Department of Infection Control, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China.
State Key Laboratory for Infectious Disease Prevention and Control, Department of Diarrheal Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Am J Infect Control. 2020 Jan;48(1):26-32. doi: 10.1016/j.ajic.2019.06.013. Epub 2019 Jul 27.
Increased percentage of Pseudomonas aeruginosa from bronchoalveolar lavage fluid of patients in June 2016 was observed. P aeruginosa were also obtained from flexible bronchoscope and rinse water in the microbiological surveillance in June 2016.
Reprocessing procedure of bronchoscope was assessed, and environmental samples were collected. P aeruginosa isolates recovered from bronchoalveolar lavage fluid of patients between May and September 2016 and environment were characterized using multilocus sequence typing and pulsed-field gel electrophoresis.
A novel multilocus sequence type (ST) of P aeruginosa was defined as ST 2387. ST671 and ST 2387 were both cultured from bronchoscopes and connecting tube in manual reprocessing cleaning equipment. One strain from a patient was indistinguishable from the clones obtained from the bronchoscope and connecting tube revealed by pulsed-field gel electrophoresis. Two strains from 2 patients from the burn intensive care unit were identical, and highly related to 2 other strains from the burn intensive care unit. The persistence of P aeruginosa in bronchoscopes, connecting tubes, and final rinse water was terminated by replacement of the connecting tube.
We report a pseudo-outbreak of P aeruginosa associated with bronchoscope, for which connecting tube was the hidden reservoir for contaminating bronchoscopes. This highlights that effective measures are needed to control the bacterial load in final rinsing water to protect reusable equipment from contamination in reprocessing and cleaning.
2016 年 6 月，从患者支气管肺泡灌洗液中观察到铜绿假单胞菌的百分比增加。2016 年 6 月的微生物监测还从软性支气管镜和冲洗水中获得了铜绿假单胞菌。
评估了支气管镜的再处理程序，并收集了环境样本。对 2016 年 5 月至 9 月期间从患者支气管肺泡灌洗液和环境中分离出的铜绿假单胞菌分离株进行多位点序列分型和脉冲场凝胶电泳分析。
定义了一种新型铜绿假单胞菌的多位点序列型（ST），为 ST2387。ST671 和 ST2387 均从手动再处理清洗设备的支气管镜和连接管中培养。从一名患者中分离出的一株与从支气管镜和连接管中获得的克隆通过脉冲场凝胶电泳显示的克隆无法区分。2 名烧伤重症监护病房的患者的 2 株分离株完全相同，与来自烧伤重症监护病房的另外 2 株分离株高度相关。更换连接管可终止铜绿假单胞菌在支气管镜、连接管和最终冲洗水中的持续存在。
我们报告了一起与支气管镜相关的铜绿假单胞菌假暴发事件，其中连接管是污染支气管镜的隐藏储液器。这表明需要采取有效措施来控制最终冲洗水中的细菌负荷，以防止再处理和清洗过程中污染可重复使用的设备。
