JUSTIFICATION AND OBJECTIVES
The maintenance of the CPAP equipment by the patient may have an important impact on its use as well as the condition of his nasal airways. Respiratory therapists recommend that their patients clean their masks and accessories once a week in order to prevent the proliferation of pathogens. Without proper maintenance, these pathogens could spread to the upper respiratory tract and mouth, causing nasal congestion (colds, rhinitis, etc.).

METHODS
Samples were taken from the inner surface of the mask and from the base of the tube and of the humidifier.

RESULTS
There is an undeniable correlation associated with the age of the mask. Older masks produce more bacteria and fungi.

DISCUSSION
Microbes found on the skin are often harmless, but when the balance of this environment is altered, several pathogens can cause infections.

Gram positive cocci from Staph epidermidis, Staph aureus, Micrococcus and Streptococcus are facultative anaerobes that can invade the skin and produce harmful exotoxins.

Gram from positive bacilli provokes infections of the hair follicle and sweat glands.

Gram from negative bacilli and Pseudomonas grow abundantly on organic compounds such as sweat.

Handwashing with soap is considered the best way to prevent the spread of viruses and bacteria and is considered the core of most infection control programs. The same principles should apply to CPAP equipment.

CONCLUSION
The maintenance and cleanliness of CPAP accessories which are in contact with the skin, mouth and nasal airways and are used repeatedly for months or even years, are important factors to bear in mind.

There was a high incidence of bacterial growth as well as fungi and yeast.

Equipment older than 6 months (masks, tubing, water containers) had a significantly higher numbers of fungi and colonies as well as a more diverse bacterial populations.

In instances surpassing a 6-12 months period, we have not been able to adequately reduce the number of bacteria with repeated soap washing and we believe that the silicone surface may become resistant to disinfection over time.

Preliminary data suggest that we should insist on regular cleaning and mask changes every 6 months.

Abbreviated translation from : CPAP Masks are sources of microbial contamination - Neil Gillis Lab Supervisor, Metrowest Medical Center Original document available for consultation :

https://airwayhealth.ca/en/wp-content/uploads/2018/05/CPAP-mask-6-month-contamination.pdf