title: Contamination of single-use bronchoscopes in critically ill patients.
abstract: Disposable bronchoscopes such as the Ambu aScopeTM3 are marketed as 'single use' The risks of contamination from prolonged device storage before possible re-use are unknown. Following clinical bronchoscopy in patients whose lungs were mechanically ventilated, 20 aScopeTM3's bronchoscopes received a standard 'social clean' and were then stored. Subsequent paired saline flush and swab samples were taken at time zero, and at 24 h and 48 h. Positive microbiological cultures were obtained from at least one time point from 16 of the 20 bronchoscopes. Pathogens considered at high risk of causing pneumonia were isolated from seven bronchoscopes, with significant quantities from six of them. Our study demonstrates that aScopeTM3's should not be re-used on the same patient, as clinically significant growth of micro-organisms occurs frequently, despite adequate social cleaning. Culture of bronchoscopes themselves may be a potentially useful diagnostic tool in the context of pulmonary infection. Our data make it clear that these devices are single use and not single patient use.
authors.affiliation: University Hospital South Manchester, Manchester, UK.|Manchester Academic Health Sciences Campus, Manchester, UK.
authors.forename: B A
authors.initials: BA
authors.lastname: McGrath
authors.affiliation: Health Education North-West, Manchester, UK.
authors.forename: S
authors.initials: S
authors.lastname: Ruane
authors.affiliation: University Hospital South Manchester, Manchester, UK.
authors.forename: J
authors.initials: J
authors.lastname: McKenna
authors.affiliation: University Hospital South Manchester, Manchester, UK.
authors.forename: S
authors.initials: S
authors.lastname: Thomas
mesh_terms: D020680:Bronchoscopes / Q000382:microbiology*; D001999:Bronchoscopy / Q000295:instrumentation; D016638:Critical Illness / Q000628:therapy*; D003428:Cross Infection / Q000382:microbiology / Q000635:transmission*; D003666:Decontamination / Q000379:methods; D004209:Disposable Equipment / Q000382:microbiology*; D004739:England; D004866:Equipment Contamination / Q000706:statistics & numerical data*; D017743:Equipment Reuse; D005336:Fiber Optic Technology / Q000295:instrumentation; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000295:instrumentation; D012121:Respiration, Artificial; D013997:Time Factors
keywords: bronchoscopy; fibre-optic intubation; nosocomial infection