The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts


Douglas S. Laher1, Franklyn Sandusky1, Linda Schoolcraft2, Livia Matt3

Background: Utilization of the common canister protocol (CCP) has become widely accepted as a means to minimize waste of medications dispensed from metered dose inhalers. The cost savings and popularity of the CCP have many hospitals considering such an option despite the lack of evidence-based, peer-reviewed data to alleviate concerns of microbial cross-contamination. Considering CCP as a cost-savings option, Fairview Hospital conducted a small-scale surveillance study in the pulmonary function laboratory to assess whether or not cross-contamination took place.

Methods: Patients receiving pre/post bronchodilator spirometry testing were administered their medication via the CCP using the Respironics Optichamber valved holding chamber (VHC). The medication canisters and dispensing boots were disinfected after each patient use with 70% isopropyl alcohol wipes; allowed to air dry, and were placed into a medication storage container. At the end of business day (equating to 5-6 patient exposures), the canister and boot were swabbed for culture and sent to the microbiology laboratory for testing.

Results: A total of twenty-three (23) canisters/boots were swabbed for culture. Each culture was monitored for microbial growth for a period not less than forty-eight (48) hours, and not more than seventy-two (72) hours. Of the twenty-three specimens, eighteen (78.3%) were negative for microbial growth. Five cultures (21.7%) grew at least one colony of coagulase-negative staphylococci (CNS).

Conclusion: This data suggests that when disinfected appropriately, cross-contamination of infectious microbial organisms did not take place when using the CCP. While CNS are normal flora of the dermis and are typically benign, it should be noted however; that CNS infections are commonly found with indwelling catheters, with invasive procedures and in open wounds. Hence; heightened awareness of potential cross-contamination and constant appreciation for infection control precautions must be considered by those institutions that evaluate or implement the CCP. More scientific research; including product evaluations of the VHCs must be conducted to validate the safety of the CCP.