Observational studyJornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia2019
Microbiological contamination of nebulizers used by cystic fibrosis patients: an underestimated problem.
Observational study in Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Infection prevention and control knowledge, attitudes, and practices among patients and informal caregivers in home-based care: A systematic review.American journal of infection control · 2026Pooled it
- Insights into the mechanisms of infection transmission via inanimate surfaces.Frontiers in microbiology · 2026Review
- Microbial contamination of medicines, medical devices, cosmetics, child and personal care products: a comprehensive review of secondary contamination risks in home-use settings.Frontiers in microbiology · 2026Review
- Disinfection of medical devices with a steam machine that operates at atmospheric pressure and is suitable for home usage.Scientific reports · 2025Article
- Tolerability and Pharmacokinetic Evaluation of Inhaled Dry Powder Tobramycin in Children with Cystic Fibrosis.Pharmaceutics · 2025Article
- Microbial Contamination of Nebulizers in Patients With Cystic Fibrosis.Turkish archives of pediatrics · 2025Article
- A Survey of Cystic Fibrosis Center Recommendations for Nebulizer Cleaning and Disinfection.Respiratory care · 2024Article
- Feasibility of performing the 3-minute step test with remote supervision in children and adolescents with cystic fibrosis: A comparative study.Pediatric investigation · 2024Article
- Evolution of Resistance against Ciprofloxacin, Tobramycin, and Trimethoprim/Sulfamethoxazole in the Environmental Opportunistic PathogenAntibiotics (Basel, Switzerland) · 2024Article
- Effect of Disinfection Method and Testing Methodology on the Performance of a Breath-Enhanced Jet Nebulizer.Pharmaceutics · 2023Article
- Bacterial Contamination of Inhalation Chambers Used for Cats and Dogs with Chronic Airway Diseases.Pathogens (Basel, Switzerland) · 2023Article
- Impact of COVID-19 social distancing recommendations on pulmonary function, nutritional status, and morbidity in patients with cystic fibrosis.Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo · 2023Article
- A Systematic Review on KAP of Nebulization Therapy at Home.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2021Review
- Assessment of the microbial load of airway clearance devices used by a cohort of children with cystic fibrosis.Infection prevention in practice · 2021Article
- Distribution of Burkholderia cepacia complex species isolated from industrial processes and contaminated products in Argentina.International microbiology : the official journal of the Spanish Society for Microbiology · 2021Article
- Evaluation of different cleaning methods for feline inhalation chambers after bacterial contamination.Journal of feline medicine and surgery · 2021Article
- Nebulizer Care and Inhalation Technique in Children with Cystic Fibrosis.Children (Basel, Switzerland) · 2020Article
- Nebuliser hygiene in cystic fibrosis: evidence-based recommendations.Breathe (Sheffield, England) · 2020Review
- Thinking inside the box: nebulizer care, safe storage, and risk of infection in cystic fibrosis.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2020Article
- Colistin dry powder inhalation with the Twincer™: An effective and more patient friendly alternative to nebulization.PloS one · 2020Article
Corrections and comments
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Authors and funding
8 authors at 8 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveHome nebulizers are routinely used in the treatment of patients with cystic fibrosis (CF). This study aims to evaluate the contamination of nebulizers used for CF patients, that are chronically colonized by Pseudomonas aeruginosa, and the association of nebulizer contamination with cleaning, decontamination and drying practices.
methodsA cross-sectional, observational, multicenter study was conducted in seven CF reference centers in Brazil to obtain data from medical records, structured interviews with patients/caregivers were performed, and nebulizer's parts (interface and cup) were collected for microbiological culture.
resultsoverall, 77 CF patients were included. The frequency of nebulizer contamination was 71.6%. Candida spp. (52.9%), Stenotrophomonas maltophilia (11.9%), non-mucoid P. aeruginosa (4.8%), Staphylococcus aureus (4.8%) and Burkholderia cepacia complex (2.4%) were the most common isolated pathogens. The frequency of nebulizers' hygiene was 97.4%, and 70.3% of patients reported cleaning, disinfection and drying the nebulizers. The use of tap water in cleaning method and outdoor drying of the parts significantly increased (9.10 times) the chance of nebulizers' contamination.
conclusionDespite the high frequency hygiene of the nebulizers reported, the cleaning and disinfection methods used were often inadequate. A significant proportion of nebulizers was contaminated with potentially pathogenic microorganisms for CF patients. These findings support the need to include patients/caregivers in educational programs and / or new strategies for delivering inhaled antibiotics.
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