Northern Ireland Public Health Laboratory, Nightingale (Belfast City) Hospital, Belfast, Northern Ireland, UK.
School of Medicine, Dentistry and Biomedical Science, The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, Northern Ireland, UK.
Pediatr Pulmonol. 2020 Nov;55(11):3012-3020. doi: 10.1002/ppul.24994. Epub 2020 Aug 7.
Patients with cystic fibrosis have increased morbidity/mortality due to chronic respiratory infections, which primarily originate from the environment. Infection prevention and control emphasize the importance of cleaning and disinfection of respiratory devices, however, there is a paucity of guidance on toothbrush hygiene, which have been shown to be a source of cystic fibrosis (CF) pathogens.
This study examined steam disinfection of toothbrushes contaminated with clinically significant CF isolates (n = 80; Gram positive = 33; Gram negative = 32, and non-tuberculous mycobacteria = 6) and yeasts (n = 9), as well as oral streptococci (n = 26) and environmental Pseudomonas aeruginosa (n = 12).
Steam disinfection eradicated all organisms tested, as well as all organisms in CF sputum applied to toothbrushes.
Steam disinfection offers a relatively simple, cheap and available method of eliminating non-spore-forming CF pathogens on toothbrushes. Toothbrushes should be thoroughly rinsed after each use before steam disinfection, to remove plaque, epithelial cells, and residual toothpaste. Toothbrushes should be steam disinfected after each use employing a baby bottle steam disinfector, adhering to manufacturers' operating instructions and stored in the disinfector until next used within 12 to 24 hours. Toothbrushes should be replaced every 3 to 4 months, or sooner if the bristles look worn out, as well as every time a pulmonary exacerbation occurs or every time the patient is treated for a pulmonary/throat infection. Steam disinfection of toothbrushes is crucial when the patient is undergoing eradication regimes for P. aeruginosa and methicillin-resistant Staphylococcus aureus, so that the patient does not become reinfected from this source, thereby aiding eradication and enhancing patient safety.
囊性纤维化患者因慢性呼吸道感染而导致发病率和死亡率增加，这些感染主要来自环境。感染预防和控制强调了清洁和消毒呼吸设备的重要性，但对于牙刷卫生的指导却很少，而牙刷已被证明是囊性纤维化（CF）病原体的来源。
本研究检查了受临床显著 CF 分离株（n=80；革兰氏阳性=33；革兰氏阴性=32，非结核分枝杆菌=6）和酵母（n=9）污染的牙刷的蒸汽消毒，以及口腔链球菌（n=26）和环境铜绿假单胞菌（n=12）。
蒸汽消毒消除了所有测试的生物，以及应用于牙刷的 CF 痰中的所有生物。
蒸汽消毒为消除牙刷上的非孢子形成 CF 病原体提供了一种相对简单、廉价且可行的方法。每次使用后，牙刷都应彻底冲洗，以去除牙菌斑、上皮细胞和残留的牙膏。每次使用后，应使用婴儿奶瓶蒸汽消毒器对牙刷进行蒸汽消毒，遵循制造商的操作说明，并在 12 至 24 小时内将其储存在消毒器中以备下次使用。牙刷应每 3 至 4 个月更换一次，或者如果刷毛看起来磨损了，或者每当患者进行铜绿假单胞菌和耐甲氧西林金黄色葡萄球菌根除治疗时，应更换牙刷，以防止患者从该来源再次感染，从而有助于根除并增强患者安全性。
