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CC BY-NC-ND 4.0 · Sleep Sci 2017; 10(01): 28-34
DOI: 10.5935/1984-0063.20170005
ORIGINAL ARTICLE

Continuous Positive Airway Pressure: Is it a route for infection in those with Obstructive Sleep Apnoea?

Liam Mercieca
1   Department of Medicine, Mater Dei Hospital, Msida, Malta.
,
Richard Pullicino
1   Department of Medicine, Mater Dei Hospital, Msida, Malta.
,
Kyra Camilleri
1   Department of Medicine, Mater Dei Hospital, Msida, Malta.
,
Rodianne Abela
2   Bacteriology Laboratory, Pathology Department, Mater Dei Hospital, Msida, Malta.
,
Sean Apap Mangion
1   Department of Medicine, Mater Dei Hospital, Msida, Malta.
,
Julian Cassar
1   Department of Medicine, Mater Dei Hospital, Msida, Malta.
,
Matthew Zammit
1   Department of Medicine, Mater Dei Hospital, Msida, Malta.
,
Christine Gatt
2   Bacteriology Laboratory, Pathology Department, Mater Dei Hospital, Msida, Malta.
,
Christopher Deguara
3   Sleep Laboratory, Department of Medicine, Mater Dei Hospital, Msida, Malta.
,
Christopher Barbara
2   Bacteriology Laboratory, Pathology Department, Mater Dei Hospital, Msida, Malta.
,
Peter Fsadni
1   Department of Medicine, Mater Dei Hospital, Msida, Malta.
,
Stephen Montefort
1   Department of Medicine, Mater Dei Hospital, Msida, Malta.
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Abstract

Introduction Continuous positive airway pressure (CPAP) is the standard treatment for obstructive sleep apnoea (OSA), with limited data about the prevalence of respiratory infections and microbial colonization in these patients.

Objectives The aim of this study was to determine if CPAP use is associated with respiratory infections and to identify the organisms that colonize or infect these patients.

Method A retrospective, case-controlled study in patients diagnosed with OSA was carried out. 137 patients were recruited and interviewed using a questionnaire. A nasal swab was taken from each patient. Patients using CPAP machines had swabs taken from masks and humidifiers.

Results 66 (48.2%) patients received CPAP treatment with 60.6% of them having a heated humidifier. 78.8% were male, with the majority using a full face mask (63.6%). No significant difference was seen in the prevalence of rhinosinusitis, lower respiratory tract infections and hospital admissions for pneumonia between CPAP and non-CPAP treated patients. The presence of a humidifier did not influence the prevalence of infections. Commensal flora was predominantly cultured from nasal swabs from both patient groups. Coagulase Negative Staphylococci and Diphtheroids were the main organisms cultured from masks and humidifiers respectively.

Conclusions This study shows that the use of CPAP, choice of mask and humidifier have no significant impact on the prevalence of infections and micro-organisms isolated. This is very reassuring to the physician prescribing CPAP therapy and users.

Respiratory tract infections - Obstructive sleep apnea - Continuous positive airway pressure - Drug-related side effects and adverse reactions

Ethics

The study received approval from the University of Malta Research Ethics committee.


Funding/Conflicts of Interest

None declared.


APPENDIX



Publication History

Received: 06 June 2016

Accepted: 22 December 2016

Article published online:
29 September 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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