The Science Journal of the American Association for Respiratory Care

2006 OPEN FORUM Abstracts

RISK OF BACTERIAL CONTAMINATION OF SHARED USE METERED DOSE INHALERS: PROSPECTIVE SURVEILLANCE FROM ONCOLOGICAL ICU

Malik, I. MD, Finch, C. RRT, Rudersdorf, T., Price, K. MD
University of Texas MD Anderson Cancer Center, Houston, TX

Background: Continuous use of metered dose inhalers (MDI) between patients is a common practice in hospitals and is presumed to have a low infection risk. Since the MDI canisters are not sterile, contamination is likely despite conscientious decontamination of surfaces and aseptic techniques. Bacterial contamination of shared MDI canisters may pose special risks for cancer patients who are vulnerable to infection due to leukopenia and/or immunosuppression. More aggressive and multidrug resistant organisms are frequent in cancer patients who are on multiple antibiotics. We studied the rate and seasonal variation of bacterial contamination from shared-use of MDI canisters in the medical and surgical oncological ICU of a large comprehensive cancer center.

Methods:  Microbiological data from specimens obtained from shared-use MDI's were collected prospectively over a period of 3 months.  All adult and pediatric non-ventilated ICU patients who required bronchodilators via MDI were enrolled in the study.  Sterile specimens were taken from 3 different sites on the MDI.  The inner aspect of right and left lip of the canister at the junction between the canister and spacer, and the MDI plastic sleeve were swabbed using Cult swab+Amies gel swab (Cardinal Health Medical Products, OH) and BD BBL Culture SwabT Plus (Beckton Dickson, MD). The specimen were transported immediately and set up on blood agar, chocolate agar and MacConkey agar medium, and incubated for 72 hours.

Result:  Each canister served approximately 20 patients.  Analysis of microbiological swabs from the 50 MDI canisters showed no growth of bacteria at 72 hours of bacterial cultures.  The MDI's were not contaminated or infected with bacteria due to shared-use among critically ill cancer patients.

Conclusion: Our results suggest that shared-use MDI canisters are relatively safe to use in critically ill cancer patients with no risk for infection or cross contamination between patients.

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