Intranasal drug delivery devices are a potential contamination source of airways
Dispositivos intranasais de medicamentos são uma potencial fonte de contaminação das vias aéreas
Felipe Maciel Pereira; Lidiane de Castro Soares; Isadora Passamani Reis Innocencio; Luísa Costa Oliveira Valente; Beatriz Julião Vieira Aarestrup; Fernando Monteiro Aarestrup; Akinori Cardozo Nagato
Abstract
Background: The use of intranasal drug delivery devices (IDDD) for the treatment of allergic rhinitis (AR) is frequent because they are simple, efficient, and safe, and mainly because they are perceived as low-risk. However, it is speculated that contact between the nasal mucosa and an IDDD may give rise to infections once the nose is colonized by bacteria, and there are currently no proper instructions for IDDD sanitization. The objective of this study was to evaluate the possibility of contamination of an IDDD for topical medication after simulating use in healthy individuals. Methods: The in vitro study consisted of 14 healthy individuals of both sexes, between the ages of 18 and 24 years. Samples were collected immediately after the opening of each IDDD and after simulating use by the subjects. Afterwards, the samples were deposited in tubes and kept in an incubator at 37 °C. After 48 hours, the samples were inoculated on Müller-Hinton agar. Qualitative analyses of the appearance of the samples were performed after 24 and 48 hours, and after 72 hours the presence or absence of bacteria was evaluated macroscopically. Results: After 24 hours of incubation, 21.4% (n = 3) of the samples presented with a turbid appearance and after 48h, 71% (n = 10) of the samples presented with a turbid appearance and positive bacterial growth. Conclusion: The results suggest that IDDDs for topical medications may be important sources of contamination or recontamination of the nasal mucosa of individuals who are being treated for upper respiratory tract conditions. A better understanding of the risks of re-using IDDDs after previous contact with the nasal mucosa will improve guidelines on hygiene procedures and prevention of related risks.
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Resumo
Introdução: O uso de dispositivos intranasais para administração de medicamentos (IDDD) no tratamento da rinite alérgica (AR) é frequente, por serem simples, eficientes e seguros, e principalmente por serem de baixo risco. No entanto, especula-se que o contato entre a mucosa nasal e um IDDD possa causar infecções, uma vez que o nariz é colonizado por bactérias, e atualmente não há instruções adequadas para a higienização do IDDD. O objetivo deste estudo foi avaliar a possibilidade de contaminação de um IDDD para medicação tópica após simulação de uso em indivíduos saudáveis. Métodos: O estudo in vitro foi composto por 14 indivíduos saudáveis, de ambos os sexos, com idades entre 18 e 24 anos. As amostras foram coletadas imediatamente após a abertura de cada IDDD, e após a simulação do uso pelos sujeitos. Posteriormente, as amostras foram depositadas em tubos e mantidas em incubadora a 37 °C. Após 48 horas, as amostras foram inoculadas em ágar Müller-Hinton. As análises qualitativas da aparência das amostras foram realizadas após 24 e 48 horas, e após 72 horas a presença ou ausência de bactérias foi avaliada macroscopicamente. Resultados: Após 24 horas de incubação, 21,4% (n = 3) das amostras apresentaram aparência turva e, após 48h, 71% (n = 10) das amostras apresentaram aparência turva e crescimento bacteriano positivo. Conclusão: Os resultados sugerem que IDDDs para medicações tópicas podem ser importantes fontes de contaminação ou recontaminação da mucosa nasal de indivíduos em tratamento para condições do trato respiratório superior. Uma melhor compreensão dos riscos da reutilização de IDDDs após contato prévio com a mucosa nasal, melhorará as diretrizes sobre procedimentos de higiene e prevenção de riscos relacionados.
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Referências
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Submetido em:
06/03/2019
Aceito em:
18/03/2019
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