Manual Ventilation Bags as a Source for Bacterial Colonization of Intubated Patients

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Abstract
A group of 14 intensive care unit (ICU) patients were studied to determine if manual ventilation bags (MVB) could serve as a source of bacterial or fungal pathogens that could colonize the respiratory tract of intubated patients. A total of 51 cultures were simultaneously obtained of patient's sputum, the exterior MVB surface, MVB port, and MVB interior (postexhalation valve). Pathogens colonizing or infecting the respiratory tract of intubated ICU patients were frequently simultaneously present on the exterior surface of the MVB and inside the MVB port used to connect the MVB with the endotracheal tube. In addition, coagulase-negative staphylococci and yeast were frequently present on the exterior surface of the MVB. The interior of the MVB was usually sterile. In three instances pathogens were isolated from the MVB before isolation from the patient's sputum. MVB may serve as a source for colonizing the respiratory tract of intubated ICU patients and/or the hands of medical personnel. The exterior surface and port of MVB should be cleaned of visible debris and disinfected at least once a day.