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Pseudoepidemic of Rhodotorula rubra in Patients Undergoing Fiberoptic Bronchoscopy

Published online by Cambridge University Press:  21 June 2016

Karen K. Hoffmann ,
David J. Weber  and
William A. Rutala
Karen K. Hoffmann*
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
David J. Weber
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
William A. Rutala
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
*
CB# 7030 Burnett-Womack 547, School of Medicine, University of North Carolina, Chapel Hill, NC 27599.7030
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Abstract

Between March and June 1988, Rhodotorula rubra was isolated from the bronchial washings of 30 of 56 (54%) patients undergoing bronchoscopy at a North Carolina community hospital. Pulmonary disease consistent with invasive fungal pneumonia was not apparent for any patient. Repeat sputum cultures were performed on 11 patients, none of whom were positive for R rubra. Investigation revealed fungal contamination of two brushes used to clean the bronchoscope channels and one positive sample of the tub water used to test the integrity of the bronchoscope prior to cleaning and disinfection. Control measures instituted were high-level disinfection of all equipment used to clean the bronchoscopes, including the brushes, complete air drying of the bronchoscopes before storing and storage of equipment in closed cabinets. An additional case one month after instituting these measures prompted the addition of a final 70% ethyl alcohol rinse of the bronchoscopes immediately prior to storage. Over a six-month period no additional cases have been identified.

Despite published disinfection guidelines, pseudoepidemics and infections from contaminated equipment continue to appear. This pseudoepidemic investigation revealed a site for contaminating bronchoscopes that has not been previously reported, the inner cannula cleaning brushes. This emphasizes the need for stringent adherence to recommended cleaning and disinfection guidelines.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 10 , Issue 11 , November 1989 , pp. 511 - 514
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

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