Spraggs P D, Hanekom W H, Mochloulis G, Joseph T, Kelsey M C
Department of Otolaryngology, Whittington Hospital, London, UK.
J Hosp Infect. 1994 Dec;28(4):315-21. doi: 10.1016/0195-6701(94)90095-7.
Atomizers working on the Venturi principle are used by otolaryngology departments in the UK to spray cocaine and other local anaesthetic and vasoconstricting solutions into the nasal cavities. These devices are rarely cleaned, nor is the cocaine in the reservoir changed between patients. This study aimed to assess the risk of cross-infection with such an atomizer of the Down's design. Nutrient broth from a sterile atomizer was sprayed into the nasal cavities of 12 healthy volunteers on three occasions, the tip of the nozzle was withdrawn between sprays into the right nostril, but not between sprays into the left. On each occasion the tip of the nozzle, a nutrient broth rinse of the inner tube of the nozzle and the residue of broth in the reservoir of the atomizer were cultured and the colonies compared with those from a nasal swab collected previously. The results show transmisson of bacteria from the nasal vestibule on to the tip, into the nozzle and into the reservoir of the atomizer. Examination of the minimum inhibitory concentration values of 10% cocaine with and without Nipasept preservative indicated poor antibacterial properties. We conclude that the use of an atomizer on more than one patient poses a risk of cross-infection, and recommend their replacement with a single-use disposable nasal atomizer.
英国的耳鼻喉科部门使用基于文丘里原理的喷雾器，将可卡因及其他局部麻醉和血管收缩溶液喷入鼻腔。这些器械很少清洗，而且患者之间储液器中的可卡因也不更换。本研究旨在评估唐氏设计的这种喷雾器导致交叉感染的风险。将来自无菌喷雾器的营养肉汤三次喷入12名健康志愿者的鼻腔，每次向右侧鼻孔喷雾之间将喷嘴尖端抽出，但向左侧鼻孔喷雾之间不抽出。每次喷雾后，对喷嘴尖端、喷嘴内管的营养肉汤冲洗液以及喷雾器储液器中的肉汤残渣进行培养，并将菌落与之前采集的鼻拭子菌落进行比较。结果显示细菌从鼻前庭传播到喷嘴尖端、进入喷嘴并进入喷雾器储液器。对含和不含尼泊金防腐剂的10%可卡因的最低抑菌浓度值进行检测，结果表明其抗菌性能较差。我们得出结论，对多名患者使用同一喷雾器存在交叉感染风险，并建议用一次性鼻腔喷雾器取代它们。
