title: An outbreak of multidrug-resistant Pseudomonas aeruginosa infection associated with contamination of bronchoscopes and an endoscope washer-disinfector.
abstract: Over a two-month period, two distinct types of Pseudomonas aeruginosa resistant to ceftazidime and azlocillin were isolated from bronchial specimens of ITU patients who had been previously bronchoscoped. The source of the outbreak was probably a faulty contaminated bronchoscope washer-disinfector which had been purchased a year earlier but not properly maintained. This paper describes the outbreak, the identification and elimination of the source, and the steps taken to prevent recurrence. Several automated, closed washer-disinfectors had been bought by the hospital in response to health and safety concerns about glutaraldehyde disinfection toxicity, but the operation and maintenance of these machines had not been supervised. Several other washer-disinfectors were also found to be faulty. The potential hazards of automated endoscope washer-disinfectors and the importance of controlled professional maintenance, servicing and training is discussed.
authors.affiliation: Department of Infection, Guy's King's and St Thomas' School of Medicine, St Thomas' Hospital Campus, London, SE17EH, UK. silke.schelenz@kcl.ac.uk
authors.forename: S
authors.initials: S
authors.lastname: Schelenz
authors.forename: G
authors.initials: G
authors.lastname: French
mesh_terms: D001390:Azlocillin / Q000494:pharmacology; D020680:Bronchoscopes / Q000382:microbiology*; D002442:Ceftazidime / Q000494:pharmacology; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D004196:Disease Outbreaks; D004203:Disinfection / Q000379:methods; D018432:Drug Resistance, Multiple; D004866:Equipment Contamination; D006801:Humans; D008131:London / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D011552:Pseudomonas Infections / Q000453:epidemiology* / Q000517:prevention & control; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification
chemical_list: D002442:Ceftazidime; D001390:Azlocillin