Moisture Exchangers Do Not Prevent Patient Contamination of Ventilators. A Microbiological Study

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Abstract
Mechanically ventilated patients (33) in an intensive care unit were studied to verify a claim that the Servo humidifer acts as a bacterial barrier. The Servo humidifier was used on all patients. It was changed once daily, and the connecting tubes were changed once weekly. Daily bacterial cultures were taken from the trachea of the patient as well as from the humidifier, the tubing and the ventilator. In 25 of the patients, the same bacterial strain as in the trachea of the patient could not be isolated from the outside of the humidifer, from the tubing or the ventilator. In 8 patients a breakthrough of bacterial strains from the trachea through the humidifer could be demonstrated. In 4 of these 8 patients the breakthrough strains appeared to establish themselves in the respirator environment, while in the other 4 they appeared only temporarily outside the humidifer. The clinical importance of the establishment of a bacterial strain in the ventilator is not clear, but it seems prudent that the introduction of the Servo humidifer should not lead to less stringent cleaning and/or disinfection routines of ventilators and tubing than before.

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