Cleaning and infection control of airway clearance devices used by CF patients

Manor, Eynav; Gur, Michal; Geffen, Yuval; Bentur, Lea

doi:10.1177/1479972317707652

Cited by 11 publications

(20 citation statements)

References 25 publications

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“…Potential CF pathogens have been found on nebulizers [29][30][31][32][33] but only in a few instances have these been consistent with pathogens identified from the patient's respiratory samples [34,35]. Increased use of aerosolized medications was found to be a risk factor for PA acquisition in a mathematical model of PA risk factors [36].…”

Section: Acquisition From the Healthcare Environmentmentioning

confidence: 99%

Infection prevention and control in cystic fibrosis: a systematic review of interventions

Rowbotham

Palser

Smith

et al. 2019

Expert Review of Respiratory Medicine

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Introduction: Cystic fibrosis is a life-limiting genetic condition characterized by recurrent pulmonary infection. Acquisition of infection can occur from environmental reservoirs, person-to-person transmission and from the healthcare environment. Primary prevention of infections through infection prevention and control measures is an important strategy in cystic fibrosis care. Areas covered: Here we present a systematic review of the evidence base around infection prevention and control in cystic fibrosis. We found 36 studies and 7 guidelines that met our inclusion criteria. Strategies covered include cohort segregation, individual segregation, hand hygiene, facemasks, combination strategies, equipment strategies, and adherence. Quality of evidence overall was deemed low or very low. Most guideline recommendations have little or no evidence to support them. Expert opinion: Although low quality, there is an abundance of evidence suggesting segregation is beneficial in reducing pathogen spread. Undertaking high-quality studies may, therefore, be ethically challenging. Large-scale registry studies may provide a better strategy for answering questions on the efficacy of infection control policy. With the rise of antibiotic resistance, effective eradication of cystic fibrosis pathogens is becoming more difficult so primary prevention through infection control will become increasingly important over the coming years. ARTICLE HISTORY

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Section: Acquisition From the Healthcare Environmentmentioning

confidence: 99%

Infection prevention and control in cystic fibrosis: a systematic review of interventions

Rowbotham

Palser

Smith

et al. 2019

Expert Review of Respiratory Medicine

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“…For more information, the reader is referred to a recent publication on infection prevention and control guidelines for the growing number of respiratory devices. 132…”

Section: Infection Controlmentioning

confidence: 99%

Cystic Fibrosis Lung Disease: An Overview

Turcios¹

2019

Respir Care

130

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Although better insights into the natural course of cystic fibrosis (CF) have led to treatment approaches that have improved pulmonary health and increased the life expectancy of individuals with this disorder, lung disease remains the main cause of morbidity and mortality in patients with CF. Evidence suggests that airway epithelial defects in ions-water transport lead to dehydrated mucus, impaired mucus clearance, and mucus adhesion to airway surfaces. An increase in mucin secretion is also suggested by the formation of endobronchial mucus plaques and plugs, which become the main sites of air flow obstruction, infection, and inflammation conducing to early small airways disease followed by the development of bronchiectasis. The lung involvement is usually progressive with intermittent exacerbations. Aggressive management and advances in treatment delay, but, do not prevent progression of lung disease. Respiratory failure ensues and is the major cause of death. The lung parenchyma is virtually untouched for much of the course of the disease. This review focuses on the lung involvement in cystic fibrosis and summarizes new developments on the diagnostic approach of CF and pathogenesis of related lung disease. Current therapeutic modalities, novel therapies targeting the basic genetic defect, and lung transplantation are also reviewed.

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“…There is a lack of scientific evidence available pertaining to the optimum temperature of water specifically for washing nebulisers; however, nebuliser manufacturers generally recommend warm or hot water in their instructions ( table S2 ). A study looking at the cleaning of airway clearance devices showed complete or partial eradication of bacterial yield in 50% and 30%, respectively, of contaminated airway clearance devices when they were soaked for 10 min in hot water (temperature unspecified) and detergent, and rinsed with hot water before air drying [ 13 ].…”

Section: Evidence-based Guidancementioning

confidence: 99%

“…In theory, air drying the nebuliser should significantly reduce the risk of nosocomial infection. In the study by M anor et al [ 13 ], simple cleaning and air drying without disinfection was found to be effective in most cases. Air drying has been advocated as a method of drying to cause least recontamination of cleaned parts [ 62 ] and is now the drying technique of choice advocated by many nebuliser manufacturers.…”

Section: Dryingmentioning

confidence: 99%

Nebuliser hygiene in cystic fibrosis: evidence-based recommendations

Bell

Alexander

Carson

et al. 2020

Breathe

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Nebulised therapies are extensively used in the daily therapeutic management of cystic fibrosis both for mucociliary clearance and for the management of chronic infections. Extensive developments have been made in relation to nebulised drug delivery mechanisms and drug formulations, and guidelines have been prepared that have addressed the appropriate use of such therapies. However, due to these developments, a plethora of nebuliser devices and drug chambers exist, and frequently, the limited guidance provided in relation to nebuliser hygiene is to follow manufacturers' instructions. Such instructions are inconsistent and at times confusing, translating to an increase in the burden associated with nebuliser maintenance. An evidence-based universal guideline relating to nebuliser care and hygiene is urgently required that is applicable to both at-home use and inpatient use. This article reviews the scientific literature in order to propose an evidence-based approach to nebuliser hygiene to ensure optimum drug delivery, and infection prevention and control.Educational aimsTo understand the reasons why nebuliser hygiene is important.To give an overview of the current nebuliser care instructions that have been described by manufacturers, societies and the scientific literature.To outline the current nebuliser hygiene practices used by persons with cystic fibrosis in the home and hospital settings.To highlight areas that need further evaluation to promote optimum nebuliser care.To establish an evidence-based guideline for nebuliser hygiene in relation to cystic fibrosis.

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Cleaning and infection control of airway clearance devices used by CF patients

Cited by 11 publications

References 25 publications

Infection prevention and control in cystic fibrosis: a systematic review of interventions

Infection prevention and control in cystic fibrosis: a systematic review of interventions

Cystic Fibrosis Lung Disease: An Overview

Nebuliser hygiene in cystic fibrosis: evidence-based recommendations

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