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Bacterial contamination of inhalation chambers: results of a pilot study
Tjalling W de Vries1, Siemon R Rienstra, Eric R van der Vorm
1Department of Pediatrics, Medical Center Leeuwarden Noord, Leeuwarden, The Netherlands. tjalling.de.vries@znb.nl
Abstract:
Spacers are used in the treatment of children with asthma. It is advised to clean the spacers regularly. However, cleaning can influence drug delivery. One obvious reason to clean a spacer is prevention of bacterial contamination. Whether spacers are contaminated or not is unknown. We cultured spacers, brought in by children with asthma or recurrent wheeze who visited our outpatient clinic during a 4-month period. The spacers of 64 children were studied, and 24 (38%) were contaminated; most often (13 cases), Bacillus species were found. Only one spacer grew a potential pathogenic bacterium (Pseudomonas aeruginosa). No correlation with type of inhaler, duration of usage, drug, or visual aspect was found. Spacers, cleaned according to national guidelines, were not less contaminated. Bacterial contamination of spacers is frequent, but the bacteria cultured are not pathogenic. Intensive cleaning of spacers does not influence the level of contamination with environmental bacteria.
Insights
Bacterial contamination of asthma spacers is common in children, but the bacteria are typically not harmful. Regular cleaning, even following guidelines, does not significantly reduce this contamination.
Area of Science:
- Pediatric Pulmonology
- Microbiology
- Asthma Management
Background:
- Spacers are crucial for delivering asthma medication to children.
- Regular cleaning of spacers is recommended to prevent bacterial contamination.
- The impact of cleaning on drug delivery and actual contamination levels is unclear.
Purpose of the Study:
- To investigate the prevalence of bacterial contamination in children's asthma spacers.
- To identify the types of bacteria present in contaminated spacers.
- To assess the effectiveness of current cleaning guidelines.
Main Methods:
- Culturing of spacers from 64 children with asthma or recurrent wheeze over 4 months.
- Identification of bacterial species found on the spacers.
- Correlation analysis with inhaler type, usage duration, medication, and visual appearance.
Main Results:
- 38% (24/64) of spacers showed bacterial contamination.
- Bacillus species were the most common contaminants (13 cases).
- Only one spacer had potentially pathogenic Pseudomonas aeruginosa; no correlation found with cleaning or usage factors.
Conclusions:
- Bacterial contamination of pediatric asthma spacers is frequent.
- The identified bacteria are generally non-pathogenic environmental contaminants.
- Current cleaning practices, including adherence to national guidelines, do not effectively reduce contamination levels.
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