Gubler J G, Salfinger M, von Graevenitz A
Medizinische Klinik, Kantonsspital, Winterthur, Switzerland.
Chest. 1992 May;101(5):1245-9. doi: 10.1378/chest.101.5.1245.
We describe a pseudoepidemic due to nontuberculous mycobacteria contaminating the water tank of a machine used to clean and disinfect fiberoptic endoscopes. Forty-six bronchoscopies performed on 41 patients during a six-month period yielded 16 specimens positive for acid-fast bacilli (AFB). One specimen showed Mycobacterium avium complex from an AIDS patient and one, M tuberculosis from a patient with active cavitary tuberculosis. In four patients, only the smears showed AFB; subsequent cultures remained negative. Of the rest, seven contained M chelonae and three M gordonae, all in patients with no clinical signs of mycobacterial disease. Two of the three M gordonae isolates represented laboratory contamination from an antimicrobial solution in a culture medium. Four patients in the beginning of the pseudoepidemic were treated for presumed tuberculosis until negative culture results were available. Control of the "outbreak" was achieved by regular disinfection of the implicated water tank in the cleaning machine. Contamination of bronchoscopes with nontuberculous mycobacteria can lead to unnecessary diagnostic and therapeutic interventions.
我们描述了一起由非结核分枝杆菌污染用于清洁和消毒纤维支气管镜的机器水箱所导致的假性流行。在六个月期间，对41例患者进行了46次支气管镜检查，结果发现16份标本抗酸杆菌（AFB）呈阳性。一份标本来自一名艾滋病患者，检测出鸟分枝杆菌复合群；另一份来自一名患有活动性空洞性肺结核的患者，检测出结核分枝杆菌。在4例患者中，仅涂片显示AFB阳性；后续培养结果均为阴性。其余患者中，7例含有龟分枝杆菌，3例含有戈登分枝杆菌，所有患者均无分枝杆菌病的临床症状。3株戈登分枝杆菌中有2株分离株代表培养基中抗菌溶液的实验室污染。在假性流行初期，有4例患者因疑似结核病接受了治疗，直至培养结果为阴性。通过定期对清洗机中涉及的水箱进行消毒，“疫情”得到了控制。支气管镜被非结核分枝杆菌污染可导致不必要的诊断和治疗干预。
