Study: contaminated reusable bronchoscopes could cause secondary infections in COVID-19 patients

By Jay Kumar, PSQH

Contaminated bronchoscopes could cause infections among patients and healthcare staff, according to a study recently published in the journal Infection Control & Hospital Epidemiology.

Bronchoscopes are used to examine patients’ lungs, but when they’re contaminated, they could spread microbes that may cause secondary infections. Although it isn’t clear how often COVID-19 patients receive bronchoscopies, it’s not uncommon for patients with severe lung ailments to undergo the procedure.

“It is possible that contaminated bronchoscopes could infect COVID-19 patients with other infectious diseases,” said Cori L. Ofstead, MSPH, one of the study authors, in a release. “It’s also possible that contaminated devices could expose health care workers to the virus when they are cleaning and disinfecting them between patients. Given what we’ve learned about the overall level of bronchoscope contamination, we urgently need to know whether healthcare personnel are getting exposed to the virus or other pathogens on bronchoscopes due to the lack of PPE and other supplies.”

Using sterile, disposable bronchoscopes would “substantially reduce the risks” to patients and healthcare staff, the researchers wrote. But single-use bronchoscopes are not widely available and may not be effective for some bronchoscopy uses, they added.

Some COVID-19 patients also suffer from other bacterial and fungal lung infections and can have worse outcomes, so contaminated bronchoscopes can prove especially harmful to them, the researchers wrote. Most bronchoscopes are reusable and cleaned/disinfected after every procedure, but the researchers say cleaning and disinfection is often done improperly.

Reprocessing effectiveness has not been evaluated in epidemic settings and research is needed to confirm that COVID-19, influenza viruses, and other pathogens are eliminated in these settings, according to the researchers.

“No patient should suffer from preventable nosocomial infections due to bronchoscopy,” Ofstead said. “Using bronchoscopes that have physical defects and harbor viruses, bacteria, or fungi puts vulnerable patients at risk and could have adverse effects on public health. Institutions are obligated to protect both patients and reprocessing personnel and ensure bronchoscope reprocessing practices adhere to guidelines and manufacturer instructions.”