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874. Pseudo-outbreak of Adenovirus in Bronchoscopy Suite
BACKGROUND: Adenoviruses (Adv) are non-enveloped viruses that can survive for long periods on environmental surfaces. However, only 1 prior publication describes an adenovirus pseudo-outbreak associated with bronchoscopes. In 1/ 2020 infectious disease physicians noted a cluster of Adv PCR-positive...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776145/ http://dx.doi.org/10.1093/ofid/ofaa439.1063 |
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author | Seidelman, Jessica L Akinboyo, Ibukunoluwa Taylor, Bonnie McLay, Carol Smith, Becky Lewis, Sarah S |
author_facet | Seidelman, Jessica L Akinboyo, Ibukunoluwa Taylor, Bonnie McLay, Carol Smith, Becky Lewis, Sarah S |
author_sort | Seidelman, Jessica L |
collection | PubMed |
description | BACKGROUND: Adenoviruses (Adv) are non-enveloped viruses that can survive for long periods on environmental surfaces. However, only 1 prior publication describes an adenovirus pseudo-outbreak associated with bronchoscopes. In 1/ 2020 infectious disease physicians noted a cluster of Adv PCR-positive bronchiolar lavage (BAL) samples, which prompted an outbreak investigation. METHODS: We reviewed medical charts, clinical microbiology, procedure logs, bronchoscope reprocessing logs, bronchoscope cleaning, and high-level disinfection (HLD) practices. RESULTS: On 1/28/20 an infectious diseases physician alerted infection prevention to a cluster of 5 lung transplant patients diagnosed with Adv positive BAL samples. Four out of the 5 patients had the bronchoscopy in the same bronchoscopy suite. We reviewed BAL results from all bronchoscopies performed in this suite from 11/1/19 to 1/24/20 and found a total of 10 patients with positive Adv PCR results. Eight out of the 10 patients had bronchoscopies with one of two bronchoscopes. Of all patients who had a bronchoscopy with the bronchoscope from 11/1/19 to 1/24/20 and had respiratory viral panel sent at that time, 6 of 11 (55%) who underwent procedure with Scope A and 4 of 24 (17%) who underwent procedure with Scope B had positive Adv PCR results. Sham BALs were performed on both bronchoscopes and testing for Adv was negative. However, on inspection by the manufacturer, one scope failed both wet and dry leak tests and had several physical defects. Following removal of both bronchoscopes from service we did not find any positive Adv samples from the bronchoscopy unit. CONCLUSION: Previously, very few pseudo-outbreaks of Adv have been linked to bronchoscopes. We identified a pseudo-outbreak of Adv associated with 2 bronchoscopes in a hospital-based bronchoscopy suite that stopped once we removed the associated bronchoscopes from the procedural unit. Bronchoscopy-related pseudo-outbreaks occur despite standardized procedures for HLD. Bronchoscopy clinics, particularly those with a high volume of immunocompromised patients, should prospectively review BAL cultures to identify unusual pathogen trends. These trends may be a sign of damaged equipment that would otherwise go undetected. DISCLOSURES: All Authors: No reported disclosures |
format | Online Article Text |
id | pubmed-7776145 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-77761452021-01-07 874. Pseudo-outbreak of Adenovirus in Bronchoscopy Suite Seidelman, Jessica L Akinboyo, Ibukunoluwa Taylor, Bonnie McLay, Carol Smith, Becky Lewis, Sarah S Open Forum Infect Dis Poster Abstracts BACKGROUND: Adenoviruses (Adv) are non-enveloped viruses that can survive for long periods on environmental surfaces. However, only 1 prior publication describes an adenovirus pseudo-outbreak associated with bronchoscopes. In 1/ 2020 infectious disease physicians noted a cluster of Adv PCR-positive bronchiolar lavage (BAL) samples, which prompted an outbreak investigation. METHODS: We reviewed medical charts, clinical microbiology, procedure logs, bronchoscope reprocessing logs, bronchoscope cleaning, and high-level disinfection (HLD) practices. RESULTS: On 1/28/20 an infectious diseases physician alerted infection prevention to a cluster of 5 lung transplant patients diagnosed with Adv positive BAL samples. Four out of the 5 patients had the bronchoscopy in the same bronchoscopy suite. We reviewed BAL results from all bronchoscopies performed in this suite from 11/1/19 to 1/24/20 and found a total of 10 patients with positive Adv PCR results. Eight out of the 10 patients had bronchoscopies with one of two bronchoscopes. Of all patients who had a bronchoscopy with the bronchoscope from 11/1/19 to 1/24/20 and had respiratory viral panel sent at that time, 6 of 11 (55%) who underwent procedure with Scope A and 4 of 24 (17%) who underwent procedure with Scope B had positive Adv PCR results. Sham BALs were performed on both bronchoscopes and testing for Adv was negative. However, on inspection by the manufacturer, one scope failed both wet and dry leak tests and had several physical defects. Following removal of both bronchoscopes from service we did not find any positive Adv samples from the bronchoscopy unit. CONCLUSION: Previously, very few pseudo-outbreaks of Adv have been linked to bronchoscopes. We identified a pseudo-outbreak of Adv associated with 2 bronchoscopes in a hospital-based bronchoscopy suite that stopped once we removed the associated bronchoscopes from the procedural unit. Bronchoscopy-related pseudo-outbreaks occur despite standardized procedures for HLD. Bronchoscopy clinics, particularly those with a high volume of immunocompromised patients, should prospectively review BAL cultures to identify unusual pathogen trends. These trends may be a sign of damaged equipment that would otherwise go undetected. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7776145/ http://dx.doi.org/10.1093/ofid/ofaa439.1063 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Poster Abstracts Seidelman, Jessica L Akinboyo, Ibukunoluwa Taylor, Bonnie McLay, Carol Smith, Becky Lewis, Sarah S 874. Pseudo-outbreak of Adenovirus in Bronchoscopy Suite |
title | 874. Pseudo-outbreak of Adenovirus in Bronchoscopy Suite |
title_full | 874. Pseudo-outbreak of Adenovirus in Bronchoscopy Suite |
title_fullStr | 874. Pseudo-outbreak of Adenovirus in Bronchoscopy Suite |
title_full_unstemmed | 874. Pseudo-outbreak of Adenovirus in Bronchoscopy Suite |
title_short | 874. Pseudo-outbreak of Adenovirus in Bronchoscopy Suite |
title_sort | 874. pseudo-outbreak of adenovirus in bronchoscopy suite |
topic | Poster Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776145/ http://dx.doi.org/10.1093/ofid/ofaa439.1063 |
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