1997 OPEN FORUM Abstracts
SURVEILLANCE OF RESERVOIR CROSS-CONTAMINATION WITH MULTIPLE PATIENT MDI USE
Crystal L. Dunlevy, EdD, RRT, Joseph L. Rau, Jr., PhD, RRT, Susan B. Roman, MMSc, MT, SM, Georgia State University, Atlanta, GA
Introduction: At many hospitals, it is standard practice for RCPs to deliver MDI therapy to patients each patient is supplied with his own reservoir device, and a common canister is used for multiple patients. The purpose of this study was to perform infection control surveillance of MDI canisters for cross-contamination with multiple patient reservoir devices, as they are currently used at a local hospital. Materials & Methods: Human subjects approval was obtained and data was collected at a 600 bed acute care university teaching institution. The Aerosol Cloud Enhancer (ACE) was the reservoir device monitored in the study. All patients in the study had been using the ACE for at least 24 hours prior to data collection. All data was collected by the same investigator, using universal precautions. The study population consisted of 60 nonintubated patients who were receiving MDI treatments. Three cultures were obtained for each subject. The sequence of specimen collection was carried out as follows: swab MDI canister nozzle (culture A); disinfect MDI canister nozzle with alcohol prep pad; repeat swab of canister nozzle (culture B); swab ACE MDI adapter site (culture C); administer MDI treatment. Specimen collection swabs were inserted into transport packs, labeled, & analyzed by a clinical microbiologist for growth after 1, 2, 3, and 5 days incubation. Subjects were profiled according to gender, and age. Probabilities for the number of positive cultures will be calculated from a binomial distribution, with a significance level of 0.05. Results: 38 subjects were male; 22 were female. Mean age of subjects was 53. For group A, 3 cultures tested positive for Staphylococcus epidermidis; B - 5 cultures tested positive for that same organism; C - 11 cultures tested positive for a variety of organisms. Binomial distributions for each culture set (A, B, and C) were < 0.001, indicating significantly low probability of obtaining a positive culture. Conclusion: The likelihood of contamination is low when common canisters are used with multiple reservoir devices. Because canisters may be shared without significant risk of contamination, this may translate into savings for both patient and respiratory care department.