Audit of bronchoscope disinfection: a survey of procedures in England and Wales and incidents of mycobacterial contamination.
Procedures used for cleaning/disinfection of fibreoptic bronchoscopes and incidents of mycobacterial contamination were assessed by postal questionnaire. Information supplied by the Infection Control Doctor in 129 of 198 hospitals (65.2%) was used to audit local practice for compliance with national guidelines. Discrepancies between recommended and local practice included lack of specification of detergent/cleaning agent (57%), inadequate contact time for chemical disinfection (40%) and the use of tap water rather than sterile water for rinsing the disinfected bronchoscope (39.7%). Other procedural anomalies associated with mycobacterial contamination included failure to adhere to manufacturers' instructions to dismantle valves prior to cleaning and to autoclave valves/accessories. The association of mycobacterial incidents with the use of automatic washer/disinfectors (17 of 18 incidents) together with Department of Health warnings of build-up of biofilm within these chemical-process machines gives further cause for concern.
Uttley
A H
AH
Dulwich Public Health Laboratory and Regional Tuberculosis Centre, Dulwich Hospital, East Dulwich Grove, London, UK.
Simpson
R A
RA
D020680:Bronchoscopes; D001999:Bronchoscopy / Q000706:statistics & numerical data; D004203:Disinfection / Q000379:methods*; D004739:England / Q000453:epidemiology; D004866:Equipment Contamination / Q000706:statistics & numerical data*; D005336:Fiber Optic Technology; D006801:Humans; D017053:Infection Control; D008485:Medical Audit; D016926:Mycobacterium chelonae / Q000302:isolation & purification*; D011795:Surveys and Questionnaires; D014852:Wales / Q000453:epidemiology