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Previous Volume 348:214-220 January 16, 2003 Number 3 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Perspective by Feigal, D. W. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Several outbreaks and pseudo-outbreaks of Pseudomonas aeruginosa and Serratia marcescens infections associated with bronchoscopy have been reported. We conducted an investigation of P. aeruginosa and S. marcescens isolates related to bronchoscopy at a community hospital.

Methods We reviewed the records of all bronchoscopic procedures at the community hospital from July to October 2001. Environmental samples were obtained. Pulsed-field gel electrophoresis (PFGE) was performed on isolates of P. aeruginosa.

Results From July 1 to October 31, 2001, 66 bronchoscopic procedures were performed in 60 patients, and 43 specimens were obtained for bacterial culture; 20 of the specimens (47 percent) were positive for P. aeruginosa. Six (30 percent) of the specimens that were positive for P. aeruginosa also yielded S. marcescens. All 20 P. aeruginosa isolates were associated with procedures performed with three of four new bronchoscopes from the same manufacturer. Contrary to manufacturing specifications, the biopsy-port caps on all four bronchoscopes were easily removable, and P. aeruginosa was cultured from the biopsy ports of the three implicated bronchoscopes. The PFGE patterns of P. aeruginosa isolates from the bronchoscopes, patients, and two environmental samples were indistinguishable. One patient was hospitalized with P. aeruginosa pneumonia 11 days after bronchoscopy. The manufacturer reported a design change instituted in 1997, and production problems may have resulted in the distribution of bronchoscopes that did not meet specifications.

Conclusions We documented contamination of bronchoscopes with P. aeruginosa and S. marcescens and possible infection of patients at a community hospital as a result of the inadequate disinfection of bronchoscopes because of a manufacturing defect.

Source Information

From the Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta (D.L.K.); the Tennessee Department of Health, Nashville (D.L.K., T.F.J., A.S.C.); the Vanderbilt University School of Medicine, Nashville (T.F.J., A.S.C., P.S.C., W.S.); and Skyline Medical Center, Nashville (G.G.M., J.A.P.).

Address reprint requests to Dr. Schaffner at the Vanderbilt University School of Medicine, Medical Center North, Rm. A-1124, Nashville, TN 37232, or at william.schaffner{at}vanderbilt.edu.

Full Text of this Article

Related Letters:

Outbreaks of Infection Associated with Bronchoscopes
Cetre J.-C., Salord H., Vanhems P., Srinivasan A., Perl T. M., Schaffner W., Jones T. F.
Extract | Full Text | PDF  
N Engl J Med 2003; 348:2039-2040, May 15, 2003. Correspondence

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