Schelenz S, French G
Department of Infection, Guy's King's and St Thomas' School of Medicine, St Thomas' Hospital Campus, London, SE17EH, UK.
J Hosp Infect. 2000 Sep;46(1):23-30. doi: 10.1053/jhin.2000.0800.
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.
在两个月的时间里，从先前接受过支气管镜检查的重症监护病房（ITU）患者的支气管标本中分离出两种对头孢他啶和阿洛西林耐药的不同类型的铜绿假单胞菌。此次疫情的源头可能是一台有故障的受污染支气管镜清洗消毒器，该设备一年前购买，但未得到妥善维护。本文描述了此次疫情、源头的识别与消除，以及为防止疫情复发所采取的措施。由于对戊二醛消毒毒性存在健康与安全方面的担忧，医院购买了几台自动封闭式清洗消毒器，但这些机器的操作和维护未得到监督。还发现其他几台清洗消毒器也有故障。文中讨论了自动内镜清洗消毒器的潜在危害以及专业控制维护、维修和培训的重要性。
