Can single-use bronchoscopes help prevent nosocomial COVID-19 infections?

ABSTRACT

Introduction: The reduction of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission has been achieved through numerous public health initiatives worldwide. In the hospital environment, certain high-risk procedures have the potential to cause transmission of the virus to health-care workers and nosocomial transmission to patients through different mechanisms including the generation of aerosols and fomite formation via contamination of medical devices.

Areas covered: Aerosol-generating procedures such as bronchoscopy are considered high risk for SARS-CoV-2 transmission. As a result, single-use devices should be used where possible and changing to single-use flexible bronchoscopes has been advised by respiratory societies internationally. In this paper, we outline the rationale for this advice and have analyzed the evidence relating to the reduction in SARS-CoV-2 transmission arising from a switch to these single-use devices and the potential impact that this switch may have on the quality of pulmonology services.

Expert opinion: In this paper, we outline the rationale for this advice and have analyzed the evidence relating to the reduction in SARS-CoV-2 transmission arising from a switch to these single-use devices and the potential impact that this switch may have on the quality of pulmonology services.

KEYWORDS:

• Single-use bronchoscope
• disposable
• COVID-19
• SARS-CoV-2
• nosocomial transmission

Article highlights

• Bronchoscopy is considered an aerosol-generating procedure (AGP).

• Bronchoscopy is associated with an increase risk of spread of COVID-19 not only due to being an AGP but also because of the requirement of cleaning bronchoscopes.

• Single-use flexible bronchoscopes are now commercially available and were initially used predominantly for intubation.

• However in the COVID-19 era, they have gained popularity due to many reasons including no requirement for cleaning, portability, and ease of use.

• Although no case of patient-to-patient spread of COVID-29 due to bronchoscopy has been reported, reusable flexible bronchoscopes are associated with contamination by human protein, DNA, and harbor infection even after standard cleaning.

Declaration of interest

M Kennedy has received equipment from The Surgical Company for bronchoscopic training (screen and 10 single use bronchoscopes). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.