Medical devices for cystic fibrosis care may be portable reservoirs of potential pathogens

Linnane, Barry; Collins, Louise; Bussmann, Neidin; O’Connell, Nuala H.; Dunne, Colum P.

doi:10.1016/j.jhin.2017.04.015

Cited by 11 publications

(10 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, a number of studies have shown that P. aeruginosa and S. aureus clones can be found both in the LAW and UAW of these patients [12,21]. Also, the oral cavity, as well as objects introduced in the mouth such as the toothbrush, were shown to have a role as bacterial reservoirs [11,22]. As highlighted in a recent literature review [11], it is still not clear whether typical CF bacterial species are transient members of the oral flora in patients with occasional and chronic bronchopulmonary colonisation.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal monitoring of sinonasal and oral bacterial reservoirs to prevent chronic lung infection in people with cystic fibrosis

et al. 2020

View full text Add to dashboard Cite

BackgroundParanasal sinuses act as bacterial reservoirs and contribute to transmitting bacteria to the lower airway of patients with cystic fibrosis (CF). Also, passage of bacteria from the oral cavity to the lungs may occur.MethodsWe evaluated the presence of Pseudomonas aeruginosa, Staphylococcus aureus, Stenotrophomonas maltophilia, Achromobacter xylosoxidans and Serratia marcescens in sputum and nasal lavage of 59 patients with CF, and also collected saliva and used toothbrushes from 38 of them. We assessed the clonal identity of the strains isolated from the different samples by pulsed-field gel electrophoresis.ResultsAbout 80% of the patients were positive for at least one of the bacterial species examined in nasal lavage and sputum. Among the subjects with positive sputum, 74% presented the same species in the nasal lavage and saliva, and 26% on their toothbrush. S. aureus was the most abundant species in all samples. Clonal identity (≥80% similarity) of the strains isolated among the different samples from each patient was confirmed in almost all cases. Longitudinal observation helped to identify five patients who were colonised in the lower airways after an initial period of nasal or oral colonisation.ConclusionNasal and oral sites act as bacterial reservoirs, favouring the transmission of potentially pathogenic microorganisms to the lower airway. The lack of eradication from these sites might undermine the antibiotic therapy applied to treat the lung infection, allowing the persistence of the bacteria within the patient if colonisation of these sites is not assessed, and no specific therapy is performed.

show abstract

Section: Discussionmentioning

confidence: 99%

Longitudinal monitoring of sinonasal and oral bacterial reservoirs to prevent chronic lung infection in people with cystic fibrosis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…To our knowledge, no system exists to evaluate both parameters with realtime feedback; some analog manometers are sold as accessory devices for OPEP but only to gauge average pressure (eg, the Aerobika Manometer Accessory, Trudell Medical; Therapep, Smiths). These manometers have possible unintentional drawbacks however because they have the potential to harbor pathogenic bacteria 23 and are not designed for disassembly and cleaning as with OPEP devices.…”

Section: Discussionmentioning

confidence: 99%

Oscillating Positive Expiratory Pressure Therapy May Be Performed Poorly by Children With Cystic Fibrosis

et al. 2019

View full text Add to dashboard Cite

BACKGROUND: Oscillating positive expiratory pressure devices aid removal of excess secretions and reduce gas trapping in patients with hypersecretory pulmonary diseases, for example, cystic fibrosis. Oscillating positive expiratory pressure works when the patient exhales actively against a fixed resistor, which generates mean intrapulmonary pressures of 10 -20 cm H 2 O with rapid fluctuations of at least 1 cm H 2 O from the mean. In this study, we evaluated the performance of oscillating positive expiratory pressure therapy by pediatric subjects with cystic fibrosis to determine adherence to target therapeutic pressures. METHODS: Twenty-one pediatric subjects were recruited. Each had a history of using an oscillating positive expiratory pressure device twice daily and had received standardized training and instructions from the same specialist physiotherapist. Performance was evaluated by using a flow and pressure sensor placed in-line between the participant's mouth and the device. The participants performed expirations as per their normal routine. RESULTS: None of the participants achieved target therapeutic pressure ranges during expiration. The mean ؎ SD pressure generated was 16.2 ؎ 6.8 cm H 2 O, whereas mean ؎ SD flow was 31.3 ؎ 8.9 L/min. The mean ؎ SD expiration length was 2.5 ؎ 1.4 s. CONCLUSIONS: Despite standardized instruction, the results demonstrated considerable variation among the participants and overall poor technique during use. Outcomes of this study indicated that airway clearance effects of oscillating positive expiratory pressure were compromised due to poor technique.

show abstract

“…129 The handling and care of the nebulizers and airway clearance devices are extremely important. 130 Recommendations for nebulizer care include cleaning, disinfecting, rinsing, and air-drying all parts of the device between uses. 131 Cold disinfection may be achieved by using 70% isopropyl alcohol or 3% hydrogen peroxide; heated disinfection includes boiling water and microwave or dishwasher use.…”

Section: Infection Controlmentioning

confidence: 99%

Cystic Fibrosis Lung Disease: An Overview

Turcios¹

2019

Respir Care

149

View full text Add to dashboard Cite

Although better insights into the natural course of cystic fibrosis (CF) have led to treatment approaches that have improved pulmonary health and increased the life expectancy of individuals with this disorder, lung disease remains the main cause of morbidity and mortality in patients with CF. Evidence suggests that airway epithelial defects in ions-water transport lead to dehydrated mucus, impaired mucus clearance, and mucus adhesion to airway surfaces. An increase in mucin secretion is also suggested by the formation of endobronchial mucus plaques and plugs, which become the main sites of air flow obstruction, infection, and inflammation conducing to early small airways disease followed by the development of bronchiectasis. The lung involvement is usually progressive with intermittent exacerbations. Aggressive management and advances in treatment delay, but, do not prevent progression of lung disease. Respiratory failure ensues and is the major cause of death. The lung parenchyma is virtually untouched for much of the course of the disease. This review focuses on the lung involvement in cystic fibrosis and summarizes new developments on the diagnostic approach of CF and pathogenesis of related lung disease. Current therapeutic modalities, novel therapies targeting the basic genetic defect, and lung transplantation are also reviewed.

show abstract

Medical devices for cystic fibrosis care may be portable reservoirs of potential pathogens

Cited by 11 publications

References 8 publications

Longitudinal monitoring of sinonasal and oral bacterial reservoirs to prevent chronic lung infection in people with cystic fibrosis

Longitudinal monitoring of sinonasal and oral bacterial reservoirs to prevent chronic lung infection in people with cystic fibrosis

Oscillating Positive Expiratory Pressure Therapy May Be Performed Poorly by Children With Cystic Fibrosis

Cystic Fibrosis Lung Disease: An Overview

Contact Info

Product

Resources

About