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Hi Terry,
I’d be looking for a design flaw in the Automated Endoscope Reprocessors
that is hindering contact of the cleaning and disinfecting agents with every
potentially contaminated surface particularly given that it sound like it is
in more that on processor. Is that correct?
Cross sectional drawing of the Automated Endoscope Reprocessor components
might be useful in identifying sections of the reprocessor that are
hindering contact of the cleaning and disinfecting agents.
See John Hopkins experience with design flaws in a bronchoscopes:
N Engl J Med. 2003 Jan
16;348(3):221-7.
An outbreak of Pseudomonas aeruginosa infections associated with flexible
bronchoscopes
http://www.ncbi.nlm.nih.gov/pubmed/12529462
and
“Bronchoscope pseudomonas outbreak rattles John Hopkins”
http://www.endonurse.com/articles/2002/05/bronchoscope-pseudomonas-outbreak-
rattles-johns-h.aspx
regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
ABN 47533508426
Of Terry McAuley
Hi Everyone,
I have had a recent spate where a number of my endoscopy procedure centre
clients have reported culturing of “Pseudomonas species” or Gram negative
bacilli after the monthly water testing of the Automated Endoscope
Reprocessors.
Upon further investigation, the organism has been identified as Cupriavidis
pauculus. This organism is often associated with ultra filtration systems
and although it has low pathogenicity it is a risk to immunocompromised
patients.
Despite repeated water line disinfections, filter changes, disinfectant
dumps etc this bug keeps cropping up over and over again. We find that we
have cleared it in the next test after filter changes etc etc but then a
month later – we get a positive result again.
Whilst in low numbers, it is causing some concern regarding potential risks
to patients. In all cases we are not growing the organism form the
endoscopes.
I am wondering if anyone else has been experiencing the same issues?
If so – what did you do about it both in terms of managing the machines and
the risks to patients?
If you have cultured this organism, did you manage to identify the cause of
the problem?
Happy to chat offline.
Regards
Terry McAuley
Sterilisation & Infection Prevention and Control Consultant
STEAM Consulting
E: terry@steamconsulting.com.au
W: http://www.steamconsulting.com.au
A: PO BOX 779
Endeavour Hills
VIC Australia 3802
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