Effect that an educational program for cystic fibrosis patients and caregivers has on the contamination of home nebulizers.
OBJECTIVE
To describe the pathogens found in home nebulizers and in respiratory samples of cystic fibrosis (CF) patients, and to evaluate the effect that a standardized instruction regarding cleaning and disinfection of nebulizers has on the frequency of nebulizer contamination.


METHODS
We included 40 CF patients (22 males), all of whom used the same model of nebulizer. The median patient age was 11.2 ± 3.74 years. We collected samples from the nebulizer mouthpiece and cup, using a sterile swab moistened with sterile saline. Respiratory samples were collected by asking patients to expectorate into a sterile container or with oropharyngeal swabs after cough stimulation. Cultures were performed on selective media, and bacteria were identified by classical biochemical tests. Patients received oral and written instructions regarding the cleaning and disinfection of nebulizers. All determinations were repeated an average of two months later.


RESULTS
Contamination of the nebulizer (any part) was detected in 23 cases (57.5%). The nebulizer mouthpiece and cup were found to be contaminated in 16 (40.0%) and 19 (47.5%), respectively. After the standardized instruction had been given, there was a significant decrease in the proportion of contaminated nebulizers (43.5%).


CONCLUSIONS
In our sample of CF patients, nebulizer contamination was common, indicating the need for improvement in patient practices regarding the cleaning and disinfection of their nebulizers. A one-time educational intervention could have a significant positive impact.
Graduate Program in Health Sciences, School of Medicine, University of São Paulo, São Paulo, Brazil.
Adriana
A
Della Zuana
Graduate Program in Health Sciences, School of Medicine, University of São Paulo, São Paulo, Brazil.
Doroti de Oliveira
Dde O
Garcia
Graduate Program in Health Sciences, School of Medicine, University of São Paulo, São Paulo, Brazil.
Regina Célia Turola Passos
RC
Juliani
Graduate Program in Health Sciences, School of Medicine, University of São Paulo, São Paulo, Brazil.
Luiz Vicente Ribeiro Ferreira da
LV
Silva Filho
D017028:Caregivers; D002648:Child; D003550:Cystic Fibrosis / Q000382:microbiology*; D004203:Disinfection; D004866:Equipment Contamination; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008397:Masks / Q000382:microbiology*; D009330:Nebulizers and Vaporizers / Q000382:microbiology*; D013183:Sputum / Q000382:microbiology; D011795:Surveys and Questionnaires