Do you clean or contaminate your bronchoscope?

Abstract

Since the introduction of flexible endoscopes 30 yr ago, the fibre-optic bronchoscope has become an essential tool of the respiratory physician. Macroscopic examination, biopsy and brushing techniques are common to all forms of endoscopy. However, detailed microbiological examination of lavage fluid is unique to bronchoscopy. Perhaps this is a legacy that we have inherited from our predecessors, who occasionally analysed gastric lavage fluid in their search for tuberculous infection. During the early years of fibre-optic bronchoscopy, cross-infection was not considered to be a major problem (1). However, the increasing use of microbiological examination of bronchoalveolar lavage (BAL) fluid has led to the recognition of contamination as a potential source of both cross-infection and diagnostic confusion (2).