In vitro evaluation of efficacy of 5 methods of disinfection on mouthpieces and facemasks contaminated by strains of cystic fibrosis patients☆

Received 24 February 2005; received in revised form 8 June 2005; accepted 9 June 2005.

Abstract

Introduction

Home-nebulizers are a potential source of bacterial infection of the respiratory tract in patients suffering from cystic fibrosis. Recommendations for disinfecting this equipment are often arbitrary and sometimes contradictory.

Objective

To assess in vitro the effectiveness of 5 methods of disinfecting this equipment.

Methods

160 mouthpieces and 160 masks of nebulizers were artificially and massively contaminated with 16 strains of germs found in patients with cystic fibrosis (Staphylococcus aureus, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Burkholderia cenocepacia, Alcaligenes xylosoxydans). A controlled comparison was carried out of the five methods of disinfection (hypochlorite solution (0.02% active chlorine), acetic acid 3.5%, Hexanios 0.5%, washing-up detergent 0.5% and a dishwasher), tested with and without drying. Standardised bacteriological sampling took place 4 h after disinfecting.

Results

Following treatment, the disappearance of the germ was recorded in 84.1% of cases, and effective disinfecting (reduction>5 log CFU/mL) in another 10.6%. Disinfection failure (5.3%) was found almost only in the case of acetic acid against Staphylococcus aureus.

Conclusion

With the exception of acetic acid, the methods of disinfecting tested in this study appeared to be effective against common bacterial pathogens in cystic fibrosis.

Keywords: Contamination, Cystic fibrosis, Disinfection, In vitro, Nebulizer

a Center of Cystic Fibrosis, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate 10, B-1200, Brussels, Belgium

b Department of Physical Medicine and Rehabilitation, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate 10, B-1200, Brussels, Belgium

c Hygiene Unit, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate 10, B-1200, Brussels, Belgium

d Microbiology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate 10, B-1200, Brussels, Belgium

e Pediatric Pulmonology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate 10, B-1200, Brussels, Belgium

Corresponding author. Center of Cystic Fibrosis, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate 10, B-1200, Brussels, Belgium. Tel.: +32 2 764 19 39; fax: +32 2 764 89 06.

☆ Results were presented at 26th European CF Conference, Belfast 2003.

PII: S1569-1993(05)00076-7

doi:10.1016/j.jcf.2005.06.001

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