Fig. 1. Timeline depicting the relative chronology of bronchoscope B1 exposures and CR-KP (n=22) and MDR-PA (n=31) positive cultures among 33 case patients over a 185-day period (July–December 2014). Diamonds represent multidrug-resistant Pseudomonas aeruginosa (MDR-PA) detection in case patient clinical specimens. Ovals represent carbapenem-resistant Klebsiella pneumonia (CR-KP) detection in case patient clinical specimens. Shading represents genetic relatedness. Triangles represent B1 exposure. Dashed lines represent patient deaths.
vertically without coiling. Additionally, periodic culturing of clinical endoscopes was planned. Surveillance culturing of endo- scopes is a proposed strategy to detect contamination, and while the practice is not currently part of US guidelines, the Centers for
Disease Control and Prevention (CDC) endorses surveillance culturing of duodenoscopes as a supplement to recommended endoscope reprocessing procedures. Thus, surveillance culture may expand to bronchoscopes and other types of endoscopes in
