Abstract
Background
Contamination of bronchoalveolar lavage fluid is a major problem in the world. Although
2% glutaraldehyde (GA) is widely used as a disinfectant for bronchoscope cleaning,
recently, GA-tolerant mycobacteria have been isolated, which makes this problem more
complicated.
Methods
We studied the susceptibility to GA and antibiotics of mycobacteria isolated from
bronchoscope washing machines in our hospital. We also studied the minimum inhibitory
concentrations of GA and antibiotics with pump inhibitors.
Results
Twenty-nine mycobacteria were isolated, of which 26 were Mycobacterium chelonae. Among 18 isolates of M chelonae, excluding 8 isolates in which some results were not reproducible, 50% (9 of 18)
were 2% GA-tolerant. One hundred percent (9 of 9) of the GA-tolerant isolates and
11% (1 of 9) of the GA-sensitive isolates were either resistant or intermediately
resistant to 2 or 3 classes of antibiotics. Efflux pump inhibitors did not influence
the susceptibility to GA and antibiotics.
Conclusions
It was suggested that there might be an association of GA tolerance with antibiotic
resistance in M chelonae. There may a different mechanism(s) other than that involving efflux pumps with regard
to GA tolerance and antibiotic resistance in M chelonae. When bronchoscopy-related mycobacterial infections are suspected, physicians and
clinical microbiologists should exercise care in handling GA-tolerant mycobacteria,
which may be resistant to multiple antibiotics.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Infection ControlAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- False positive results of bacteriological examination for mycobacteria in BALF.J Jpn Society Bronchol. 1986; 8 (In Japanese): 338-345
- A pseudo-outbreak of Mycobacterium chelonae infections related to bronchoscopy.Infect Control Hosp Epidemiol. 1997; 18: 136-137
- Pseudoepidemic of nontuberculous mycobacteria due to a contaminated bronchoscope cleaning machine.Chest. 1992; 101: 1245-1249
- Occurrence of nontuberculous mycobacteria in environmental samples.Appl Environ Microbiol. 1999; 65: 2492-2496
- Bacterial contamination and its elimination from bronchoscopes and automatic bronchoscope-washing machines.Kokkyu. 1991; 10 (In Japanese): 320-326
- Glutaraldehyde resistant mycobacteria from bronchoscope washers.J Hosp Infect. 1993; 25: 147-149
- Mycobactericidal efficacy of ethanol as disinfectant on a strain of Mycobacterium abscessus isolated from bronchial lavage fluid that was highly resistant to glutaraldehyde.J Jpn Society Bronchol. 2000; 22 (In Japanese): 251-254
- Lessons from outbreaks associated with bronchoscopy.Infect Control Hosp Epidemiol. 2001; 22: 403-408
- Detection and identification of mycobacteria by amplification of rRNA.J Clin Microbiol. 1990; 28: 1751-1759
- Rapid identification of mycobacteria to the species level by polymerase chain reaction and restriction enzyme analysis.J Clin Microbiol. 1993; 31: 175-178
- Susceptibility testing of Mycobacteria, Nocardia, and other aerobic Actinomycetes: tentative standard.2nd edn. National Committee for Clinical Laboratory Standards, Wane, PA2000 (M24–T2)
- Reduced glutaraldehyde susceptibility in Mycobacterium chelonae associated with altered cell wall polysaccharides.J Antimicrob Chemother. 1999; 43: 759-765
- Possible mechanisms for the relative efficacies of orthophthalaldehyde and glutaraldehyde against glutaraldehyde-resistant Mycobacterium chelonae.J Appl Microbiol. 2001; 91: 80-92
- Multidrug resistance in enteric and other Gram-negative bacteria.FEMS Microbiol Lett. 1996; 139: 1-10
- Antiseptics and disinfectants: activity, action, and resistance.Clin Microbiol Rev. 1999; 12: 147-179
Article info
Publication history
Kitakyushu, Japan
Footnotes
☆This study was supported by Grant-in-Aid for Scientific Research (C) 14570253 from the Ministry of Education, Culture, Sports, Science and Technology, Japan.
Identification
Copyright
© 2004 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
