Outbreak of Cystoscopy-Related Urinary Tract Infections With Pseudomonas aeruginosa in South Korea, 2022: A Case Series
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Purpose: This study conducted an epidemiological investigation of Pseudomonas aeruginosa urinary tract infections (UTIs) following cystoscopy at Chilgok Kyungpook National University Hospital. Materials and Methods: From May 16 to July 15, 2022, among 353 patients who underwent cystoscopy, 6 patients reported febrile UTIs following cystoscopy. They were admitted to the urology department of the hospital after visiting the Emergency Department. P. aeruginosa was found in the urine cultures of 4 of the 6 hospitalized patients. During the epidemiological investigation, no changes were observed in factors such as the reprocessing procedures for endoscopic equipment. Therefore, microbiological tests were performed using environmental samples derived from the endoscopic equipment and cleaning process. Results: P. aeruginosa was identified in a dual-enzymatic detergent (EmPower) used during the endoscope cleaning process. After changing the disinfectant and cleaning process, no further bacterial growth was observed in subsequent microbiological tests. Conclusions: This study highlights the potential of cystoscopes to serve as reservoirs for bacteria due to inadequate cleaning during the disinfection process. To minimize the risk of infections following cystoscopy, it is important to pay close attention to the reprocessing and cleaning of cystoscopes.
Abstract
Purpose: This study conducted an epidemiological investigation of Pseudomonas aeruginosa urinary tract infections (UTIs) following cystoscopy at Chilgok Kyungpook National University Hospital. Materials and Methods: From May 16 to July 15, 2022, among 353 patients who underwent cystoscopy, 6 patients reported febrile UTIs following cystoscopy. They were admitted to the urology department of the hospital after visiting the Emergency Department. P. aeruginosa was found in the urine cultures of 4 of the 6 hospitalized patients. During the epidemiological investigation, no changes were observed in factors such as the reprocessing procedures for endoscopic equipment. Therefore, microbiological tests were performed using environmental samples derived from the endoscopic equipment and cleaning process. Results: P. aeruginosa was identified in a dual-enzymatic detergent (EmPower) used during the endoscope cleaning process. After changing the disinfectant and cleaning process, no further bacterial growth was observed in subsequent microbiological tests. Conclusions: This study highlights the potential of cystoscopes to serve as reservoirs for bacteria due to inadequate cleaning during the disinfection process. To minimize the risk of infections following cystoscopy, it is important to pay close attention to the reprocessing and cleaning of cystoscopes.
참고문헌 (24)
- Nathwani D, "Clinical and economic consequences of hospital-acquired resistant and multidrug-resistant Pseudomonas aeruginosa infections : a systematic review and meta-analysis", Antimicrob Resist Infect Control, 3, pp.32~ (2014)
- Morrison Jr AJ, "Epidemiology of infections due to Pseudomonas aeruginosa", Rev Infect Dis, 6(Suppl 3), pp.S627~S642 (1984)
- Qiu L, "Investigating the failure of repeated standard cleaning and disinfection of a Pseudomonas aeruginosa–infected pancreatic and biliary endoscope", Am J Infect Control, 43, pp.e43~e46 (2015)
- Fernández-Cuenca F, "Nosocomial outbreak linked to a flexible gastrointestinal endoscope contaminated with an amikacin-resistant ST17 clone of Pseudomonas aeruginosa", Eur J Clin Microbiol Infect Dis, 39, pp.1837~1844 (2020)
- Srinivasan A, "An outbreak of Pseudomonas aeruginosa infections associated with flexible bronchoscopes", New Engl J Med, 348, pp.221~227 (2003)
- DiazGranados CA, "Outbreak of Pseudomonas aeruginosa infection associated with contamination of a flexible bronchoscope", Infect Control Hosp Epidemiol, 30, pp.550~555 (2009)
- Gillespie JL, "Outbreak of Pseudomonas aeruginosa infections after transrectal ultrasound-guided prostate biopsy", Urology, 69, pp.912~914 (2007)
- Bou R, "Nosocomial outbreak of Pseudomonas aeruginosa infections related to a flexible bronchoscope", J Hosp Inf, 64, pp.129~135 (2006)
- Kumarage J, "Transmission of multi-drug resistant Pseudomonas aeruginosa between two flexible ureteroscopes and an outbreak of urinary tract infection : the fragility of endoscope decontamination", J Hosp Infect, 102, pp.89~94 (2019)
- Strand CL, "Nosocomial Pseudomonas aeruginosa urinary tract infections", JAMA, 248, pp.1615~1618 (1982)
- Almallah Y, "Urinary tract infection and patient satisfaction after flexible cystoscopy and urodynamic evaluation", Urology, 56, pp.37~39 (2000)
- Herr HW, "The risk of urinary tract infection after flexible cystoscopy in patients with bladder tumor who did not receive prophylactic antibiotics", J Urol, 193, pp.548~551 (2015)
- Jørgensen PH, "A microbiological evaluation of level of disinfection for flexible cystoscopes protected by disposable endosheaths", BMC Urol, 13, pp.46~ (2013)
- McCombie SP, "Urinary tract infection following flexible cystoscopy : a comparison between sterilised cystoscopes and disposable sterile sheaths", J Clin Urol, 6, pp.220~224 (2013)
- Burke DM, "The community-based morbidity of flexible cystoscopy", BJU Int, 89, pp.347~349 (2002)
- Herr HW, "Should antibiotics be given prior to outpatient cystoscopy? A plea to urologists to practice antibiotic stewardship", Eur Urol, 65, pp.839~842 (2014)
- Sorbets E, "An outbreak of Pseudomonas aeruginosa urinary tract infections following outpatient flexible cystoscopy", Am J Infect Control, 47, pp.1510~1512 (2019)
- Flores-Mireles AL, "Urinary tract infections : epidemiology, mechanisms of infection and treatment options", Nat Rev Microbiol, 13, pp.269~284 (2015)
- Dunkerley RC, "Practical technique for adequate cleansing of endoscopes : a bacteriological study of pHisoHex and Betadine", Gastrointest Endosc, 23, pp.148~149 (1977)
- Penna TC, "The efficacy of chemical agents in cleaning and disinfection programs", BMC Infect Dis, 1, pp.16~ (2001)
- Fukuzaki S, "Mechanisms of actions of sodium hypochlorite in cleaning and disinfection processes", Biocontrol Sci, 11, pp.147~157 (2006)
- Augustin M, "Assessment of enzymatic cleaning agents and disinfectants against bacterial biofilms", J Pharm Pharm Sci, 7, pp.55~64 (2004)
- Wendelboe AM, "Outbreak of cystoscopy related infections with Pseudomonas aeruginosa : New Mexico, 2007", J Urol, 180, pp.588~592 (2008)
- O'Horo JC, "Carbapenem-resistant Enterobacteriaceae and endoscopy : an evolving threat", Am J Infect Control, 44, pp.1032~1036 (2016)
