Pseudo-outbreak of Legionella pneumophila serogroup 8 infection associated with a contaminated ice machine in a bronchoscopy suite
Autor: | A. N. Schuetz, Bruce S. Ribner, Dan Jackson, R Hughes, T. C. Williams, F. S. Nolte, R. M. Howard |
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Rok vydání: | 2009 |
Předmět: |
Microbiology (medical)
Serotype Adult Male Disease reservoir Epidemiology Legionella pneumophila Asepsis Microbiology Bronchoscopies Disease Outbreaks chemistry.chemical_compound Bronchoscopy Medicine Humans Buffered charcoal yeast extract agar Serotyping Aged Disease Reservoirs Cross Infection biology medicine.diagnostic_test business.industry Ice Middle Aged biology.organism_classification medicine.disease Infectious Diseases Bronchoscopes chemistry Equipment Contamination Legionnaires' disease Female Legionnaires' Disease business Water Microbiology Bronchoalveolar Lavage Fluid |
Zdroj: | Infection control and hospital epidemiology. 30(5) |
ISSN: | 1559-6834 0195-9417 |
Popis: | Objective.To investigate the marked increase noted over an 8-month period in the number ofLegionella pneumophilaisolates recovered from bronchoalveolar lavage fluid specimens obtained during bronchoscopy in our healthcare system.Setting.Bronchoscopy suite that serves a 580-bed tertiary care center and a large, multisite, faculty practice plan with approximately 2 million outpatient visits per year.Methods.Cultures of environmental specimens from the bronchoscopy suite were performed, including samples from the air and water filters, bronchoscopes, and the ice machine, with the aim of identifyingLegionellaspecies. Specimens were filtered and acid-treated and then inoculated on buffered charcoal yeast extract agar. Serogrouping was performed on all isolates recovered from patient and environmental samples.Results.AUL. pneumophilaisolates recovered from patients were serogroup 8, a serogroup that is not usually recovered in our facility. An epidemiologic investigation of the bronchoscopy suite revealed the ice machine to be contaminated withL. pneumophilaserogroup 8. Patients were exposed to the organism as a result of a recently adopted practice in the bronchoscopy suite that involved directly immersing uncapped syringes of sterile saline in contaminated ice baths during the procedures. At least 1 patient was ill as a result of the pseudo-outbreak. Molecular typing of isolates recovered from patient and environmental samples revealed that the isolates were indistinguishable.Conclusions.Extensive cleaning of the ice machine and replacement of the machine's water filter ended the pseudo-outbreak. This episode emphasizes the importance of using aseptic technique when performing invasive procedures, such as bronchoscopies. It also demonstrates the importance of reviewing procedures in all patient areas to ensure compliance with facility policies for providing a safe patient environment. |
Databáze: | OpenAIRE |
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