Microbiological contamination of nebulizers used by cystic fibrosis patients: an underestimated problem.

Autor:	Riquena B; Novartis Biociências S.A. Brasil, São Paulo (SP), Brasil., Monte LFV; Hospital da Criança de Brasília José Alencar, Brasília (DF), Brasil., Lopes AJ; Departamento de Pneumologia, Hospital Universitário Pedro Ernesto da Universidade do Estado do Rio de Janeiro, (RJ), Brasil., Silva-Filho LVRFD; Unidade de Pneumologia, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP), Brasil.; Hospital Israelita Albert Einstein, São Paulo (SP), Brasil., Damaceno N; Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo (SP), Brasil., Aquino EDS; Associação Mineira de Assistência a Mucoviscidose - AMAM, Belo Horizonte (MG), Brasil., Marostica PJC; Hospital de Clínicas, Porto Alegre (RS), Brasil.; Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brasil., Ribeiro JD; Laboratório de Fisiologia Pulmonar, Centro de Investigação em Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas (SP), Brasil.
Jazyk:	English; Portuguese
Zdroj:	Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia [J Bras Pneumol] 2019 May 30; Vol. 45 (3), pp. e20170351. Date of Electronic Publication: 2019 May 30.
DOI:	10.1590/1806-3713/e20170351
Abstrakt:	Objective: Home nebulizers are routinely used in the treatment of patients with cystic fibrosis (CF). This study aims to evaluate the contamination of nebulizers used for CF patients, that are chronically colonized by Pseudomonas aeruginosa, and the association of nebulizer contamination with cleaning, decontamination and drying practices. Methods: A cross-sectional, observational, multicenter study was conducted in seven CF reference centers in Brazil to obtain data from medical records, structured interviews with patients/caregivers were performed, and nebulizer's parts (interface and cup) were collected for microbiological culture. Results: overall, 77 CF patients were included. The frequency of nebulizer contamination was 71.6%. Candida spp. (52.9%), Stenotrophomonas maltophilia (11.9%), non-mucoid P. aeruginosa (4.8%), Staphylococcus aureus (4.8%) and Burkholderia cepacia complex (2.4%) were the most common isolated pathogens. The frequency of nebulizers' hygiene was 97.4%, and 70.3% of patients reported cleaning, disinfection and drying the nebulizers. The use of tap water in cleaning method and outdoor drying of the parts significantly increased (9.10 times) the chance of nebulizers' contamination. Conclusion: Despite the high frequency hygiene of the nebulizers reported, the cleaning and disinfection methods used were often inadequate. A significant proportion of nebulizers was contaminated with potentially pathogenic microorganisms for CF patients. These findings support the need to include patients/caregivers in educational programs and / or new strategies for delivering inhaled antibiotics.
Databáze:	MEDLINE
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