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Microbiological contamination in high and low flow oxygen humidifiers: A systematic review
I de la Fuente-Sancho1, Ó Romeu-Bordas1, I Fernández-Aedo2
1Organización Sanitaria Integrada de Bilbao-Basurto, Bilbao, Bizkaia, España.
Aim:
To determine the risk of microbiological contamination with hospital use high- and low-flow bubbling humidifiers.
Methods:
A systematic literature review was carried out in 6 databases. Observational or experimental studies published between 1990 and 2016 were selected, written in English or Spanish, and in which microbiological contamination with hospital use high- and low-flow bubbling humidifiers was investigated.
Results:
A total of 12 articles were included: 4 analyzed the water from reusable humidifiers, 4 analyzed the water from prefilled system humidifiers, and the rest compared samples from both models. Microbial contamination was observed in all studies in which reusable humidifiers were evaluated, usually involving common bacteria from the skin flora, while potential pathogenic species were notified in 2 studies. No microbial contamination was isolated from reusable humidifiers, regardless of whether they had been consecutively used over time by a single patient or by several patients.
Conclusion:
On one hand, there seems to be a low risk of contamination during the first weeks of use of prefilled humidifiers, which allows multiple use in different patients, without a risk of cross-contamination. On the other hand, it should be underscored that handling reusable humidifiers without correct aseptic measures can increase the risk of contamination; replacing reusable humidifiers with prefilled models therefore could be the safest option.
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