Research for infection protection
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Author: Marchand, G. / Duchaine, C. / Lavoie, J. / Veilleitte, M / Cloutier Y. (2016) Source: Marchand, G. et al. Bacteria emitted in ambient air during bronchoscopy – a risk to health care workers? American Journal of Infection Control, 2016, in press.

STUDY

Marchand, G. / Duchaine, C. / Lavoie, J. / Veilleitte, M / Cloutier Y. (2016)

Danger from the air – bacteria emitted in the air during bronchoscopies

Background: Increased occupational hazard: healthcare workers are constantly at risk of acquiring an infection at work. Some medical treatments additionally increase this risk – for example by airborne microorganisms. Procedures that may release infectious aerosols include intubations and bronchoscopies. Inserting the bronchoscope makes the patient cough, which emits droplets that the healthcare worker might inhale. In their study, Marchand et al. for the first time examined the concentration of bioaerosols the staff is exposed to during bronchoscopy.


Methods: Marchand et al. investigated the air contamination by airborne bacteria during bronchoscopies. For this, they conducted full-day sampling in two examination rooms. All samples were taken within a radius of 1.5 metres of the patient’s mouth and the breathing zone of the employee. Afterwards, culturable bacteria were identified and the samples were examined for further pathogens by quantitative PCR.


Results: The mean concentration of culturable bacteria was between 43 and 100 CFU/m3 air in Room A and between 40 and 370 CFU/m3 air in Room B. During the bronchoscopies, the concentration was significantly higher compared to background measurements.
The analysis of the samples revealed a variety of pathogens. Most of the pathogens detected were normal non-pathogenic pathogens such as Streptococcus spp., Neisseria spp and Corynebacterium spp. However, the authors also detected several opportunistic pathogens, such as Streptococcus pneumoniae. All samples contained at least one Staphylococcus strain, further analyses, however, showed that they did not include Staphylococcus aureus.


Conclusions: The study shows that potentially pathogenic bacteria may escape into the air when the bronchoscope insertion makes the patent cough. Hence, healthcare worker who are in close proximity of the patient during the examination may come into contact with nosocomial pathogens. The researchers recommend responding to the risk by implementing respective hygiene protocols and providing necessary personal protective equipment.

Furthermore, the authors emphasise that the survivability of microorganisms is often underestimated: nosocomial pathogens can survive on inanimate surfaces and get into the air again later on due to movements and air turbulences. Hence, the authors think that intensive and extensive disinfection of the examination rooms is of great importance.


Source:
Marchand, G. et al. Bacteria emitted in ambient air during bronchoscopy – a risk to health care workers? American Journal of Infection Control, 2016, in press.


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