Potential effect of contaminated bronchoscopes on COVID-19 patients

Editor's Note

In this Letter to the Editor, epidemiologist and researcher Cori L. Ofstead, MSPH, and colleagues caution that because of high bronchoscope contamination rates found during routine use in previous studies, the possibility of bronchoscopy-associated transmission of COVID-19 or other pathogens must be considered.

Though high-level disinfection should eliminate these risks when bronchoscopes are well-maintained and reprocessed according to manufacturer’s instructions and professional guidelines, practices are frequently substandard, and pathogens are commonly present on patient-ready endoscopes, Ofstead and colleagues say.

In addition, gastrointestinal (GI) pathogens found in bronchoscopes and bronchoalveolar lavage samples suggests there may be cross-contamination caused by intermingling bronchoscopes and GI endoscopes during reprocessing, they say.

Because there have been recent research reports on COVID-19 patients with diarrhea and abdominal pain as well as fecal carriage of the virus in severely ill and asymptomatic patients, great care must be taken to minimize cross-contamination during all endoscope reprocessing, the researchers say.

Ofstead and colleagues urgently recommend further research assessing potential contamination of reusable bronchoscopes.