The influence of inhaled corticosteroids and spacer devices on the growth of respiratory pathogenic microorganisms

BackgroundGuidelines advise weekly cleansing of spacers, with one of the reasons being to prevent the spacers from becoming colonized with respiratory pathogens. Earlier work in clinical settings showed conflicting results.MethodsCommon respiratory pathogens and Candida albicans were applied on Petri dishes with and without inhaled corticosteroids and in 3 brands of spacer devices, with and without inhaled corticosteroids. Growth was measured.ResultsAfter 24 hours, Staphylococcus aureus grew in 7 of 18 spacers (39%); Pseudomonas aeruginosa grew in 12 out of 18 spacers (67%); and C albicans survived in 5 of 18 spacers (28%). Microorganisms survived on Petri dishes with fluticasone and beclomethasone but not when budesonide was applied. One out of 30 metal Nebuhalers (3%) was colonized after 24 hours, whereas of 30 Volumatics 8 (27%) and Aerochambers, 17 (57%) still had viable microorganisms. Application of inhaled steroids did not affect growth in the spacers.ConclusionThe colonization of metal spacers is lower than of spacers made of polycarbonate or polyethylene. C albicans can survive in spacers. The survival of microorganisms in spacers is not influenced by inhaled corticosteroids.