Bronchoscopes are getting contaminated during use by various pathogens. Disinfection of bronchoscope after each procedure is essential to prevent the out break of pseudo infection. The aim of the present study was to assess the efficacy of manual disinfection of bronchoscope in a tuberculosis endemic region by microbiological analysis of bronchoscopic channel aspirates.
Fifty consecutive adult patients who underwent bronchoscopy for different indications from January 2008 to April 2008 were included in this study. After each procedure, videoscopes were checked for the leakage and subsequently cleaned with 2.45% w/v activated gluteraldehyde as per recommendation. Before and after each procedure, the suction channel was flushed with normal saline and samples were collected in a sterile container with liquid broth for microbiological analysis.
Cultures of post procedure channel aspirates were positive for bacteria (other than mycobacteria) in forty eight patients (96%) and mycobacteria in twelve patients (24%). Streptococcus mitis was the commonest gram positive organism (24%) and Neisseria species was the commonest gram negative organism (55%) isolated. On culture of pre procedure samples, Acinetobacter lwoffi was isolated in one case (2%) and mycobacteria in one case (2%).
Despite following the standard cleaning protocol, isolation of aerobic organism and mycobacteria in 4% of pre procedure sample raises the possibility of tolerance of these organisms against usual cleaning procedure. However, isolation of two different organisms in pre procedure samples rules out the possibility of formation of biofilm inside the bronchoscope.
Despite standard manual disinfection, there are still risks of pseduepidemic and quality of disinfection process should be assessed at the periodic interval to reduce such risks. Culture of the samples especially for mycobacteria are better indicator to asses the efficacy of disinfection. As many patient undergo bronchoscopy to rule out diagnosis of tuberculosis in tubercular endemic region, effective disinfection is essential to prevent the false result.
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