Department of Surgery-Otorhinolaryngology, Head and Neck Surgery, University of Adelaide and Flinders University, Adelaide, Australia.
Int Forum Allergy Rhinol. 2011 Jul-Aug;1(4):303-7. doi: 10.1002/alr.20047. Epub 2011 Mar 16.
Saline nasal irrigation is a mainstay in the medical management of chronic rhinosinusitis (CRS) with proven efficacy. However, bacterial contamination of irrigation bottles has recently been reported and this may contribute to recurrent infections. Sterilization is effective but could a change in bottle design obviate the need for regular sterilization?
A total of 20 stable CRS patients were given a NasalCare® (Techworld Corporation, Inc., Downington, PA) irrigation bottle to use regularly for 1 week. This bottle incorporates a 1-way valve to prevent irrigant regurgitation. Swabs were taken from their sinonasal cavity and 3 sites on the bottle-nozzle, valve, and inner surface.
This study cultured a range of organisms from all sites of the bottle, including common CRS pathogens such as S. aureus, P. aeruginosa, and E. coli. Whereas the bottle's inner surface had the lowest bacterial recovery rate, the frequent culture of organisms at this site suggests a 1-way valve cannot completely prevent irrigant reflux. The high rate of organism detection at the nozzle and valve of the bottle is concerning, as bacteria at these sites may be transported to the nose during nasal douching.
Saline irrigation will continue to be an essential component of CRS management. However, despite employing a 1-way liquid valve in this study, nasal irrigation bottles can still become contaminated with bacteria. Thus, patient education, irrespective of bottle design, will be essential in preventing bacterial contamination of nasal irrigation devices. The results of our survey suggest this message is not getting across to our patients.
盐水鼻腔冲洗是慢性鼻-鼻窦炎（CRS）医学治疗的主要方法，其疗效已得到证实。然而，最近有报道称冲洗瓶中存在细菌污染，这可能导致感染反复发作。消毒是有效的，但改变瓶设计是否可以避免定期消毒？
共 20 例稳定的 CRS 患者使用 NasalCare®（Techworld Corporation，Inc.，Downington，PA）冲洗瓶，每周使用一次。该瓶采用单向阀以防止冲洗液反流。从患者的鼻腔和鼻窦腔以及瓶嘴、阀门和内表面的 3 个部位采集拭子。
本研究从瓶的所有部位培养出多种微生物，包括金黄色葡萄球菌、铜绿假单胞菌和大肠杆菌等常见 CRS 病原体。虽然瓶内表面的细菌回收率最低，但该部位频繁培养出微生物表明单向阀不能完全防止冲洗液反流。瓶嘴和阀门处经常检测到细菌，这令人担忧，因为这些部位的细菌可能在鼻腔冲洗时被输送到鼻腔。
盐水冲洗将继续成为 CRS 管理的重要组成部分。然而，尽管本研究采用了单向液体阀，但鼻腔冲洗瓶仍可能被细菌污染。因此，无论瓶设计如何，患者教育对于防止鼻腔冲洗装置的细菌污染至关重要。我们的调查结果表明，这一信息并没有传达给我们的患者。
