Burgos F, Torres A, González J, Puig de la Bellacasa J, Rodriguez-Roisin R, Roca J
Servei de Pneumologia i Allérgia Respiratoría, Hospital Clínic, Barcelona, Spain.
Eur Respir J. 1996 Dec;9(12):2612-7. doi: 10.1183/09031936.96.09122612.
The potential risk of spirometers in the transmission of respiratory infections has not been yet established. We performed a prospective cross-sectional study to determine the rate of colonization of a water-sealed spirometer and a pneumotachograph, and the potential risk of cross-transmission of microorganisms to patients using each of these devices. Fifty four patients (aged 51 +/- 18 (mean +/- SD) yrs) were included in the study. All of them had undergone forced spirometry with bronchodilator response by means of the water-sealed spirometer (n = 36) or the pneumotachograph (n = 18). None had a clinically apparent respiratory infection at the time of the study. Routine hygiene measures for respiratory equipment were performed before the study protocol. Samples for microbiological cultures of different parts both of the water-sealed spirometer (proximal and distal tubing, bell and water-bell) and pneumotachograph (proximal and distal tubing) were taken daily before and after the usual series of lung function tests during a 5 day period. Pharyngeal swab cultures were obtained before spirometry and 7 days later in each subject. Thirty six out of a total of 40 (90%) culture samples from the water-sealed spirometer showed microbial growth compared to 4 out of 30 (13%) samples obtained from the pneumotachograph (p < 0.0001). Significant colonization of the water-sealed spirometer was apparent after the third day of the study. The microorganisms most frequently isolated were penicillium sp. (62%), Pseudomonas fluorescens (32%), and Burkholderia cepacea (48%). Distal tubing, water and water-bell were the parts of the water-sealed spirometer that showed higher colonization counts (> or = 10(4) colony-forming units (cfu).mL-1). No transmission sequence of potentially pathogenic microorganisms from equipment to patients or vice versa could be demonstrated. In summary, the water-sealed spirometer frequently became colonized by microorganisms. The potential hazard of such equipment as reservoirs of microorganisms suggests a need for the implementation of new hygiene measures for their maintenance.
肺活量计在呼吸道感染传播中的潜在风险尚未确定。我们进行了一项前瞻性横断面研究，以确定水封式肺活量计和呼吸流速计的定植率，以及使用这些设备时微生物交叉传播给患者的潜在风险。54名患者（年龄51±18（平均±标准差）岁）纳入研究。他们均通过水封式肺活量计（n = 36）或呼吸流速计（n = 18）进行了支气管扩张剂反应的用力肺活量测定。研究时均无明显的临床呼吸道感染。在研究方案实施前，对呼吸设备采取了常规卫生措施。在5天期间，每天在进行常规系列肺功能测试前后，采集水封式肺活量计（近端和远端管道、浮筒和水槽）和呼吸流速计（近端和远端管道）不同部位的微生物培养样本。在每个受试者进行肺活量测定前和7天后采集咽拭子培养样本。水封式肺活量计的40个培养样本中有36个（90%）显示有微生物生长，而呼吸流速计的30个样本中有4个（13%）显示有微生物生长（p < 0.0001）。研究第三天后，水封式肺活量计出现明显的大量定植。最常分离出的微生物是青霉菌（62%）、荧光假单胞菌（32%）和洋葱伯克霍尔德菌（48%）。远端管道、水槽和水槽是水封式肺活量计中定植计数较高（≥10⁴菌落形成单位（cfu）·mL⁻¹）的部位。未发现潜在致病微生物从设备传播给患者或反之的传播序列。总之，水封式肺活量计经常被微生物定植。此类设备作为微生物储存库的潜在危害表明需要实施新的卫生维护措施。
