Research Shows Bronchoscope Cleaning Remains Challenging

By on 8:59 AM

An article in Infection Control Today discusses the difficulty organizations face in eliminating potentially harmful contaminants from used bronchoscopes.

Author Kelly Pyrek analyzes research on the cleaning and disinfection of bronchoscopes and shares insight presented by a prominent researcher on the topic at the most recent Association of Professionals in Infection Control and Epidemiology (APIC) annual meeting.

A few key takeaways are as follows:
  • Several years ago, numerous infections were associated with contaminated bronchoscopes in a short period. 
  • At the time, the Food and Drug Administration (FDA) issued a safety communication about microbial transmission and infection associated with bronchoscopes. The agency urged adherence to sterile processing guidelines, noting that inadequate cleaning could lead to failure of high-level disinfection (HLD) or sterilization. 
  • FDA also advised that bronchoscopes with signs of damage be repaired or replaced.
  • Research published earlier this year detailed the work of researchers examining 24 used bronchoscopes that underwent reprocessing in accordance with institutional practices. After manual cleaning, the researchers reported that all bronchoscopes had residual contamination. Protein was detected in samples from all bronchoscopes post-manual cleaning and post-HLD. Microbial growth was found in 58% of fully reprocessed bronchoscopes.
  • Visible irregularities (e.g., retained fluid, scratches, damaged insertion tubes and distal ends) were observed in all bronchoscopes.
  • The researchers wrote the following: "Inadequate reprocessing practices may have contributed to bioburden found on bronchoscopes. However, even when guidelines were followed, HLD was not effective. A shift toward the use of sterilized bronchoscopes is recommended. In the meantime, quality management programs and updated reprocessing guidelines are needed."
Pyrek's article takes a deep dive into this challenging matter and offers some valuable guidance on what organizations should do to improve compliance and reduce infection risks. Access the article by clicking here.

For additional insight, read the ICCS blog on Bronchoscopes: A Risk for Infection?, which discusses the FDA's safety communication and a Centers for Disease Control and Prevention (CDC) Health Advisory issued around the same time concerning reprocessing practices. The blog also shares FDA recommended precautions for facilities reprocessing flexible bronchoscopes.

Phenelle Segal, RN, CIC, FAPIC

Phenelle Segal, RN, CIC, FAPIC, is the founder and president of Infection Control Consulting Services LLC (ICCS). Phenelle has more than 30 years' experience providing customized comprehensive infection control and prevention services to healthcare facilities nationwide. Her services focus on assisting hospitals, ambulatory surgery centers, dental office and oral surgery practices, doctor's offices, nursing homes and other organizations with implementing and maintaining an infection control program that: complies with The Joint Commission, AAAHC, Centers for Medicaid and Medicare Services (CMS) and other regulatory agencies; respond to situations of noncompliance; and improve the processes for reducing risk.