Molecular strain typing of M. tuberculosis isolates from a suspected outbreak involving a faulty bronchoscope.
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We evaluated the efficacy of phenolated glutaraldehyde in a 1:8 solution for the disinfection of bronchofibroscopes that were highly contaminated with Serratia marcescens and Pseudomonas aeruginosa. An Olympus BF-P10 bronchofibroscope was contaminated with artificial samples containing one of the aforementioned microorganisms in concentrations nearing 10(8) colony forming units per milliliter (cfu/ml). The instruments were then washed with soap and water and submerged in a 1:8 solution of phenolated glutaraldehyde. Samples were taken for culturing after contamination, after washing, and after 10, 15 and 30 min in the disinfectant solution. The level of cfu/ml in the cultures was measured and the definition of failure-to-disinfect was a finding of > or = 1 cfu/ml after each experimental procedure. Twenty procedures, 10 for each microorganism, were carried out. Washing of the bronchofibroscope afforded significant elimination of microorganisms and no colony growth was observed in cultures after 10 min submersion in phenolated glutaraldehyde. We conclude that immersion in a 1:8 solution of phenolated glutaraldehyde after careful washing is a valid way to disinfect bronchofibroscopes that are highly contaminated with S. marcescens and P. aeruginosa.
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Many patients with lung cancer develop airway obstruction and hemoptysis. Endoscopic palliation can relieve symptoms and improve the quality of life for many patients. Patient factors, lesion characteristics and location, and regional expertise are important to consider when planning therapy. Cost, convenience, time to relief of symptoms, duration of palliation, and the need for serial procedures should also be considered. Further advances in technology will likely allow better palliation in the future. A wide armamentarium of modalities and careful communication with the patient's other providers are essential for optimal patient outcome.
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A screening method for detecting the dissemination of malignant tumours to the bifurcal lymph nodes is described. The procedure was performed in 300 patients. Malignancies were found in 255 cases, 216 of which were bronchogenic cancers. The transcarinal mediastinal needle biopsy (TMNB) was positive in 25% of all cases with malignant diseases, but in patients with anaplastic tumours a positive TMNB was found in 40%. No complications occurred, the method could be applied to out-patients, and if positive, mediastinoscopy could be avoided.