OBJECTIVE: To investigate an apparent outbreak involving simultaneous isolation of Pseudomonas aeruginosa and Serratia marcescens from bronchoalveolar lavage (BAL) samples. DESIGN: Retrospective and prospective cohort studies using chart review, environmental sampling, and ribotyping of all available isolates. Cleaning and disinfection procedures for the bronchoscopes were also evaluated. SETTING: A 380-bed private hospital in São Paulo, Brazil PATIENTS: Forty-one patients who underwent bronchoscopic procedures between December 1994 and October 1996 and from whom P. aeruginosa and S. marcescens were concomitantly isolated. Bronchoscopes and related items were microbiologically assessed. RESULTS: P. aeruginosa and S. marcescens were simultaneously isolated from BAL samples 12.6\% of the time (41 of 324) during the epidemic period versus 1.8\% of the time (1 of 54) in the pre-epidemic period (P = .035). Ribotyping revealed two strains of P. aeruginosa and one of S. marcescens that were isolated from BAL samples of patients with no signs of respiratory tract infection, suggesting a pseudo-outbreak. Evaluation of bronchoscope disinfection revealed that inappropriate methods were being used. Implementation of simple control measures resulted in a significant decrease in simultaneous isolation of these species. CONCLUSION: Prevention of pseudo-outbreaks requires meticulous use of preventive measures for infection-prone medical procedures.
%0 Journal Article
%1 silva_pseudo-outbreak_2003
%A Silva, Cláudia V
%A Magalhães, Vanda D
%A Pereira, Crésio R
%A Kawagoe, Julia Y
%A Ikura, Chizue
%A Ganc, Arnaldo J
%D 2003
%J Infection Control and Hospital Epidemiology: The Official Journal of the Society of Hospital Epidemiologists of America
%K Brazil, Bronchoalveolar Bronchoscopes, Bronchoscopy, Cohort Contamination, Cross Disease Disinfection, Equipment Hospitals, Humans, Infection, Infections, Lavage, Outbreaks, Private, Prospective Pseudomonas Retrospective Reuse, Ribotyping, Serratia Studies, aeruginosa, marcescens
%N 3
%P 195--197
%R 10.1086/502195
%T Pseudo-outbreak of Pseudomonas aeruginosa and Serratia marcescens related to bronchoscopes
%U http://www.ncbi.nlm.nih.gov/pubmed/12683511
%V 24
%X OBJECTIVE: To investigate an apparent outbreak involving simultaneous isolation of Pseudomonas aeruginosa and Serratia marcescens from bronchoalveolar lavage (BAL) samples. DESIGN: Retrospective and prospective cohort studies using chart review, environmental sampling, and ribotyping of all available isolates. Cleaning and disinfection procedures for the bronchoscopes were also evaluated. SETTING: A 380-bed private hospital in São Paulo, Brazil PATIENTS: Forty-one patients who underwent bronchoscopic procedures between December 1994 and October 1996 and from whom P. aeruginosa and S. marcescens were concomitantly isolated. Bronchoscopes and related items were microbiologically assessed. RESULTS: P. aeruginosa and S. marcescens were simultaneously isolated from BAL samples 12.6\% of the time (41 of 324) during the epidemic period versus 1.8\% of the time (1 of 54) in the pre-epidemic period (P = .035). Ribotyping revealed two strains of P. aeruginosa and one of S. marcescens that were isolated from BAL samples of patients with no signs of respiratory tract infection, suggesting a pseudo-outbreak. Evaluation of bronchoscope disinfection revealed that inappropriate methods were being used. Implementation of simple control measures resulted in a significant decrease in simultaneous isolation of these species. CONCLUSION: Prevention of pseudo-outbreaks requires meticulous use of preventive measures for infection-prone medical procedures.
@article{silva_pseudo-outbreak_2003,
abstract = {{OBJECTIVE:} To investigate an apparent outbreak involving simultaneous isolation of Pseudomonas aeruginosa and Serratia marcescens from bronchoalveolar lavage {(BAL)} samples. {DESIGN:} Retrospective and prospective cohort studies using chart review, environmental sampling, and ribotyping of all available isolates. Cleaning and disinfection procedures for the bronchoscopes were also evaluated. {SETTING:} A 380-bed private hospital in São Paulo, Brazil {PATIENTS:} Forty-one patients who underwent bronchoscopic procedures between December 1994 and October 1996 and from whom P. aeruginosa and S. marcescens were concomitantly isolated. Bronchoscopes and related items were microbiologically assessed. {RESULTS:} P. aeruginosa and S. marcescens were simultaneously isolated from {BAL} samples 12.6\% of the time (41 of 324) during the epidemic period versus 1.8\% of the time (1 of 54) in the pre-epidemic period {(P} = .035). Ribotyping revealed two strains of P. aeruginosa and one of S. marcescens that were isolated from {BAL} samples of patients with no signs of respiratory tract infection, suggesting a pseudo-outbreak. Evaluation of bronchoscope disinfection revealed that inappropriate methods were being used. Implementation of simple control measures resulted in a significant decrease in simultaneous isolation of these species. {CONCLUSION:} Prevention of pseudo-outbreaks requires meticulous use of preventive measures for infection-prone medical procedures.},
added-at = {2011-03-11T10:05:34.000+0100},
author = {Silva, Cláudia V and Magalhães, Vanda D and Pereira, Crésio R and Kawagoe, Julia Y and Ikura, Chizue and Ganc, Arnaldo J},
biburl = {https://www.bibsonomy.org/bibtex/254b51520498e21f593030a6c3dc495f9/jelias},
doi = {10.1086/502195},
interhash = {8180686b2ea846ae713cbe7f5e639cc0},
intrahash = {54b51520498e21f593030a6c3dc495f9},
issn = {{0899-823X}},
journal = {Infection Control and Hospital Epidemiology: The Official Journal of the Society of Hospital Epidemiologists of America},
keywords = {Brazil, Bronchoalveolar Bronchoscopes, Bronchoscopy, Cohort Contamination, Cross Disease Disinfection, Equipment Hospitals, Humans, Infection, Infections, Lavage, Outbreaks, Private, Prospective Pseudomonas Retrospective Reuse, Ribotyping, Serratia Studies, aeruginosa, marcescens},
month = mar,
note = {{PMID:} 12683511},
number = 3,
pages = {195--197},
timestamp = {2011-03-11T10:05:48.000+0100},
title = {Pseudo-outbreak of Pseudomonas aeruginosa and Serratia marcescens related to bronchoscopes},
url = {http://www.ncbi.nlm.nih.gov/pubmed/12683511},
volume = 24,
year = 2003
}