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Microbial contamination of home nebulizers in children with cystic fibrosis and clinical implication on the number of pulmonary exacerbations

BMC Pulmonary Medicine Feb 14, 2020

Tabatabaii SA, Khanbabaee G, Sadr S, et al. - As children with cystic fibrosis (CF) are vulnerable to Pseudomonas aeruginosa (P. aeruginosa) colonization, early detection of pulmonary contamination in these children is essential. Given the widespread practice home nebulization of antibiotics in Iran in treatment for patients with CF, researchers sought to perform a bacteriological survey in this regard. At Mofid Children’s Hospital, Tehran, they conducted an observational, cross-sectional study on 61 children with CF from September 2017 to March 2018. From 61 home nebulizers utilized by children diagnosed with CF, they performed the swab sampling. Each patient provided contemporaneous sputum sample or deep nasopharyngeal swab for bacterial and fungal testing. Outcomes revealed contamination of 43 (70.5%) nebulizers; 31 (50.8%) mouthpieces, 21 (34.4%) reservoirs, and 11 (18%) connecting tubes. P. aeruginosa was identified to be the most common organism to be isolated; it was recovered from 19 (31%) nebulizers, 16 of them belonged to patients chronically colonized with P. aeruginosa. This indicates that the nebulizers may serve as potential reservoirs of pathogens for the patients’ lung. Perpetuating colonization is a possible concern in the ones recently colonized with P. aeruginosa and, hence, they recommend paying more attention to the decontamination of nebulizer to prevent an ongoing infection.
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