Author(s): Abhay Uppe1, Vipul Sengal2, Girija Nair3, Ria Shah4, Aditya Agrawal5
Valved holding chambers (VHCs) or spacers are devices which have been used with pressurised metered dose inhaler containing inhaled corticosteroids and beta agonists or muscarinic inhibitors in patients of chronic obstructive airway diseases. Spacers can be a reservoir of bacteria.1 Biofilms may be produced by bacteria which protect them from antibiotic penetration thus making them antibiotic resistant. There are very few studies on spacer devices related to bacterial infection in patients due to spacer use.
To investigate if spacer is a potential source of infection in patients of obstructive airway diseases. To identify the organisms grown and whether they produce biofilms.
We enrolled 40 patients of diagnosed obstructive airway disease to whom we had prescribed metered dose inhaler with spacer for the first time. We took swabs from the inner wall of the spacer. Three samples were collected with each taken one week apart, 1st being the pre-use sample and 2nd and 3rd being post use. 3rd sample especially being taken after washing the spacer under tap water, drying it in room air by the patient at home and then collecting the sample with aseptic precautions.
Our data identified growth of micrococci, bacillus, and Pseudomonas in 8 post use spacer swab samples and 5 pre-use samples also grew pathological and non-pathological bacteria.
Since there was a growth of bacteria in some spacers, this could be a source of infection in these patients.