Microbiologic contamination study of nebulizers after aerosol therapy in patients with cystic fibrosis

Vassal, Serge; Taamma, R.; Marty, N.; Sardet, A; d’Athis, Philippe; Brémont, F.; Dalphin, Marie‐Laure; Plésiat, Patrick; Rault, G.; Thubert, J.; Dominique, S.; Lemeland, J.F.; Derelle, J.; Blech, M.; Roussey, M; Perrin, M.; Sautegeau, A.

doi:10.1067/mic.2000.110214

Cited by 64 publications

(51 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Finally it should be noted that isolation of the same P. aeruginosa strain from multiple individuals attending the same CF clinic does not necessarily indicate patient-to-patient transmission. Exposure to unrecognized point sources within a center, such as contaminated respiratory equipment, may also account for repeated isolation of the same strain (625,677). Likewise, some strains of P. aeruginosa are more prevalent and widespread within the soil, lakes, and streams of a geographical location, and the epidemiology of P. aeruginosa within a CF center may merely reflect random acquisition from these reservoirs by patients (501,503).…”

Section: Pathogenesis Of Pulmonary Decline In Cfmentioning

confidence: 99%

Clinical Significance of Microbial Infection and Adaptation in Cystic Fibrosis

et al. 2011

View full text Add to dashboard Cite

SUMMARY A select group of microorganisms inhabit the airways of individuals with cystic fibrosis. Once established within the pulmonary environment in these patients, many of these microbes adapt by altering aspects of their structure and physiology. Some of these microbes and adaptations are associated with more rapid deterioration in lung function and overall clinical status, whereas others appear to have little effect. Here we review current evidence supporting or refuting a role for the different microbes and their adaptations in contributing to poor clinical outcomes in cystic fibrosis.

show abstract

Section: Pathogenesis Of Pulmonary Decline In Cfmentioning

confidence: 99%

Clinical Significance of Microbial Infection and Adaptation in Cystic Fibrosis

et al. 2011

View full text Add to dashboard Cite

show abstract

“…[12][13][14] There is only one reference regarding bacterial contamination found in a hand-held nebulizer in a day-hospital setting. Vassal et al 15 studied 44 subjects with CF and positive sputum cultures for Pseudomonas aeruginosa and found two thirds of the nebulizers to be contaminated with pathogens after a single use. The method described for collecting specimens was to rinse out the entire nebulizer system (nebulizer cup, corrugated tubing, and mouthpiece), homogenize the fluid, and then culture it.…”

Section: Inconsistency Of Guidelinesmentioning

confidence: 99%

Device Cleaning and Infection Control in Aerosol Therapy

O'Malley

2015

Respir Care

View full text Add to dashboard Cite

Aerosol delivery equipment used to administer inhaled medications includes the nebulizer, positive expiratory pressure devices added to the nebulizer, and valved holding chambers (spacers). These devices are semi-critical medical devices, and as such, infection prevention and control (IPC) guidelines recommend that they be cleaned, disinfected, rinsed with sterile water, and air-dried. There is confusion surrounding the care of aerosol devices because of inconsistencies in the various published IPC guidelines, lack of a standard of practice among institutions and respiratory therapists (RTs), and manufacturer's instructions for use of these devices are not always compatible with guidelines or practice. Challenges lie in awareness of IPC guidelines and establishing a standard for the care of aerosol delivery devices among all stakeholders/manufacturers, governments, vendors, and users. The latest IPC guideline from the Cystic Fibrosis Foundation, reviewed and endorsed by the Society for Healthcare Epidemiology of America and the Association for Professionals in Infection Control, has a recommendation for disposable nebulizers and a recommendation for reusable nebulizers. Reusable nebulizers should be cleaned, disinfected, rinsed with sterile water (if using a cold disinfectant), and air-dried between uses. The mouthpiece/mask of disposable nebulizers should be wiped with an alcohol pad, the residual volume should be rinsed out with sterile water after use, and the nebulizer should be replaced every 24 h. The RT plays a significant and responsible role in providing and teaching aerosol therapy to patients. The RT and all stakeholders need to work together to provide a standard of care for the safe use of aerosol delivery devices.

show abstract

“…It also bears the risk of patient reinfection and bacterial resistance development within the device when regular cleaning and disinfection of the apparatus is omitted [4,5]. An interesting alternative to wet nebulisation is dry powder inhalation.…”

Section: Introductionmentioning

confidence: 99%