LOW BACTERIAL-CONTAMINATION OF NEBULIZERS IN-HOME TREATMENT OF CYSTIC-FIBROSIS PATIENTS

Many reports have shown bacterial contamination of nebulizers used by patients with cystic fibrosis (CF) at home. At the Stockholm CF centre we recommend dismantling the equipment, washing, rinsing and drying i t after each use, and disinfecting it once daily by boiling water or b y 2% acetic acid followed by drying without rinsing. We studied whethe r patients comply with these recommendations and whether they are suff icient to prevent bacterial contamination. Nebulizers from 49 CF patie nts were investigated, 21 of whom are chronically colonized with Pseud omonas aeruginosa and one with Burkholderia cepacia. All patients were visited at home. Thirty-nine patients (79%) disinfected their equipme nt after the latest use in accordance with our recommendations. Thirty -eight pieces showed no, or only scanty, growth of micro-organisms bel onging to the normal oropharyngeal flora. A moderate growth of cl-stre ptococci was observed from a further five pieces. Four of these had no t been cleaned after the latest inhalation occasion, and one was visib ly dirty. Pseudomonads were observed from three pieces; two of these h ad been disinfected by boiling water and one by acetic acid, followed by rinsing in tap water. All three had been inadequately dried. Pseudo monads could not be cultured simultaneously from the sputum of these t hree patients. In conclusion, most patients comply with our cleaning a nd disinfection recommendations and these recommendations appear satis factory in preventing bacterial contamination.