Yanjun Zhang1, Haijian Zhou2, Qianqian Jiang1, Qin Wang3, Shan Li3, Yi Huang4. 1. Department of Infection Control, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China. 2. State Key Laboratory for Infectious Disease Prevention and Control, Department of Diarrheal Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. 3. Interventional Treatment Center of Respiratory Diseases, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China. 4. Department of Infection Control, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China. Electronic address: huangliur@163.com.
Abstract
BACKGROUND: Increased percentage of Pseudomonas aeruginosa from bronchoalveolar lavage fluid of patients in June 2016 was observed. P aeruginosa were also obtained from flexible bronchoscope and rinse water in the microbiological surveillance in June 2016. METHODS: Reprocessing procedure of bronchoscope was assessed, and environmental samples were collected. P aeruginosa isolates recovered from bronchoalveolar lavage fluid of patients between May and September 2016 and environment were characterized using multilocus sequence typing and pulsed-field gel electrophoresis. RESULTS: A novel multilocus sequence type (ST) of P aeruginosa was defined as ST 2387. ST671 and ST 2387 were both cultured from bronchoscopes and connecting tube in manual reprocessing cleaning equipment. One strain from a patient was indistinguishable from the clones obtained from the bronchoscope and connecting tube revealed by pulsed-field gel electrophoresis. Two strains from 2 patients from the burn intensive care unit were identical, and highly related to 2 other strains from the burn intensive care unit. The persistence of P aeruginosa in bronchoscopes, connecting tubes, and final rinse water was terminated by replacement of the connecting tube. CONCLUSIONS: We report a pseudo-outbreak of P aeruginosa associated with bronchoscope, for which connecting tube was the hidden reservoir for contaminating bronchoscopes. This highlights that effective measures are needed to control the bacterial load in final rinsing water to protect reusable equipment from contamination in reprocessing and cleaning.
BACKGROUND: Increased percentage of Pseudomonas aeruginosa from bronchoalveolar lavage fluid of patients in June 2016 was observed. P aeruginosa were also obtained from flexible bronchoscope and rinse water in the microbiological surveillance in June 2016. METHODS: Reprocessing procedure of bronchoscope was assessed, and environmental samples were collected. P aeruginosa isolates recovered from bronchoalveolar lavage fluid of patients between May and September 2016 and environment were characterized using multilocus sequence typing and pulsed-field gel electrophoresis. RESULTS: A novel multilocus sequence type (ST) of P aeruginosa was defined as ST 2387. ST671 and ST 2387 were both cultured from bronchoscopes and connecting tube in manual reprocessing cleaning equipment. One strain from a patient was indistinguishable from the clones obtained from the bronchoscope and connecting tube revealed by pulsed-field gel electrophoresis. Two strains from 2 patients from the burn intensive care unit were identical, and highly related to 2 other strains from the burn intensive care unit. The persistence of P aeruginosa in bronchoscopes, connecting tubes, and final rinse water was terminated by replacement of the connecting tube. CONCLUSIONS: We report a pseudo-outbreak of P aeruginosa associated with bronchoscope, for which connecting tube was the hidden reservoir for contaminating bronchoscopes. This highlights that effective measures are needed to control the bacterial load in final rinsing water to protect reusable equipment from contamination in reprocessing and cleaning.
Authors: Kimberley V Sukhum; Erin P Newcomer; Candice Cass; Meghan A Wallace; Caitlin Johnson; Jeremy Fine; Steven Sax; Margaret H Barlet; Carey-Ann D Burnham; Gautam Dantas; Jennie H Kwon Journal: Commun Med (Lond) Date: 2022-06-01
Authors: Michael J Brenner; Jared A Shenson; Austin S Rose; Tulio A Valdez; Masayoshi Takashima; Omar G Ahmed; Philip A Weissbrod; Robert S Hong; Hamid Djalilian; Jeffrey S Wolf; Robert J Morrison; Peter L Santa Maria; Isaac D Erbele Journal: OTO Open Date: 2021-11-10