Doctor Holding Bronchoscopes

Prevention Strategies

A Few Common Causes of Ventilator-Associated Pneumonia

VAP can be traced to reusable bronchoscopes. Bronchoscopes

Ventilator-associated pneumonia (VAP) is caused by microbial contamination in the lungs. Microbes may enter the lung during intubation or mechanical ventilation. Common species associated with VAP include (most common listed first): Pseudomonas, Staphylococcus aureus, Enterobacteriaceae, Streptococcus, Haemophilus, Acinetobacter, and Neisseria. VAP is commonly polymicrobial. Causative pathogens—and their associated drug resistance rates—vary based on hospital and geography. VAP is not normally due to fungal or virus infections in immunocompetent hosts. VAP-causing pathogens generally remain in the lung, spreading into blood or pleural space in less than 10 percent of cases.

The source of causative pathogens is another matter. Bronchoscopes, tubing, endotracheal cuffs, and other respiratory accessories and instruments can all be colonized by VAP-causing pathogens. Pathogens can also originate in the environment (air, water, fomites) or be transmitted between staff and patients. It is less likely that pathogens are directly inhaled by patients, than they are introduced into the airway by healthcare devices or via aspiration.

[bb-article-cta cta_text='To read and download the full guide on VAP and Bronchoscopy, enter your email and click the button']

Commonly, VAP can be traced to reusable bronchoscopes. Bronchoscopes are used to perform bronchoalveolar lavages (BALs), collect diagnostic cultures, aid sample collection, and assist intubation. They provide a look inside the airway and an open channel for other instruments to pass into the airway. Contamination can occur during procedures or any time a bronchoscope is handled. Infection from patient flora can be introduced as the bronchoscope passes through the oropharynx and into the airway. Contamination from exogenous bacteria can also occur during reusable bronchoscope cleaning, transport, or storage.

Contaminated, reused bronchoscopes may spread pathogens to subsequent patients and are a noted cause of VAP. Even with properly disinfected bronchoscopes, individual patients may experience “distal spread of organisms” that can lead to pulmonary infection. Bronchoscopes may also cause abrasions in the airway that may increase risk of microbial colonization and VAP.

Outbreaks associated with contaminated bronchoscopes can be deadly. Even the most sophisticated hospitals are not immune. In 2000, P. aeruginosa on bronchoscopes contributed to the deaths of three critically ill patients and caused 48 respiratory and bloodstream infections. An earlier outbreak in South Carolina led to extremely pathogenic, multidrug-resistant Mycobacterium tuberculosis spreading into the community. Respiratory infections like VAP occur worldwide due to contaminated bronchoscope and ventilator equipment, and prevention is a challenge for small and large hospitals alike.

More Outpatient Clinic Articles
Strategies for Reducing Gastroenterology Billing Errors
Insurance Reimbursement
Determining the right documentation, coding, and billing process that works for your practice can take time. Here are tips on how to keep an open mind, look for problems, invest in your team, and work with your staff to refine your strategy.
A Few Common Causes of Ventilator-Associated Pneumonia
Prevention Strategies
Many pathogens can cause ventilator-associated pneumonia, or VAP. These pathogens can enter the lungs via contaminated respiratory devices. A few linked studies here provide information about how devices, particularly bronchoscopes, can contribute to VAP.
More From Single-Use Endoscopy
endoscopist

Gastrointestinal Endoscopy Applications

Surveys show that patients in urban settings are willing to pay more, and rural patients will wait longer, for a same gender endoscopist.

Public Health

Pre-COVID personal protective equipment use was more relaxed than it is now, according to physician surveys.

April is Esophageal Cancer Awareness Month

Gastrointestinal Endoscopy Applications

Mindy Mintz Mordecai, founder, CEO of the Esophageal Cancer Action Network (ECAN), shares how the organization has adjusted during the pandemic to keep momentum going toward a cancer-free future for Americans at risk for Esophageal Cancer. April is Esophageal Cancer Awareness Month.