A Role for Selection in the Evolution of Genetic Robustness

Background: Reusable nasal-spray devices are frequently used in otolaryngologic examinations, and there is an increasing concern about the risk of cross-contamination from these devices. The aim of our study was to determine, by means of microbiologic analysis, the safety of a positivedisplacement or pump-type atomizer after multiple uses. Methods: A reusable nasal spray bottle, pump, and tips were used in the nasal physical examination of 282 patients admitted to a tertiary otolaryngology clinic. The effectiveness of 2 different methods of prophylaxis against microbiologic contamination (the use of protective punched caps or rinsing the bottle tip with alcohol) was compared with that of a control procedure. Results: Although there was no statistically significant difference in positive culture rates among the types of nasal spray bottles tested, methicillin-resistant coagulase-negative staphylococci were isolated in 4 of 198 cultures. Conclusion: Given these findings, we concluded that additional precautions (such as the use of an autoclave between sprays, disposable tips, or disposable devices) are warranted to avoid interpatient cross-contamination from a reusable nasal spray device. Background Topical vasoconstrictive and anesthetic agents that exert a decongestant and/or local anesthetic action on the mucous membranes of the nasal and pharyngeal cavities are routinely used in otolaryngologic practice. To improve the ease of the nasal examination and to make the patient more comfortable, such agents are administered before anterior rhinoscopy, flexible fiber optic or rigid endoscopy, or videolaryngoscopy is performed. Devices that deliver topical vasoconstrictive and anesthetic agents usually convey the medication by either of 2 methods: the Venturi principle or the positive-pressure principle. The risk of contamination of the medication delivery systems as well as the risk of atomizer-associated cross-infection has been investigated, and various results have been reported. Obviously, the administration of an aerosolized agent via a single-use atomizer is a definitive (but costly) solution to that problem. In this study, we assessed the risk of the cross-contamination of multiple-use positivepressure type nasal sprays and discussed relevant findings in the literature. Methods The study consisted of the microbiologic examination of multiple-dose decongestant nasal spray bottles used to administer an aerosolized agent before the anterior rhinoPublished: 13 March 2007 BMC Ear, Nose and Throat Disorders 2007, 7:2 doi:10.1186/1472-6815-7-2 Received: 10 August 2006 Accepted: 13 March 2007 This article is available from: http://www.biomedcentral.com/1472-6815/7/2 © 2007 Aydin et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.