BACTERIAL-COLONIZATION AS A POTENTIAL SOURCE OF NOSOCOMIAL RESPIRATORY-INFECTIONS IN 2 TYPES OF SPIROMETER

The potential risk of spirometers in the transmission of respiratory i nfections has not been yet established, We performed a prospective cro ss-sectional study to determine the rate of colonization of a water-se aled spirometer and a pneumotachograph, and the potential risk of cros s-transmission of micro-organisms to patients using each of these devi ces. Fifty four patients (aged 51+/-18 (mean+/-SD) yrs) were included in the study, All of them had undergone forced spirometry with broncho dilator response by means of the water-sealed spirometer (n=36) or the pneumotachograph (n=18), None had a clinically apparent respiratory i nfection at the time of the study, Routine hygiene measures for respir atory equipment were performed before the study protocol, Samples for microbiological cultures of different parts both of the water-sealed s pirometer (proximal and distal tubing, bell and water-bell) and pneumo tachograph (proximal and distal tubing) were taken daily before and af ter the usual series of lung function tests during a 5 day period, Pha ryngeal swab cultures were obtained before spirometry and 7 days later in each subject. Thirty six out of a total of 40 (90%) culture sample s from the water-sealed spirometer showed microbial growth compared to 4 out of 30 (13%) samples obtained from the pneumotachograph (p<0.000 1), Significant colonization of the water-sealed spirometer was appare nt after the third day of the study, The microorganisms most frequentl y isolated were Penicillium sp. (624), Pseudomonas fluorescens (32%), and Burkholderia cepacea (48%), Distal tubing, water and water-bell we re the parts of the water-scaled spirometer that showed higher coloniz ation counts (greater than or equal to 10(4) colony-forming units (cfu ). mL(-1)). No transmission sequence of potentially pathogenic microor ganisms from equipment to patients or vice versa could be demonstrated . In summary, the water-sealed spirometer frequently became colonized by microorganisms, The potential hazard of such equipment as reservoir s of microorganisms suggests a need for the implementation of new hygi ene measures for their maintenance.