Face masks and cough etiquette reduce cough generated bioaerosols containing pseudomonas aeruginosa

Abstract

Introduction/Aim: The CF Foundation (USA) recently updated their infection control guidelines to include the recommendation that patients with cystic fibrosis (CF) wear surgical face masks in communal areas of health facilities to reduce transmission of aerosolised pathogens. The aim of this study was to investigate the effectiveness of face masks and cough etiquette techniques for reducing viable bioaerosols in patients with CF and chronic P. aeruginosa infection. Methods: Subjects were enrolled from the Adult CF Centre, The Prince Charles Hospital, Brisbane and positioned in a validated, aerosolsampling device and performed activities for 5 minutes each: 1.talking; 2. talking with surgical mask; 3.unmasked coughing; 4.coughing with surgical mask; 5.coughing with N95 mask; 6.coughing with hand covering mouth. A 6-stage Andersen Cascade Impactor, positioned at 2 metres, collected and sized viable aerosols. Quantitative sputum and aerosol cultures was performed. Subjects rated their comfort levels with the masks Results: 25 (15 male) adults, mean (SD) age of 31.2 (7.7) years and FEV1 of 50.7 (17.4) % predicted were enrolled. 76% subjects produced viable P. aeruginosa during unmasked coughing. Cough etiquette, surgical mask and the N95 reduced infectious cough aerosols of 53.4, 93.8, 94.5% respectively, with the surgical mask rated more comfortable. Conclusion: Face masks are effective in reducing cough generated infectious droplet nuclei in people with CF, with the surgical mask providing enhanced patient comfort. Cough etiquette provides less protection than masks.L6178415062017-08-23 <br />