In this study, we used an automatic bronchoscope washer, with 2% glutaraldehyde as the disinfectant agent. The disinfection time was 10 min between uses, and 23 min after completion of daily use. The disinfection time between uses was somewhat shorter than that recommended in the APIC guidelines. Despite this, cross-contamination of M tuberculosis was not a problem in our bronchoscopic procedures, even when we performed the more sensitive amplification procedures for the diagnosis of tuberculosis. One possible explanation is that we employed experienced personnel for bronchoscope washing. Two experts have been working in our bronchoscopic laboratory for the last 5 years, and are well acquainted with bronchoscope washing and maintenance. They are aware of the importance of careful cleaning before automatic disinfection other canadian pharmacy levitra.
Immediately following a procedure, all bronchoscopes were aggressively hand-brushed to remove remaining tissue and blood. Disinfectant and rinsing solutions were changed frequently. Routine surveillance cultures have been taken from fiberoptic bronchoscopes every month. There have been no positive culture findings for M tuberculosis in the washing fluid from bronchoscopic channels during regular monitoring for several years in our laboratory. In our opinion, regular monitoring procedures to screen for cross-contamination should include techniques that amplify M tuberculosis if bronchoscopic specimens are used for the diagnosis of tuberculosis using amplification techniques. If this regular monitoring reveals positive results for M tuberculosis DNA in a laboratory, laboratory staff should strengthen their bronchoscopic disinfection procedures.
Although 400 bronchoscopic procedures were included in this study, pulmonary tuberculosis was confirmed in only 43 patients, and usually with a low colony count of M tuberculosis.