BACKGROUND AND PURPOSE: Domiciliary nebulisers are widely used in @entity1030 ( @entity1030 ) but nebuliser cleaning practice has not been assessed in @entity1 with @entity1030 who are often elderly and may have severe disease and multiple comorbidities. We aimed to evaluate microbial contamination of home nebulisers used by @entity1 with @entity1030 . METHODS: Random microbiological assessment of domiciliary nebulisers was undertaken together with an enquiry into cleaning practices. We also examined the effectiveness of the trust-wide cleaning instructions in eradicating isolated microorganisms in a laboratory setting. RESULTS: The mean age of @entity1 in this study was 71 (range 40-93) years, and in 68% of @entity1 a large number of significant comorbidities were present. Forty-four nebuliser sets were obtained and 73% were contaminated with microorganisms at >100 colony forming units/plate. Potentially pathogenic bacteria colonised 13 of the 44 nebulisers (30%) and organisms isolated included @entity2782 , @entity794 , multidrug resistant Serratia marcesans, @entity526 and multiresistant Klebsiella spp, Enterobacteriaceae and fungus @entity4278 . Washing of nebuliser masks, chambers and mouthpieces achieved complete eradication of Gram-positive @entity364 . Gram-negative organisms were incompletely eradicated, which may be attributed to the presence of biofilms. We also found that in @entity1 with pathogenic organisms cultured on the nebuliser sets, there was a higher probability of occurrence of a @entity1030 with a mean number of exacerbations of 3.3 (SD=1) per year in the group in whom pathogens were isolated compared with 1.7 (SD=1.2) exacerbations per year in those whose sets grew non-pathogenic flora (p=0.02). CONCLUSIONS: Nebulisers contaminated with microorganisms are potential reservoirs delivering serious pathogens to the lung. Relationships between nebuliser contamination, clinical infection and exacerbations require further examination, but is a potential concern in elderly @entity1 with @entity1030 with comorbidities who fail to effectively maintain reasonable standards of nebuliser cleanliness.

Microbial contamination of domiciliary nebulisers and clinical implications in XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity2782 :: ('MESH:D011552', 'Disease') :: ['Pseudomonas aeroginosa'] @entity794 :: ('1280', 'Species') :: ['Staphylococcus aureus'] @entity4278 :: ('5507', 'Species') :: ['Fusarium oxysporum'] @entity364 :: ('MESH:D009181', 'Disease') :: ['bacterial and fungal flora'] @entity1030 :: ('MESH:D029424', 'Disease') :: ['chronic obstructive pulmonary disease', 'COPD exacerbation', 'COPD'] @entity526 :: ('562', 'Species') :: ['Escherichia coli']
@entity1030 :: (MESH:D029424,Disease) :: ['chronic obstructive pulmonary disease']
