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Microbial contamination of nebulizers in the home treatment of cystic fibrosis
Author(s) -
Blau H.,
Mussaffi H.,
Mei Zahav M.,
Prais D.,
Livne M.,
Czitron B. M.,
Cohen H. A.
Publication year - 2007
Publication title -
child: care, health and development
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.832
H-Index - 82
eISSN - 1365-2214
pISSN - 0305-1862
DOI - 10.1111/j.1365-2214.2006.00669.x
Subject(s) - nebulizer , medicine , contamination , cystic fibrosis , pseudomonas aeruginosa , sputum , microbiology and biotechnology , bacteria , pathology , biology , anesthesia , ecology , tuberculosis , genetics
Background Home nebulizers are in widespread use in cystic fibrosis (CF) and other chronic pulmonary diseases. Bacterial contamination may be a source of respiratory tract colonization. Objectives To investigate microbial contamination of home nebulizers in CF patients, compare with sputum cultures and relate to cleaning practices. Methods A total of 29 home nebulizers of CF patients were cultured. Families were interviewed regarding cleaning routines and patients had sputum cultures for bacteria and fungi. Results In total, 19/29 (65%) nebulizers were contaminated: 18 reservoir cups, 14 mouthpieces and five filters. Pseudomonas spp. were isolated from 10 nebulizers (35%) and all 10 had Pseudomonas aeruginosa airway infection although without genetic typing we could not be sure this was the same bacteria as that from their nebulizer unit. An additional 7/29 had Pseudomonas aeruginosa airway infection without a contaminated nebulizer ( P = 0.001). No nebulizers were contaminated with Aspergillus . Only 4/19 contaminated nebulizers (22%) had been cleaned after every use, compared with seven of the 10 (70%) uncontaminated nebulizers ( P = 0.017). Only 7/19 patients with contaminated nebulizers (37%) and 5/10 with clean nebulizers (50%) recalled receiving cleaning instructions (not significant). Conclusions Home nebulizers are frequently contaminated, particularly when cleaning instructions are inadequate, and may be a source of airway infection or reinfection especially following contamination from a patient chronically colonized with P. aeruginosa . Simple oral and written cleaning instructions should be offered.