.

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Section: Discussionmentioning

confidence: 99%

Stenotrophomonas maltophilia isolates in a tertiary care hospital in Northeastern Brazil

Lemos

Paixão

Santos³

et al. 2019

BJHR

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“…Although infectious complications of flexible bronchoscopy are uncommon, outbreaks and pseudo-outbreaks related to bronchoscopy have been reported [3][4][5][8][9][10][11][12][13] . The proper method for high-level disinfection or sterilization of bronchoscopes is well described in current guidelines [1,2,7] .…”

Section: Discussionmentioning

confidence: 99%

A Pseudo-Outbreak of Pseudomonas putida and Stenotrophomonas maltophilia in a Bronchoscopy Unit

et al. 2016

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39 patients. The bronchoscopy models Olympus BF-1T160 and BF-160 were contaminated. Both bronchoscopes and other contaminated material (cleaning brushes, diluted cleaning solutions, and the sink) were isolated, but new cases continued to appear. The AER was recently installed, and new connections were used for the water lines and new tubes were connected to the AER. Initially, specimens were obtained from the external circuits and the internal walls of the AER. Finally, cultures were made from the filters on the water lines, and growth of P. putida and S. maltophilia was found. The investigation revealed that the BW specimens were contaminated because sterile saline was injected by means of the biopsy port of the bronchoscope and was recovered through the same channel by means of the proximal suction port. No patients developed clinical signs or symptoms of infection, but the positive cultures did lead to treatment of 21 patients. Conclusions: We described a pseudooutbreak related to a contaminated bronchoscope because of inadequate installation of the AER for used new water lines and because the new tubes were connected to the AER. The antibacterial filters of the AER used tap water, and this may have contained low levels of microorganisms. No serious clinical complications derived from this pseudo-outbreak. © 2016 S. Karger AG, Basel Key WordsBronchoscope · Pseudo-outbreak · Automated endoscope reprocessor · Pseudomonas putida · Stenotrophomonas maltophilia Abstract Background: Endoscopes represent the medical devices most commonly linked to health care-associated outbreaks and pseudo-outbreaks. Most of the recent outbreaks and pseudo-outbreaks have resulted from contaminated automated endoscope reprocessors (AER) or the use of damaged or malfunctioning bronchoscopes or contaminated equipment. Objectives: We investigated a pseudo-outbreak of Pseudomonas putida and Stenotrophomonas maltophilia recovered from bronchial washing (BW) specimens obtained during bronchoscopy in a bronchoscopy unit. Methods: Samples were obtained from environmental surfaces in the endoscopy suite, bronchoscopes, and bronchoscopic dispensable material, and specimens of cleaning solutions, cleaning brushes, the AER, and the ultrasound system were sent for bacterial culture. Medical records were reviewed to identify possible infections after a bronchoscopy. Results: P. putida and S. maltophilia were isolated from BW samples of

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“…AER contamination was identified in 21 studies. [22][23][24][25]28,33,34,[36][37][38][40][41][42][43][44][45][46][47][48][49][50] Among them, 10 pertained to a combination of AER and water source contamination. [22][23][24][25]28,33,34,[36][37][38] In the majority of these, the contaminated water source led to the contamination of the AER itself.…”

Section: Sources Of Contaminationmentioning

confidence: 99%

“…7,16,54,55,57,60,61,63,67,72,73,79,83,85,[89][90][91] Among the 38 studies describing pseudo-outbreaks that reported data on antibiotic use, 14 described at least 1 patient being on antibiotics. 14,25,28,34,35,40,41,43,50,51,66,70,75,92 Among these studies, 7 pertained to pseudo-outbreaks by NTM. 25,28,34,35,43,50,75 Factors positively correlated with the percentage of patients receiving antibiotics were the characterization of the study event as an outbreak (r = 0.617; P < .001) and the identification of M. tuberculosis (r = 0.479; P < .001) as the causative agent.…”

Section: Pathogensmentioning

confidence: 99%

Bronchoscopy-related outbreaks and pseudo-outbreaks: A systematic review

Kakoullis,

Economidou,

Mehrotra

et al. 2023

Infect. Control Hosp. Epidemiol.

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Objective: To identify and report the pathogens and sources of contamination associated with bronchoscopy-related outbreaks and pseudo-outbreaks. Design: Systematic review. Setting: Inpatient and outpatient outbreaks and pseudo-outbreaks after bronchoscopy. Methods: PubMed/Medline databases were searched according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, using the search terms “bronchoscopy,” “outbreak,” and “pseudo-outbreak” from inception until December 31, 2022. From eligible publications, data were extracted regarding the type of event, pathogen involved, and source of contamination. Pearson correlation was used to identify correlations between variables. Results: In total, 74 studies describing 23 outbreaks and 52 pseudo-outbreaks were included in this review. The major pathogens identified in these studies were Pseudomonas aeruginosa, Mycobacterium tuberculosis, nontuberculous mycobacteria (NTM), Klebsiella pneumoniae, Serratia marcescens, Stenotrophomonas maltophilia, Legionella pneumophila, and fungi. The primary sources of contamination were the use of contaminated water or contaminated topical anesthetics, dysfunction and contamination of bronchoscopes or automatic endoscope reprocessors, and inadequate disinfection of the bronchoscopes following procedures. Correlations were identified between primary bronchoscope defects and the identification of P. aeruginosa (r = 0.351; P = .002) and K. pneumoniae (r = 0.346; P = .002), and between the presence of a contaminated water source and NTM (r = 0.331; P = .004) or L. pneumophila (r = 0.280; P = .015). Conclusions: Continued vigilance in bronchoscopy disinfection practices remains essential because outbreaks and pseudo-outbreaks continue to pose a significant risk to patient care, emphasizing the importance of stringent disinfection and quality control measures.

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Stenotrophomonas maltophilia Pseudo-outbreak at a University Hospital Bronchoscopy Unit in Turkey

Abstract: ABSTRACT

Cited by 4 publications

References 8 publications

Stenotrophomonas maltophilia isolates in a tertiary care hospital in Northeastern Brazil

Stenotrophomonas maltophilia isolates in a tertiary care hospital in Northeastern Brazil

A Pseudo-Outbreak of <b><i>Pseudomonas putida</i></b> and <b><i>Stenotrophomonas maltophilia</i></b> in a Bronchoscopy Unit

Bronchoscopy-related outbreaks and pseudo-outbreaks: A systematic review

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