Taking a control sample before bronchoalveolar lavage might be a good idea say Irish respiratory physicians after finding contamination in a bronchoscope that was considered clean.

Writing in a letter to Thorax the researchers from several hospitals in Ireland detail the case of a two-year old boy with cystic fibrosis who underwent flexible bronchoscopy and bronchoalveolar lavage.

The bronchoscope used on the boy had been used on a previous patient and was “supposedly cleaned and decontaminated” prior to reuse.

However when they performed a ‘control lavage’ by suctioning sterile 0.9% NaCL through the instrument they noticed a cloudy appearance suggesting contamination, which was later confirmed.

The case suggests potential benefits of performing a simple control lavage, the authors said.

A contaminated bronchoscope could result in false-positive BAL results, or the BAL culture results could be ‘true-positives’ with the pathogen flushed into the patients airways during lavage, they said.

This was an iatrogenic infection and a “gross medical error” that could potentially be repeated in in multiple patients on multiple lists, they added.