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Laboratory and Animal Investigations |

The Potential for Dissemination of Mycobacterium tuberculosis Through the Anesthesia Breathing Circuit*

Paul B. Langevin, MD; Kenneth H. Rand, MD; A. Joseph Layon, MD, FCCP
Author and Funding Information

*From the Departments of Anesthesiology (Drs. Langevin and Layon), Pathology (Dr. Rand), Surgery (Dr. Layon), and Medicine (Dr. Layon), University of Florida College of Medicine, Gainesville, FL. Supported in part by a grant from Pall Biomedical Products Co, East Hills, NY. The company received a draft of the article but did not proof or edit it.



Chest. 1999;115(4):1107-1114. doi:10.1378/chest.115.4.1107
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Background: Respiratory pathogens that pass through the anesthesia breathing system potentially can infect other patients. This study was designed to determine if bacteria can pass through contemporary anesthesia breathing systems and if the environment within the machine is hostile to these organisms.

Methods: Staphylococcus aureus, Pseudomonas aeruginosa, and Mycobacterium tuberculosis were nebulized into the expiratory limb of an anesthesia breathing circuit and collected from the inspiratory and expiratory limbs in an impinger system that provided a quantitative determination of the number of organisms entering the circuit and the number that would reach the patient in the inspiratory gas. Bacteria were collected before, during, and after nebulization. A second experiment determined if a saturated solution of soda lime was bactericidal.

Results: When the gas flow through the circuit was interrupted for < 1 h following the nebulization period, large numbers of microorganisms (1 × 103 to 1 × 105, around 100% of the nebulized organisms) were collected from the inspiratory gas. Soda lime itself was not bactericidal for any of the organisms tested, but solutions of this material with a pH of 12 were bactericidal.

Conclusion: Cross contamination between patients may occur unless the gas flow through the anesthesia breathing system is interrupted for > 1 h.

Abbreviations: BHI = brain-heart infusion; MHA = Mueller-Hinton agar; PBS = phosphate-buffered saline solution; TB = tuberculosis

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