Soluble squalamine tablets for the rapid disinfection of home nebulizers of cystic fibrosis patients.
BACKGROUND
The bacterial contamination of nebulizers represents a major problem for cystic fibrosis (CF) patients that can lead to reduced nebulizer performance and increase the risk of patient reinfection by the contaminating bacteria.


OBJECTIVE
We investigated the potential use of squalamine, a broad-spectrum antimicrobial compound, as a nebulizer disinfectant.


METHODS
Pari LC nebulizers were artificially contaminated with a suspension of bacteria (Staphylococcus aureus and Pseudomonas aeruginosa; 10(8) CFU/mL) and fungi (Candidida albicans and Aspergilus niger; 10(7) CFU/mL) and then disinfected by immersion in squalamine solution for 20 min. Glutaraldehyde and Korsolex peracetic acid were used as disinfectant controls.


RESULTS
We found that 0.5 g/L squalamine reduced the levels of viable S. aureus and P. aeruginosa by 5 log(10) and the level of viable C. albicans by 4 log(10) after 20 min. A concentration of 2 g/L was needed to reduce the level of A. niger cells by 4 log(10) in 6 hours. Finally, a formulation of squalamine in the form of a soluble disinfecting tablet containing 2.5% (w/w) squalamine was developed and successfully applied for nebulizer disinfection.


CONCLUSIONS
Our results suggest that aminosterol derivatives may be used by CF patients for rapid and easy home nebulizer disinfection and that soluble tablets may be developed for this purpose.
Unité de Recherche des Maladies Infectieuses et Tropicales Emergentes UMR 6236 CNRS Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France.
Lamia
L
Djouhri-Bouktab
Kamel
K
Alhanout
Véronique
V
Andrieu
Nathalie
N
Stremler
Jean Christophe
JC
Dubus
Didier
D
Raoult
Jean Marc
JM
Rolain
Jean Michel
JM
Brunel
D000280:Administration, Inhalation; D001228:Aspergillosis / Q000382:microbiology / Q000517:prevention & control; D001234:Aspergillus niger / Q000187:drug effects / Q000254:growth & development; D002176:Candida albicans / Q000187:drug effects / Q000254:growth & development; D002177:Candidiasis / Q000382:microbiology / Q000517:prevention & control; D002777:Cholestanols / Q000494:pharmacology; D003550:Cystic Fibrosis / Q000188:drug therapy / Q000382:microbiology*; D004202:Disinfectants / Q000494:pharmacology*; D004203:Disinfection / Q000379:methods; D004866:Equipment Contamination / Q000517:prevention & control*; D006801:Humans; D009330:Nebulizers and Vaporizers / Q000382:microbiology*; D011552:Pseudomonas Infections / Q000382:microbiology / Q000517:prevention & control; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000254:growth & development; D012995:Solubility; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000254:growth & development; D013607:Tablets
D002777:Cholestanols; D004202:Disinfectants; D013607:Tablets; C079655:squalamine