Mercieca Liam, Pullicino Richard, Camilleri Kyra, Abela Rodianne, Mangion Sean Apap, Cassar Julian, Zammit Matthew, Gatt Christine, Deguara Christopher, Barbara Christopher, Fsadni Peter, Montefort Stephen
Department of Medicine, Mater Dei Hospital, Msida, Malta.
Bacteriology Laboratory, Pathology Department, Mater Dei Hospital, Msida, Malta.
Sleep Sci. 2017 Jan-Mar;10(1):28-34. doi: 10.5935/1984-0063.20170005.
Continuous positive airway pressure (CPAP) is the standard treatment for obstructive sleep apnoea (OSA), with limited data about the prevalence of respiratory infections and microbial colonization in these patients.
The aim of this study was to determine if CPAP use is associated with respiratory infections and to identify the organisms that colonize or infect these patients.
A retrospective, case-controlled study in patients diagnosed with OSA was carried out. 137 patients were recruited and interviewed using a questionnaire. A nasal swab was taken from each patient. Patients using CPAP machines had swabs taken from masks and humidifiers.
66 (48.2%) patients received CPAP treatment with 60.6% of them having a heated humidifier. 78.8% were male, with the majority using a full face mask (63.6%). No significant difference was seen in the prevalence of rhinosinusitis, lower respiratory tract infections and hospital admissions for pneumonia between CPAP and non-CPAP treated patients. The presence of a humidifier did not influence the prevalence of infections. Commensal flora was predominantly cultured from nasal swabs from both patient groups. Coagulase Negative Staphylococci and Diphtheroids were the main organisms cultured from masks and humidifiers respectively.
This study shows that the use of CPAP, choice of mask and humidifier have no significant impact on the prevalence of infections and micro-organisms isolated. This is very reassuring to the physician prescribing CPAP therapy and users.
持续气道正压通气（CPAP）是阻塞性睡眠呼吸暂停（OSA）的标准治疗方法，但关于这些患者呼吸道感染和微生物定植患病率的数据有限。
本研究旨在确定使用CPAP是否与呼吸道感染相关，并确定定植或感染这些患者的微生物。
对诊断为OSA的患者进行了一项回顾性病例对照研究。招募了137名患者并使用问卷进行访谈。从每位患者采集鼻拭子。使用CPAP机器的患者从面罩和加湿器采集拭子。
66名（48.2%）患者接受了CPAP治疗，其中60.6%使用了加热加湿器。78.8%为男性，大多数使用全面罩（63.6%）。CPAP治疗组和非CPAP治疗组在鼻窦炎、下呼吸道感染和肺炎住院患病率方面未见显著差异。加湿器的使用并未影响感染患病率。两组患者的鼻拭子主要培养出共生菌群。凝固酶阴性葡萄球菌和类白喉杆菌分别是从面罩和加湿器中培养出的主要微生物。
本研究表明，CPAP的使用、面罩和加湿器的选择对感染患病率和分离出的微生物没有显著影响。这对于开具CPAP治疗处方的医生和使用者来说非常令人安心。
