Transesophageal Echocardiography, Insufficient Cleaning Practices and Lax Equipment Maintenance, and Escherichia Coli - a Breakdown in Infection Control Introduction

Escherichia coli (E. coli) is a rod-shaped, gram-negative bacillus normally found in the lower gastrointestinal tract and is part of the normal intestinal flora. In hospital settings, E. coli most commonly causes urinary tract infections. Respiratory tract infections due to E. coli are uncommon, though there have been several published reports that chronicle E. coli pneumonia in the pediatric intensive care unit (ICU) [1]. Outbreaks of respiratory tract infections with gram-negative organisms have been increasingly reported due to contamination of medical equipment including bronchoscopes which are directly inserted into the respiratory tract. Transesophageal echocardiography (TEE) is normally done by inserting the instrument into the gastrointestinal tract (the esophagus) and is used during cardiac surgery to better visualize the posterior of the heart. The gastrointestinal tract is considered “dirty” and medical equipment should receive high-level disinfection.