Whitlock W L, Dietrich R A, Steimke E H, Tenholder M F
Eisenhower Army Medical Center, Fort Gordon, Ga.
Chest. 1992 Nov;102(5):1516-9. doi: 10.1378/chest.102.5.1516.
Rhodotorula rubra was recovered in 18 bronchoscopic specimens from 15 patients from May to November 1987. One hundred and twenty-one bronchoscopies were performed during that period by two bronchoscopists (W. W.; R.D.) at Letterman Army Medical Center in San Francisco. Isolation of R rubra occurred in 11 bronchoalveolar lavage (BAL) specimens, four bronchial washes, and three transbronchial biopsies. Clinical infection was not present in any of these patients, although five were immunocompromised hosts. After a stepwise infection control review of the laboratory, the bronchoscopy suite, bronchoscopists, and the fiberoptic bronchoscope failed to recover the organism, a systematic evaluation of the cleaning procedure was undertaken. We discovered that replacement of the suction valve and the rubber biopsy valve on the biopsy channel immediately after cleaning allowed moisture to accumulate in these areas. Removal of both the suction valve and biopsy valve during periods of nonuse resulted in adequate drying of the biopsy channel and eradication of contamination from December 1987 to May 1990 (350 bronchoscopies). Epidemiologic and infection control surveillance is critical for bronchoscopy, especially when possible pathogens are recovered by BAL in the immunocompromised patient.
1987年5月至11月期间，从15名患者的18份支气管镜检查标本中分离出深红酵母。在此期间，旧金山莱特曼陆军医疗中心的两名支气管镜检查医师（W.W.；R.D.）共进行了121次支气管镜检查。深红酵母在11份支气管肺泡灌洗（BAL）标本、4份支气管冲洗标本和3份经支气管活检标本中被分离出来。尽管其中5名患者为免疫功能低下宿主，但这些患者均未出现临床感染。在对实验室、支气管镜检查室、支气管镜检查医师和纤维支气管镜进行逐步的感染控制审查后，未能再分离出该微生物，于是对清洁程序进行了系统评估。我们发现，清洁后立即更换活检通道上的吸引阀和橡胶活检阀会导致这些区域积水。在不使用期间拆除吸引阀和活检阀，可使活检通道充分干燥，并在1987年12月至1990年5月期间（350次支气管镜检查）消除污染。流行病学和感染控制监测对支气管镜检查至关重要，尤其是当免疫功能低下患者通过BAL发现可能的病原体时。
