title: Are bulb syringe irrigators a potential source of bacterial contamination in chronic rhinosinusitis?
abstract: BACKGROUND
  The purpose of this study was to determine if bulb syringe irrigators are a potential source for bacterial contamination in patients with chronic rhinosinusitis.
  
  
  METHODS
  Standard 3-oz bulb syringe irrigators (n = 24) were each flushed with the following solutions twice daily: A (n = 8), sterile isotonic saline; B (n = 8), prepared hypertonic saline (3 tsp table salt/L of sterile water); and C (n = 8), prepared baking soda/saline (1 tsp table salt + 1 tsp baking soda/L of commercial sterile water). Syringes were stored on a residential bathroom counter, and two from each group were harvested for culture weekly for 4 weeks.
  
  
  RESULTS
  There was no growth from syringes irrigated with any of the three solutions after the first 7 days of irrigation. After the entire 4-week study period, potential pathogens were recovered from 6/8 (75%) bulbs from group A, 0/8 bulbs from group B, and 1/8 bulbs (12.5%) from group C. All positive cultures revealed growth by 1-2 days postinoculation (p = 0.002). The organism recovered from syringes in group A was Pseudomonas fluorescens in all six specimens. The one positive culture in group C represented a single colony of Gram-positive cocci.
  
  
  CONCLUSIONS
  Under realistic conditions, bulb syringes are susceptible to contamination with potential bacterial pathogens, particularly when using unbuffered isotonic saline.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
authors.forename: Glenn B
authors.initials: GB
authors.lastname: Williams
authors.forename: Linda L
authors.initials: LL
authors.lastname: Ross
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Chandra
mesh_terms: D000281:Administration, Intranasal; D002908:Chronic Disease; D015169:Colony Count, Microbial; D004866:Equipment Contamination / Q000706:statistics & numerical data*; D006801:Humans; D011552:Pseudomonas Infections / Q000382:microbiology / Q000635:transmission*; D011551:Pseudomonas fluorescens / Q000254:growth & development / Q000302:isolation & purification*; D012220:Rhinitis / Q000150:complications / Q000188:drug therapy*; D012307:Risk Factors; D012852:Sinusitis / Q000150:complications / Q000188:drug therapy*; D013594:Syringes / Q000382:microbiology*; D007507:Therapeutic Irrigation / Q000009:adverse effects* / Q000295:instrumentation