title: The comparative risks of bacterial contamination between a venturi atomizer and a positive displacement atomizer.
abstract: BACKGROUND
  This laboratory study determined the incidence of internal contamination of Venturi principle atomizers and positive displacement atomizers exposed to high external concentrations of Staphylococcal aureus (Staph).
  
  
  METHODS
  Atomizer device nozzle tips were immersed into a Staph solution and I ml of spray was atomized via compressed wall air (Venturi) or hydraulic pump (positive displacement). The Venturi nozzle was then wiped with 70% isopropyl alcohol while the disposable positive displacement nozzle was replaced. After 30 minutes, 1 ml of atomized fluid was collected and cultured and the process was repeated. After sixteen uses the fluid remaining in the bottles was cultured. The Venturi atomizer also was subjected to a single use trial to determine the location of device contamination.
  
  
  RESULTS
  Venturi atomizers sprays grew Staph in every case (144/144), while positive displacement atomizer sprays never grew contaminants (0/144; p < 0.0001). At the end of 16 uses, 7/9 of Venturi atomizers had Staph within their medication reservoirs while none (0/9; p = 0.002) existed in the positive displacement atomizers. After a single use of the Venturi atomizer, the medication reservoir, the air lumen and the medication lumen of the nozzle were all contaminated with Staph.
  
  
  CONCLUSIONS
  External bacterial contamination of the atomizer nozzle tip results in internal bacterial contamination of Venturi devices in as little as one use but not of positive displacement devices. These results warrant further investigation to determine whether a risk of cross-contamination exists in a clinical setting.
authors.affiliation: Department of Surgery, University of Utah School of Medicine, USA.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Wolfe
authors.forename: Todd A
authors.initials: TA
authors.lastname: Hillman
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Bossart
mesh_terms: D004866:Equipment Contamination; D004867:Equipment Design; D006801:Humans; D008422:Materials Testing; D009330:Nebulizers and Vaporizers / Q000382:microbiology*; D011446:Prospective Studies; D013211:Staphylococcus aureus / Q000302:isolation & purification*