Bronchopulmonary cross-colonization and infection related to mycobacterial contamination of suction valves of bronchoscopes

Abstract

Recurrent episodes of mycobacterial cross-contamination of bronchoscopy specimens were identified in a large, tertiary-care referral center. One episode was followed by active pulmonary infection due to Mycobacterium tuberculosis. Initial epidemiologic investigation implicated the flexible fiberoptic bronchoscopes. In experiments, bronchoscopes and related equipment were exposed to a saline suspension of M. fortuitum (10(5)-10(7)/mL). Bronchoscopes were readily sterilized by routine cleaning and disinfection procedures, but the spring-operated suction valves remained contaminated, even after a 30-min exposure to 2% glutaraldehyde or after passage through a commercial bronchoscope washer. These results indicate that suction valves that have been heavily contaminated with mycobacterial organisms cannot be reliably disinfected with commercially available glutaraldehyde. Suction valves have since been routinely autoclaved after each use. No additional episodes of cross-contamination or infection have occurred over 24 mo of surveillance.