P48 An observational, cross-sectional study to Investigate whether room-air ventilators, used in the community setting, are colonised with Potential Airborne Pathogens (IPAP study). (11th November 2022) - Armstrong, AD
Abstract : Introduction: Long term ventilation (LTV) is a widely used treatment for the management of patients with chronic respiratory failure. As use increases, it generates further questions about aspects of care. One issue is the potential risk of contamination within the device itself and the potential risk of respiratory tract infections to a subsequent user of the device. Methods: Using an observational cross-sectional study design, the primary objective of this study was to identify whether airborne bacterial and fungal pathogens are present within a NIPPY 3+ room air ventilator following use in the community setting. Microbiological samples in the form of one single charcoal swab were taken from two specified areas of the device internal airflow pathway. Results: A total of 243 ventilators were sampled. 215 with complete data collection were included in the study. 84 (39%) were identified as no growth and 131 (61%) were positive for bacterial and/or fungal growth. Overall 307 organisms were grown from 131 ventilators ranging from 1 to 6 organisms per swab. Organisms grown are presented in figure 1 . Of the 215 ventilators screened 15 (7%) grew organisms considered to be pathogenic. Of these, 14 grew 1 pathogenic organism and 1 grew 4 distinct pathogens. Discussion: This is the largest study to date exploring the potential presence of airborne pathogens in room air ventilators. We have demonstrated that 61% of these devices were positive for bacterial or fungal growth and 7% of these were pathogenic. Pathogenic organisms included Pseudomonas aeruginosa, Staphylococcus aureus and Aspergillus sp. Although growth of pathogenic organisms was relatively rare, there are important potential adverse clinical outcomes in patients with diseases commonly treated by LTV services. 1, 2 Conclusion: We have shown that contamination of devices is rare but in 7% there is contamination with potentially pathogenic organisms, which if proven to be transferred between patients could be a cause of worse patient outcomes. References: Am J Respir Crit Care Med . 2018 Jun 1;197 (11):1410–1420. Ann Am Thorac Soc . 2015 Nov;12 (11):1602–11. Please refer to page A214 for declarations of interest related to this abstract.