D epartment
of
M edicine
Con ne c ti ng T e c h n o lo g y , Ed uca t i o n a n d D i s cove ry w ith H um anis m in Me dicine
Vol. 6 Issue 5 Dec 2017
Nebulizer Contamination
UTMC. It confirmed that nebulizers, artificial airways, and suction catheters are at risk for contamination after a single use in inpatient settings. An additional finding involved the method used to collect the contaminating bacteria. “We had been swabbing devices to extract cells for testing,” said Dr. Dewald. “Then Kristen found that vortexing was more effective for cell extraction.” The study was submitted for publication, and an abstract was submitted for presentation at the American Thoracic Society meeting next spring.
Many factors contribute to chronic respiratory complaints, including medication overuse and exposure to antibiotic resistant microorganisms. In Cystic Fibrosis patients, one known risk factor is self-contamination of personal respiratory equipment. However, there is a critical gap in evidence regarding patient contamination of such devices and risk of infection outside of Cystic Fibrosis studies. To address this gap, Department of Medicine chairman, Dr. Rajiv Dhand, third-year Medicine resident, Dr. Jonathan Dewald, clinical trials coordinator Jennifer Ferris, and, respiratory therapists, Scott Elder and Daniel Church have teamed up with Dr. Qiang He and his doctoral student, Kristen Wyckoff, from the University of Tennessee’s Department of Civil and Environmental Engineering.* Their study, “Bacterial contamination of disposable nebulizers following their first use,” was conducted on a diverse patient population here at
The interdisciplinary research team has turned its attention to determining the specific organisms responsible for contamination. They have received funding from the Physicians’ Medical Education Research Fund (PMERF) for this next study, titled “Characterization of the microbiome on respiratory devices after short-term use by patients and determination of serial changes with prolonged use.” The continued on page 3
Points of View
inevitable part of doing research, and dealing with rejection can be painful. After spending several months working on a manuscript, having it rejected is heartbreaking, especially if the reviewers do not agree with the findings. Indeed, nowadays it is the norm for papers to be rejected when they are first submitted. Likewise, it is not unusual for grants to get triaged. After putting in so much effort, the realization that your work does not measure up and is not worthy of funding can be depressing. Recently, I participated in a NIH Study Section and had firsthand experience of the grant process. I was surprised by the level of agreement between the comments of the various reviewers. There were also sharp differences, but those were much less frequent. The science behind the grants was novel and interesting. Where many investigators fell short was in the explanation and implementation of the planned experiments and other logistical issues. As we attempt to enhance scientific publications and grant funding in our department, we must be prepared to deal with the heartbreak that accompanies rejection. Persistence is the key to a successful research program.
The mission of the UT Medical Center is to promote Healing, Education and Discovery. In the Department of Medicine, we have recognized strengths in the clinical and educational areas, and the strategic plan of the institution stresses the need to enhance Discovery through original research. Research requires a passion for scientific enquiry and the desire to find answers for unresolved Rajiv Dhand, MD, Chair questions, especially those that impact patient care. Researchers are keenly aware of the painstaking and convoluted nature of the research process without any guarantee of success. Many researchers are unprepared to deal with rejection, which is another intrinsic part of the research process. Whether it is an abstract, paper, or grant, rejection is an 1