Contamination of hypertonic saline solutions in use by cystic fibrosis patients in Israel

Orit Peled, Vardit Kalamaro, Eitan Kerem, David Shoseyov, Hannah Blau, Ori Efrati, Colin Block

Research output: Contribution to journalArticlepeer-review


Background: Treatment of cystic fibrosis (CF) patients with inhaled hypertonic saline (HS) solutions is safe, beneficial and reduces exacerbation rates. We studied contamination of solutions used by Israeli CF patients for prolonged periods. Methods: The study addressed whether daily opening of previously unopened solutions caused contamination, survival of 6 CF-associated bacteria in artificially inoculated solutions, in-use contamination of solutions and patterns of their use by patients. Results: Repeated opening did not contaminate solutions and survival of indicator bacteria was variable. Mycobacterium abscessus survived in 3% HS solution for 6. weeks and Burkholderia cenocepacia and Pseudomonas aeruginosa were longer. In 30/76 (39.5%) of used solutions 49 contaminants were found, none being common CF-associated pathogens. Conclusions: Most CF-related bacteria survived to some degree in HS. Approximately 40% of solutions used by patients were contaminated by organisms of uncertain significance. Our findings highlight the potential risk posed by contamination of HS solutions and support recommendations to use sterile unit-dose formulations.

Original languageEnglish
Pages (from-to)550-556
Number of pages7
JournalJournal of Cystic Fibrosis
Issue number5
StatePublished - 2014


  • Contamination
  • Cystic fibrosis
  • Hypertonic saline
  • Sterility
  • Unit dose


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