Bacterial Colonization and Home Mechanical Ventilation: Prevalence and Risk Factors
TO investigate the prevalence of bacterial contamination of ventilators and colonization of patients, the bacteria implicated, and predisposing factors in noninvasive home ventilation. Forty patients on a home noninvasive ventilation program (mean [SD] age: 63.1 [12] years; time on ventilation: 30.7...
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Published in | Archivos de bronconeumología (English ed.) Vol. 40; no. 9; pp. 392 - 396 |
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Format | Journal Article |
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01.09.2004
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Abstract | TO investigate the prevalence of bacterial contamination of ventilators and colonization of patients, the bacteria implicated, and predisposing factors in noninvasive home ventilation.
Forty patients on a home noninvasive ventilation program (mean [SD] age: 63.1 [12] years; time on ventilation: 30.7 [25] months; daily use: 8.1 [2] hours) were enrolled in this descriptive cross-sectional study. Microbiological samples for semiquantitative cultures were swabbed from the ventilator (mask and tubing) and the nostrils. A questionnaire was completed on the underlying disease, time on the ventilation program, type of ventilator, presence of a humidifier, and attention to ventilator cleanliness and maintenance. We defined “colonization” as the presence of microorganisms in the nostrils without evidence of a host immune response, and “contamination” as the presence of surface microorganisms (on tubing or the nasal mask).
Potentially pathogenic bacteria were isolated from 6 ventilators (15%) and the nasal swabs of 10 patients (25%).
Staphylococcus aureus was the most frequently isolated one (in 5 ventilators and 6 patients—contamination coinciding with colonization in 3 cases). Other potentially pathogenic bacteria isolated were
Proteus species (from the nostrils of 2 patients) and an unidentified gram-negative bacillus from the ventilator. On analysis by underlying disease, 60% of the patients with obesity had been colonized. No other findings of note were obtained for other diseases. Contamination and colonization correlated with attention to cleanliness and maintenance of the ventilator but not with type of ventilator, time on the ventilation program, or use of a humidifier.
Home mechanical ventilators are a potential source of nasal colonization. The most frequently encountered microorganism was
S. aureus. The degree of ventilator cleaning and disinfection seems to affect contamination; thus it is necessary to impress on patients the need for adequate maintenance of their ventilators.
Conocer la prevalencia de contaminación bacteriana de los ventiladores utilizados en la ventilación mecánica no invasiva domiciliaria, la colonización en los pacientes, los microorganismos implicados y los factores favorecedores.
Se realizó un estudio descriptivo transversal en 40 pacientes en programa de ventilación mecánica no invasiva domiciliaria (edad media: 63,1 ± 12 años; tiempo en ventilación: 30,7 ± 25 meses; utilización diaria: 8,1 ± 2 h). Se tomaron muestras microbiológicas mediante escobi-llado del equipo de ventilación (mascarilla y tubuladuras) y de las fosas nasales para realizar cultivos semicuantitativos, y se completó un cuestionario que incluía enfermedad de base, tiempo en programa de ventilación, tipo de ventilador, existen-cia de humidificador y hábitos y grado de limpieza. Definimos como “colonización” la presencia de microorganismos en las fosas nasales sin evidencia de respuesta orgánica por parte del huésped, y “contaminación” como la presencia de microorganismos en una superficie (tubuladura y mascarilla nasal).
Se aislaron microorganismos potencialmen-te patógenos en las conexiones de 6 equipos (15%) y en el frotis nasal de 10 pacientes (25%).
Staphylococcus aureus fue el aislado con mayor frecuencia (5 equipos y 6 pacientes; fue coincidente en 3 casos). Otros gérmenes aislados fueron
Proteus spp. (2 casos en fosas nasales),
Streptococcus pneu-moniae (2 casos en fosas nasales) y un bacilo gramnegativo no tipificable en las conexiones. Por patologías, el único dato destacable fue que en el 60% de los pacientes con obesidad existía colonización, sin que hubiera datos significativos en el resto de enfermedades. Existe correlación positiva entre el grado de limpieza macroscópico y los aislamientos, pero no entre la contaminación, la colonización y factores como tipo de ventilador, tiempo en ventilación o uso de humidificador.
Los equipos de ventilación mecánica do-miciliario pueden representar una fuente potencial de colonización nasal. El microorganismo más representativo en-contrado fue
S. aureus. El grado de limpieza de los equipos parece influir en la contaminación, por lo que es necesario insistir en el adecuado mantenimiento de estos equipos. |
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AbstractList | OBJECTIVETo investigate the prevalence of bacterial contamination of ventilators and colonization of patients, the bacteria implicated, and predisposing factors in noninvasive home ventilation.MATERIAL AND METHODSForty patients on a home noninvasive ventilation program (mean [SD] age: 63.1 [12] years; time on ventilation: 30.7 [25] months; daily use: 8.1 [2] hours) were enrolled in this descriptive cross-sectional study. Microbiological samples for semiquantitative cultures were swabbed from the ventilator (mask and tubing) and the nostrils. A questionnaire was completed on the underlying disease, time on the ventilation program, type of ventilator, presence of a humidifier, and attention to ventilator cleanliness and maintenance. We defined "colonization" as the presence of microorganisms in the nostrils without evidence of a host immune response, and "contamination" as the presence of surface microorganisms (on tubing or the nasal mask).RESULTSPotentially pathogenic bacteria were isolated from 6 ventilators (15%) and the nasal swabs of 10 patients (25%). Staphylococcus aureus was the most frequently isolated one (in 5 ventilators and 6 patients--contamination coinciding with colonization in 3 cases). Other potentially pathogenic bacteria isolated were Proteus species (from the nostrils of 2 patients) and an unidentified gram-negative bacillus from the ventilator. On analysis by underlying disease, 60% of the patients with obesity had been colonized. No other findings of note were obtained for other diseases. Contamination and colonization correlated with attention to cleanliness and maintenance of the ventilator but not with type of ventilator, time on the ventilation program, or use of a humidifier.CONCLUSIONSHome mechanical ventilators are a potential source of nasal colonization. The most frequently encountered microorganism was S. aureus. The degree of ventilator cleaning and disinfection seems to affect contamination; thus it is necessary to impress on patients the need for adequate maintenance of their ventilators. TO investigate the prevalence of bacterial contamination of ventilators and colonization of patients, the bacteria implicated, and predisposing factors in noninvasive home ventilation. Forty patients on a home noninvasive ventilation program (mean [SD] age: 63.1 [12] years; time on ventilation: 30.7 [25] months; daily use: 8.1 [2] hours) were enrolled in this descriptive cross-sectional study. Microbiological samples for semiquantitative cultures were swabbed from the ventilator (mask and tubing) and the nostrils. A questionnaire was completed on the underlying disease, time on the ventilation program, type of ventilator, presence of a humidifier, and attention to ventilator cleanliness and maintenance. We defined “colonization” as the presence of microorganisms in the nostrils without evidence of a host immune response, and “contamination” as the presence of surface microorganisms (on tubing or the nasal mask). Potentially pathogenic bacteria were isolated from 6 ventilators (15%) and the nasal swabs of 10 patients (25%). Staphylococcus aureus was the most frequently isolated one (in 5 ventilators and 6 patients—contamination coinciding with colonization in 3 cases). Other potentially pathogenic bacteria isolated were Proteus species (from the nostrils of 2 patients) and an unidentified gram-negative bacillus from the ventilator. On analysis by underlying disease, 60% of the patients with obesity had been colonized. No other findings of note were obtained for other diseases. Contamination and colonization correlated with attention to cleanliness and maintenance of the ventilator but not with type of ventilator, time on the ventilation program, or use of a humidifier. Home mechanical ventilators are a potential source of nasal colonization. The most frequently encountered microorganism was S. aureus. The degree of ventilator cleaning and disinfection seems to affect contamination; thus it is necessary to impress on patients the need for adequate maintenance of their ventilators. Conocer la prevalencia de contaminación bacteriana de los ventiladores utilizados en la ventilación mecánica no invasiva domiciliaria, la colonización en los pacientes, los microorganismos implicados y los factores favorecedores. Se realizó un estudio descriptivo transversal en 40 pacientes en programa de ventilación mecánica no invasiva domiciliaria (edad media: 63,1 ± 12 años; tiempo en ventilación: 30,7 ± 25 meses; utilización diaria: 8,1 ± 2 h). Se tomaron muestras microbiológicas mediante escobi-llado del equipo de ventilación (mascarilla y tubuladuras) y de las fosas nasales para realizar cultivos semicuantitativos, y se completó un cuestionario que incluía enfermedad de base, tiempo en programa de ventilación, tipo de ventilador, existen-cia de humidificador y hábitos y grado de limpieza. Definimos como “colonización” la presencia de microorganismos en las fosas nasales sin evidencia de respuesta orgánica por parte del huésped, y “contaminación” como la presencia de microorganismos en una superficie (tubuladura y mascarilla nasal). Se aislaron microorganismos potencialmen-te patógenos en las conexiones de 6 equipos (15%) y en el frotis nasal de 10 pacientes (25%). Staphylococcus aureus fue el aislado con mayor frecuencia (5 equipos y 6 pacientes; fue coincidente en 3 casos). Otros gérmenes aislados fueron Proteus spp. (2 casos en fosas nasales), Streptococcus pneu-moniae (2 casos en fosas nasales) y un bacilo gramnegativo no tipificable en las conexiones. Por patologías, el único dato destacable fue que en el 60% de los pacientes con obesidad existía colonización, sin que hubiera datos significativos en el resto de enfermedades. Existe correlación positiva entre el grado de limpieza macroscópico y los aislamientos, pero no entre la contaminación, la colonización y factores como tipo de ventilador, tiempo en ventilación o uso de humidificador. Los equipos de ventilación mecánica do-miciliario pueden representar una fuente potencial de colonización nasal. El microorganismo más representativo en-contrado fue S. aureus. El grado de limpieza de los equipos parece influir en la contaminación, por lo que es necesario insistir en el adecuado mantenimiento de estos equipos. To investigate the prevalence of bacterial contamination of ventilators and colonization of patients, the bacteria implicated, and predisposing factors in noninvasive home ventilation. Forty patients on a home noninvasive ventilation program (mean [SD] age: 63.1 [12] years; time on ventilation: 30.7 [25] months; daily use: 8.1 [2] hours) were enrolled in this descriptive cross-sectional study. Microbiological samples for semiquantitative cultures were swabbed from the ventilator (mask and tubing) and the nostrils. A questionnaire was completed on the underlying disease, time on the ventilation program, type of ventilator, presence of a humidifier, and attention to ventilator cleanliness and maintenance. We defined "colonization" as the presence of microorganisms in the nostrils without evidence of a host immune response, and "contamination" as the presence of surface microorganisms (on tubing or the nasal mask). Potentially pathogenic bacteria were isolated from 6 ventilators (15%) and the nasal swabs of 10 patients (25%). Staphylococcus aureus was the most frequently isolated one (in 5 ventilators and 6 patients--contamination coinciding with colonization in 3 cases). Other potentially pathogenic bacteria isolated were Proteus species (from the nostrils of 2 patients) and an unidentified gram-negative bacillus from the ventilator. On analysis by underlying disease, 60% of the patients with obesity had been colonized. No other findings of note were obtained for other diseases. Contamination and colonization correlated with attention to cleanliness and maintenance of the ventilator but not with type of ventilator, time on the ventilation program, or use of a humidifier. Home mechanical ventilators are a potential source of nasal colonization. The most frequently encountered microorganism was S. aureus. The degree of ventilator cleaning and disinfection seems to affect contamination; thus it is necessary to impress on patients the need for adequate maintenance of their ventilators. |
Author | Andrade Vivero, G. López Martín, S. Sánchez, C. Rodríguez González-Moro, J.M. Izquierdo Alonso, J.L. de Lucas Ramos, P. de Miguel Díez, J. |
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Snippet | TO investigate the prevalence of bacterial contamination of ventilators and colonization of patients, the bacteria implicated, and predisposing factors in... To investigate the prevalence of bacterial contamination of ventilators and colonization of patients, the bacteria implicated, and predisposing factors in... OBJECTIVETo investigate the prevalence of bacterial contamination of ventilators and colonization of patients, the bacteria implicated, and predisposing... |
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SubjectTerms | Adult Aged Bacteria - isolation & purification Colonización Colonization Contaminación Contamination Cross-Sectional Studies Equipment Contamination Female Home Care Services Home mechanical ventilation Humans Male Middle Aged Nose - microbiology Prevalence Respiration, Artificial Risk Factors Surveys and Questionnaires Time Factors Ventilación mecánica domiciliaria Ventilators, Mechanical - microbiology |
Title | Bacterial Colonization and Home Mechanical Ventilation: Prevalence and Risk Factors |
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