Bacteria emitted in ambient air during bronchoscopy-a risk to health care workers?

Abstract

Background: Health care workers are at risk of occupational infections, and some procedures are known to increase this risk. The aim of this study was to qualify and quantify bioaerosol concentrations during bronchoscopy to estimate the occupational risk.

Methods: Full-day sampling was conducted in 2 rooms while bronchoscopies were performed on patients. Two microbial air samplers were used, a wet wall cyclonic sampler and an impactor, on culture media. Identification of the culturable bacterial flora was performed with chromatographic analysis of cellular fatty acid of the isolated strain and additional biochemical tests if needed. Specific polymerase chain reaction analysis was completed on wet wall cyclonic samples for the detection of influenza A and B and Mycobacterium spp.

Results: A wide variety of bacteria were collected from the ambient air. All samples yielded at least 1 Staphylococcus species. Although most of the culturable bacteria identified were normal nonpathogenic flora, such as Streptococcus spp, Neisseria spp, and Corynebacterium spp, some opportunistic pathogens, such as Streptococcus pneumoniae, were found. Neither Mycobacterium spp nor influenza virus was detected with the polymerase chain reaction method during this study.

Conclusions: Culturable bacteria from oral, nasal, and pulmonary flora are aerosolized during bronchoscopy and could be inhaled by medical staff. The potential presence of pathogens in those aerosols could represent an occupational infection risk.

Keywords: Bioaerosols; Indoor air; Occupational exposure.

Fig 1

Bar chart showing results of Tukey-Kramer multiple-comparison analysis of the combined concentrations measured in rooms A and B for culturable bacteria using the impactor (5 minutes at 28.3 Lpm). Bars represent average concentrations for the period studied. A and B indicate statistical differences between the sampling periods (P < .05).