Pediatr Allergy Respir Dis.  2006 Jun;16(2):122-130.

Bacterial Contaminations of Home Nebulizers in Asthmatic Children

Affiliations
  • 1Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea. jt42525@korea.ac.kr
  • 2Department of Laboratory Medicine, College of Medicine, Korea University, Seoul, Korea.

Abstract

PURPOSE: Nebulizers are commonly used to treat children with asthma. Some pulmonary infections associated with contaminated nebulizer units have been reported. The aims of this study were to determine whether home nebulizers are repositories of bacteria and to ascertain how asthmatic patients use and maintain their nebulizers at home.
METHODS
Fifty-five children with asthma aged 2 to 6 years were enrolled in this study. The parents were asked to bring their child's nebulizer units to regular follow-up visits. Bacterial samples which were obtained from the masks(or mouthpieces), nebulizer chambers and throat swabs were inoculated to blood agar, chocolate agar, and McConkey agar. Cultures were incubated at 5 percent CO2 incubator and observed after 24 hours. Parents completed a questionnaire regarding nebulizer usage and care in their child.
RESULTS
Bacterial contamination was found in samples from 27(49.1%) of the 55 masks(or mouthpieces) and 24(43.6%) of the 55 chambers. The predominant microorganisms isolated were Acinetobacter baumannii, Bacillus subtilis, Klebsiella pneumoniae, Staphylococcus aureus, and Candida albicans. The questionnaire revealed that 40 parents cleaned the nebulizer units with tap water(and soap) and dried then, as they had received cleaning and drying instructions from a medical staff member. Seven organisms from nebulizer units were indistinguishable from the patient's throat isolates.
CONCLUSION
We have demonstrated that home nebulizers in these asthmatic children were frequently contaminated with aerobic bacteria. Aerosolization might transmit these bacteria to their upper respiratory tracts. The education and training of home caregivers should include the principles of cleaning and maintenance of their child's nebulizer units.

Keyword

Bacterial contamination; Nebulizer; Asthma; Children; Inhalation; Throat swab

MeSH Terms

Acinetobacter baumannii
Agar
Asthma
Bacillus subtilis
Bacteria
Bacteria, Aerobic
Cacao
Candida albicans
Caregivers
Child*
Education
Follow-Up Studies
Humans
Incubators
Inhalation
Klebsiella pneumoniae
Medical Staff
Nebulizers and Vaporizers*
Parents
Pharynx
Surveys and Questionnaires
Respiratory System
Staphylococcus aureus
Agar
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