Abstract

Introduction:During bronchoscopy, a bronchoscope traverses into the bronchial tree to visualise the respiratory tract and send the washings for various investigations. This event could lead to local spread of pre-existing infection, spread of infection from one patient to the other if the bronchoscope is disinfected inadequately, or, isolation of microorganisms from bronchoscopic specimens in a patient who is clinically not infected, i.e. pseudoinfection. This study is one such investigation of an outbreak of bronchoscopic pseudo-infections in a tertiary care hospital. Materials and methods: Bronchoalveolar lavage (BAL) samples were inoculated onto MacConkeyAgar and 5% Sheep Blood Agar and incubated at 37°C overnight. The growths obtained on culture media were processed for identification and antimicrobial susceptibility on Vitek 2 Compact as per manufacturer’s instructions. To investigate the outbreak, 5-10mL of sterile water was flushed through the channels of disinfected bronchoscope and collected in a sterile container. The samples were centrifuged and inoculated onto Mac Conkey Agar and 5% Sheep Blood Agar. The growths obtained were further processed similarly as the BAL samples were processed. Environmental swabs collected from the bronchoscopy unit were also processed as the procedure mentioned above. Results: Bronchoalveolar lavage of 3 patients in a period of 1 week were contaminated with multidrug resistant Klebsiella pneumoniae. Two out of five bronchschope fluid samples were also contaminated with Klebsiella pneumoniae. Among the swabs collected from bronchoscope unit, Klebsiella pneumoniae was isolated from the endowasher detergent box. Conclusion: The risk of propagation of infection via a bronchoscope can be evaded by proper reprocessing and improving the sterilization practices.

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