Abstract
Background:Although the circuit condensate, an ideal bacterial reservoir, may flow into the humidifier reservoir (HR), no study has investigated if HR-colonized bacteria colonize other circuit locations with airflow. Therefore, the objective of this study was to explore if bacterial growth in the HR leads to bacterial colonization in the ventilator circuit. Methods: A randomized controlled experiment was performed in a public tertiary hospital in Guangdong Province, China. In vitro mechanical ventilation models (n = 60), divided into sterile water samples (n = 30) and broth samples (n = 30), were established. Sterile water was used for humidification in the ventilation models. The sterile water group contained either Acinetobacter baumannii (n = 15) or Pseudomonas aeruginosa (n = 15) in humidifier water. The broth group was similar to the sterile water group, but brain heart infusion broth was added to the HR. After 24, 72, and 168 h of continuous ventilation, bacteria in the humidifier water and at different circuit locations were sampled and cultured, and the results were analyzed by the Chi-square test. The difference in bacterial concentration at the HR outlet was analyzed by the F test, and P < 0.05 was considered statistically significant.Results:Bacterial culture results of the sterile water samples were negative. Bacteria in the humidifier water continued to proliferate in the broth group, and the bacterial concentration at different times was not significantly different (P > 0.05). With prolonged ventilation, the bacterial concentration at the HR outlet increased (P < 0.05). During continuous ventilation, no bacterial growth occurred at 10 cm from the HR outlet and the Y-piece of the ventilator circuit. The bacterial concentration at the HR outlet was higher in the P. aeruginosa group than in the A. baumannii group (P < 0.05).Conclusions:Sterile water in the HR was not conducive to bacterial growth. Although bacteria grew in the HR and could reach the HR outlet, colonization of other circuit locations was unlikely.