THE ASSESSMENT OF THE RISK OF CROSS-INFECTION WITH A MULTIUSE NASAL ATOMIZER

Atomizers working on the Venturi principle are used by otolaryngology departments in the UK to spray cocaine and other local anaesthetic and vasoconstricting solutions into the nasal cavities. These devices are rarely cleaned, nor is the cocaine in the reservoir changed between p atients. This study aimed to assess the risk of cross-infection with s uch an atomizer of the Down's design. Nutrient broth from a sterile at omizer was sprayed into the nasal cavities of 12 healthy volunteers on three occasions, the tip of the nozzle was withdrawn between sprays i nto the right nostril, but not between sprays into the left. On each o ccasion the tip of the nozzle, a nutrient broth rinse of the inner tub e of the nozzle and the residue of broth in the reservoir of the atomi zer were cultured and the colonies compared with those from a nasal sw ab collected previously. The results show transmission of bacteria fro m the nasal vestibule on to the tip, into the nozzle and into the rese rvoir of the atomizer. Examination of the minimum inhibitory concentra tion values of 10% cocaine with and without Nipasept preservative indi cated poor antibacterial properties. We conclude that the use of an at omizer on more than one patient poses a risk of cross-infection, and r ecommend their replacement with a single-use disposable nasal atomizer .