Contamination of small-volume medication nebulizers and its association with oropharyngeal colonization.

The effect of the use of small-volume medication nebulizers on oropharyngeal colonization with potentially pathogenic Gram-negative bacilli was investigated in 95 patients with respiratory disease, of whom 54 used nebulizers and 41 were controls. Inhalation therapy had a significant effect on colonization, with a relative risk of more than four. Age over 60 years also showed a significant association with colonization. One-third of the nebulizers sampled were contaminated, 71% with Gram-negative bacilli. A direct route of contamination could be demonstrated in 28% of the patients. Medication nebulizers should be thoroughly cleaned after use and stored dry between patients.