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Bacterial colonization as a potential source of nosocomial respiratory infections in two types of spirometer
F Burgos1, A Torres, J González
1Servei de Pneumologia i Allérgia Respiratoría, Hospital Clínic, Barcelona, Spain.
Abstract:
The potential risk of spirometers in the transmission of respiratory infections has not been yet established. We performed a prospective cross-sectional study to determine the rate of colonization of a water-sealed spirometer and a pneumotachograph, and the potential risk of cross-transmission of microorganisms to patients using each of these devices. Fifty four patients (aged 51 +/- 18 (mean +/- SD) yrs) were included in the study. All of them had undergone forced spirometry with bronchodilator response by means of the water-sealed spirometer (n = 36) or the pneumotachograph (n = 18). None had a clinically apparent respiratory infection at the time of the study. Routine hygiene measures for respiratory equipment were performed before the study protocol. Samples for microbiological cultures of different parts both of the water-sealed spirometer (proximal and distal tubing, bell and water-bell) and pneumotachograph (proximal and distal tubing) were taken daily before and after the usual series of lung function tests during a 5 day period. Pharyngeal swab cultures were obtained before spirometry and 7 days later in each subject. Thirty six out of a total of 40 (90%) culture samples from the water-sealed spirometer showed microbial growth compared to 4 out of 30 (13%) samples obtained from the pneumotachograph (p < 0.0001). Significant colonization of the water-sealed spirometer was apparent after the third day of the study. The microorganisms most frequently isolated were penicillium sp. (62%), Pseudomonas fluorescens (32%), and Burkholderia cepacea (48%). Distal tubing, water and water-bell were the parts of the water-sealed spirometer that showed higher colonization counts (> or = 10(4) colony-forming units (cfu).mL-1). No transmission sequence of potentially pathogenic microorganisms 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 reservoirs of microorganisms suggests a need for the implementation of new hygiene measures for their maintenance.
Insights
Water-sealed spirometers frequently harbor microorganisms, posing a potential infection risk. Enhanced hygiene measures are crucial for maintaining these respiratory devices and preventing microbial transmission.
Area of Science:
- Microbiology
- Infectious Diseases
- Pulmonary Medicine
Background:
- The risk of respiratory infection transmission via spirometers remains unclear.
- Routine hygiene protocols for respiratory equipment are standard practice.
Purpose of the Study:
- To assess microbial colonization rates of water-sealed spirometers and pneumotachographs.
- To evaluate the risk of microorganism cross-transmission to patients using these devices.
Main Methods:
- A prospective cross-sectional study involving 54 patients undergoing spirometry.
- Microbiological cultures of spirometer components and patient pharyngeal swabs were collected over 5 days.
- Comparison between water-sealed spirometers (n=36) and pneumotachographs (n=18).
Main Results:
- 90% of water-sealed spirometer samples showed microbial growth versus 13% for pneumotachographs (p < 0.0001).
- Significant colonization of water-sealed spirometers occurred by day 3.
- Penicillium sp., Pseudomonas fluorescens, and Burkholderia cepacea were frequently isolated.
Conclusions:
- Water-sealed spirometers are prone to significant microbial colonization.
- The findings highlight a potential hazard of these devices as microorganism reservoirs.
- Implementation of enhanced hygiene measures for water-sealed spirometers is recommended.