Rutala D R, Rutala W A, Weber D J, Thomann C A
Department of Hospital Epidemiology, University of North Carolina Hospitals, Chapel Hill.
Infect Control Hosp Epidemiol. 1991 Feb;12(2):89-92. doi: 10.1086/646292.
Spirometry is a widely used pulmonary function test that allows measurement of forced vital capacity and time-related measures of dynamic pulmonary function. This study was designed to identify the risk of cross-transmission associated with two commonly used dryrolling seal spirometers.
Using a prospective study design, we examined whether microbial contamination of spirometers occurred following use by patients with a heavily colonized or infected respiratory tract. Prior to spirometry evaluation, a patient's sputum culture and equipment samples (i.e., mouthpiece, proximal tubing, piston surface) were obtained. After patient evaluation, a sterile 2 L ventilation bag and sterile tubing were used to simulate the risk of infection of subsequent patients. Simulation 1 was performed immediately after patient testing and Simulation 2, representing a second patient was conducted approximately 18 hours later.
This study was conducted at the University of North Carolina Hospitals, a large university teaching facility.
Fourteen patients with underlying pulmonary disease were studied.
Our study revealed that the mouthpieces became contaminated with the patients' oral flora and with the associated respiratory pathogen. Fourteen percent of the associated tubing after patient testing contained the respiratory pathogen. All other equipment samples (e.g., interior surfaces of the machine, Simulation 1, Simulation 2 samples) were negative for the respiratory pathogen.
These data suggest that mouthpieces and spirometry tubing may become contaminated with microorganisms and should not be shared between patients. Since there is little or no bacterial contamination of the surfaces inside the spirometers and cross transmission is unlikely, it is unnecessary to routinely clean the interior surfaces of the spirometers.
肺活量测定法是一种广泛应用的肺功能测试方法，可用于测量用力肺活量以及动态肺功能的时间相关指标。本研究旨在确定与两种常用的干式滚动密封肺活量计相关的交叉传播风险。
采用前瞻性研究设计，我们检查了呼吸道大量定植或感染的患者使用肺活量计后是否发生微生物污染。在进行肺活量测定评估之前，获取患者的痰培养样本和设备样本（即吹嘴、近端管道、活塞表面）。患者评估后，使用无菌2L通气袋和无菌管道来模拟后续患者的感染风险。模拟1在患者测试后立即进行，模拟2代表第二名患者，大约在18小时后进行。
本研究在北卡罗来纳大学医院进行，这是一家大型大学教学机构。
对14名患有基础肺部疾病的患者进行了研究。
我们的研究表明，吹嘴被患者的口腔菌群和相关呼吸道病原体污染。患者测试后，14%的相关管道含有呼吸道病原体。所有其他设备样本（如机器内表面、模拟1、模拟2样本）的呼吸道病原体检测均为阴性。
这些数据表明，吹嘴和肺活量计管道可能被微生物污染，不应在患者之间共享。由于肺活量计内部表面几乎没有细菌污染，交叉传播不太可能发生，因此无需定期清洁肺活量计的内部表面。
