Nebulizers in cystic fibrosis: a source of bacterial contamination in cystic fibrosis patients?
Lorena Xavier Costa Brzezinski,Carlos Antônio Riedi,Paulo Kussek,Helena Homem de Melo de Souza,Nelson Rosario +4 more
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TLDR
In this paper, a cross-sectional, uncontrolled observational study was conducted to determine whether nebulizers are a source of microbial contamination in patients with cystic fibrosis, as well as whether the technique and frequency of disinfection of these devices is appropriate.Abstract:
OBJECTIVE: To determine whether nebulizers are a source of microbial contamination in patients with cystic fibrosis, as well as whether the technique and frequency of disinfection of these devices is appropriate. METHODS: This was a cross-sectional, uncontrolled observational study. Samples were collected from 28 patients with cystic fibrosis. Samples were collected at the homes of the patients, who were not previously informed of the purpose of the visit. Three samples were collected from each patient: one from the nebulizer chamber, one from the mask/mouthpiece, and one from the patient (oropharyngeal swab /sputum). The samples were properly stored and taken for analyses. The patients, their parents, or their legal guardians completed a questionnaire regarding nebulizer cleaning and disinfecting methods. RESULTS: We collected 84 samples from the 28 patients. Of those 28 patients, 15 (53.5%) were male. The median age of the patients was 11 years (range, 1-27 years). Of the 28 patients, 15 presented with positive oropharyngeal swab /sputum sample cultures. The most common bacterial isolates were Staphylococcus aureus (in 8 patients) and Pseudomonas aeruginosa (in 4 patients). Although the samples obtained from the nebulizers presented with various pathogens in culture, no specific species predominated. In 27 cases (96.7%), there were no associations between the samples obtained from the nebulizers and those obtained from the patients in terms of the results of the cultures. Cleaning and disinfection of nebulizers were inappropriate in 22 cases (78.6%). CONCLUSIONS: In this sample of patients, despite the inappropriate disinfection techniques, nebulizers were not found to be a source of microbial contaminationread more
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Physiotherapy for cystic fibrosis in Australia and New Zealand: A clinical practice guideline
Brenda M. Button,Christine Brown Wilson,Ruth Dentice,Narelle S Cox,Anna Middleton,Esta Lee Tannenbaum,Jennifer Bishop,Robyn Cobb,Kate Burton,Michelle Wood,Fiona Moran,Ryan Black,Summar Bowen,Rosemary Day,Julie Depiazzi,Katherine Doiron,Michael Doumit,Tiffany Dwyer,Tiffany Dwyer,Alison Elliot,L.M. Fuller,Kathleen Hall,Matthew Hutchins,Melinda Kerr,Annemarie L. Lee,Christina Mans,Lauren O'Connor,Ranjana Steward,Angela Potter,Tshepo Rasekaba,Rebecca Scoones,Ben Tarrant,Nathan Ward,Samantha West,Dianne White,L. Wilson,Jamie Wood,Anne E Holland +37 more
TL;DR: A systematic review of the literature in key areas of physiotherapy practice for CF was undertaken and a total of 30 recommendations were made, which can be used to underpin the provision of evidence‐based physiotherapy care to people with CF in Australia and New Zealand.
Journal ArticleDOI
An evaluation of different steam disinfection protocols for cystic fibrosis nebulizers.
TL;DR: It is better to leave the nebulizers wet after steam disinfection than to manipulate them by active drying, which seems to be a source of recontamination.
Journal ArticleDOI
Microbiological contamination of nebulizers used by cystic fibrosis patients: an underestimated problem
Barbara Riquena,Luciana de Freitas Velloso Monte,Agnaldo José Lopes,Luiz Vicente Ribeiro Ferreira da Silva-Filho,Neiva Damaceno,Evanirso da Silva Aquino,Paulo José Cauduro Marostica,José Dirceu Ribeiro +7 more
TL;DR: A significant proportion of nebulizers was contaminated with potentially pathogenic microorganisms for CF patients, and these findings support the need to include patients/caregivers in educational programs and / or new strategies for delivering inhaled antibiotics.
Journal ArticleDOI
Effect that an educational program for cystic fibrosis patients and caregivers has on the contamination of home nebulizers
Adriana Della Zuana,Doroti de Oliveira Garcia,Regina Celia T. P. Juliani,Luiz Vicente Ribeiro Ferreira da Silva Filho +3 more
TL;DR: In a sample of CF patients, nebulizer contamination was common, indicating the need for improvement in patient practices regarding the cleaning and disinfection of their nebulizers, and a one-time educational intervention could have a significant positive impact.
Journal ArticleDOI
Nebuliser hygiene in cystic fibrosis: evidence-based recommendations.
Jane Bell,Lauren Alexander,Jane Carson,Amanda Crossan,J. McCaughan,Hazel Mills,Damian O'Neill,John E. Moore,B. Cherie Millar +8 more
TL;DR: 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 and to ensure optimum drug delivery, and infection prevention and control.
References
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Journal ArticleDOI
Infection control recommendations for patients with cystic fibrosis: microbiology, important pathogens, and infection control practices to prevent patient-to-patient transmission
Lisa Saiman,Jane D. Siegel +1 more
TL;DR: This material is being published simultaneously in Infection Control and Hospital Epidemiology and the American Journal ofinfection Control.
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Home-use nebulizers: a potential primary source of Burkholderia cepacia and other colistin-resistant, gram-negative bacteria in patients with cystic fibrosis.
G R Hutchinson,S Parker,J A Pryor,F. Duncan-Skingle,P N Hoffman,Margaret E. Hodson,M E Kaufmann,Tyrone L. Pitt +7 more
TL;DR: Inhalation of aerosols contaminated with gram-negative bacteria generated from home-use nebulizers used by cystic fibrosis patients may be a primary route for bacterial colonization of the lung.
Journal ArticleDOI
Microbial contamination of nebulizers in the home treatment of cystic fibrosis.
TL;DR: 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.
Journal ArticleDOI
Home nebulizer use among patients with cystic fibrosis
Margaret Rosenfeld,Julia Emerson,Susan J. Astley,Pam Joy,Judy Williams-Warren,Thomas A. Standaert,Darlene L. Yim,Donna Crist,MaryJane Thykkuttathil,Mary Torrence,Stacey FitzSimmons,Bonnie W. Ramsey +11 more
TL;DR: Although not generally tested for reusability, disposable nebulizers are generally used by patients for long periods and Medication mixing is common, although its effects on aerosol properties are unknown.
Journal Article
Nebulizer use and maintenance by cystic fibrosis patients: a survey study.
TL;DR: CF patients and their respiratory therapists should immediately address and improve their nebulizer cleaning methods and replacement practices, with more focus on teaching patients to regularly clean and replace nebulizers.