[Bacterial load of the surroundings during rigid diagnostic bronchoscopy under high frequency jet-ventilation].

IF 1.2 Q4 RESPIRATORY SYSTEM
Pneumologie Pub Date : 2024-09-01 Epub Date: 2024-01-10 DOI:10.1055/a-2229-4002
Eva Luecke, Juliane Brunner, Sabine Stegemann-Koniszewski, Achim Kaasch, Katja Bauer, Gernot Geginat, Thomas Hachenberg, Thomas Schilling, Lisa-Lisett Schwarze, Jens Schreiber
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引用次数: 0

Abstract

Background: High-frequency jet ventilation (HFJV) is used in pneumological endoscopy for rigid, diagnostic, and therapeutic bronchoscopies. It is unclear to what extent the unobstructed flow of respiratory gas from the patient's lungs causes microbial contamination of the surrounding air.

Material and methods: After the start of the HFJV (15 min) in 16 rigid bronchoscopies, airborne pathogen measurements were taken directly at the distal endoscope outlet, at examiner height (40 cm above the endoscope outlet), at a 2 m distance from the endoscope in the room and at the supply air outlet of the examination room using an RCS air sampler. The number and type of pathogens isolated in the air samples were then determined, as well as germs in the bronchoalveolar lavage fluid (BALF) from the patient's lungs.

Results: An increased bacterial density (136 and 114 CFU/m3) was detected directly at the distal end of the endoscope and at examiner height at a distance of 40 cm, which decreased significantly with increasing distance from the bronchoscope (98 CFU/m3 at a distance of 2 m and 82 CFU/m3 at the supply air outlet). The most frequently detected bacteria were Staphylococcus spp., Micrococcus spp. and Bacillus spp. In the BALF, pathogens could only be cultivated in four of 16 samples, but the same pathogens were detected in the BALF and the ambient air.

Conclusion: When performing a rigid bronchoscopy, in which patients are mechanically ventilated in a controlled manner using an open HFJV system, there is an increased pathogen load in the ambient air and therefore a potential risk for the examiner.

[在高频喷射通气条件下进行硬质诊断支气管镜检查时周围环境的细菌负荷]。
背景:高频喷射通气(HFJV)用于气动内窥镜的硬性、诊断性和治疗性支气管镜检查。目前还不清楚患者肺部呼吸气体的畅通流动在多大程度上会导致周围空气受到微生物污染:在 16 例硬质支气管镜检查中,高频JV 开始后(15 分钟),使用 RCS 空气采样器直接在远端内窥镜出口、检查员高度(内窥镜出口上方 40 厘米)、检查室内距离内窥镜 2 米处以及检查室供气出口处测量空气中的病原体。然后测定了空气样本中分离出的病原体数量和种类,以及患者肺部支气管肺泡灌洗液(BALF)中的病菌:在内窥镜远端直接检测到的细菌密度增加(136 CFU/m3 和 114 CFU/m3),在距离内窥镜 40 厘米处检测到的细菌密度增加(136 CFU/m3 和 114 CFU/m3),随着与支气管镜距离的增加,细菌密度明显降低(在距离支气管镜 2 米处检测到的细菌密度为 98 CFU/m3,在供气出口处检测到的细菌密度为 82 CFU/m3)。最常检测到的细菌是葡萄球菌属、微球菌属和芽孢杆菌属。在 BALF 中,16 个样本中只有 4 个能培养出病原体,但在 BALF 和环境空气中都检测到了相同的病原体:结论:在使用开放式 HFJV 系统对患者进行机械通气的硬质支气管镜检查中,环境空气中的病原体负荷会增加,因此会给检查人员带来潜在风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pneumologie
Pneumologie RESPIRATORY SYSTEM-
CiteScore
1.80
自引率
16.70%
发文量
416
期刊介绍: Organ der Deutschen Gesellschaft für Pneumologie DGP Organ des Deutschen Zentralkomitees zur Bekämpfung der Tuberkulose DZK Organ des Bundesverbandes der Pneumologen BdP Fachärzte für Lungen- und Bronchialheilkunde, Pneumologen und Allergologen
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