Long-Term Evaluation of Decontamination of Inhalation-Therapy Equipment and the Occurrence of Necrotizing Pneumonia

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Abstract
Inhalation-therapy equipment incorporating reservoir nebulization was sampled for bacterial contamination during a four-year period after the introduction of routine daily decontamination with 0.25 per cent acetic acid. The incidence of contamination was found to be less than 10 per cent during the last three study years, as compared to 84 per cent before the use of the acetic acid regimen. Residual contamination was related to personnel error or corrosion of nebulizer jets. During the "preacetic acid era" the prevalence of necrotizing pneumonia due to gram-negative bacilli at autopsy was 7.9 per cent, whereas in the last two years studied, the incidence was 2.2 and 2.1 per cent. This prevalence is similar to that found before the use of reservoir nebulizers. These data indicate that daily decontamination of reservoir nebulizer equipment with 0.25 per cent acetic acid is effective and practical in routine hospital use.