Microbial Flora in Musical Wind Instruments and Potential Disease Transmission

Objectives: To determine if musical wind instruments (woodwinds and brass) harbor opportunistic, pathogenic, or allergenic microorganisms. Methods: A total of 117 selected sites from the mouth-piece to the bell were swabbed for 1 minute on 13 de-identified band musical instruments (BMI). The swabs were streaked onto blood agar (BAP) and Sabouraud dextrose agar (SAB). The swabs were then vortexed in 10 ml. of sterile water for 2 minutes and serially diluted from 10-3 to 10-8 and plated on BAP in triplicate for enumeration of colony forming units/swab (CFU/swab). All media were incubated at 37°C and evaluated at 24 hours for bacteria and yeasts. Three independent investigators used previously validated microbial intensity scales (0 to 4) to evaluate the streaked plates. The CFU/swab plates were averaged. Results: The internal components of BMI harbored opportunistic, pathogenic, and allergenic microorganisms as isolated and identified by routine laboratory methods. A total of 295 bacterial isolates were identified: 95 (32%) gram + cocci, 131 (44%) gram + rods, and 69 (24%) gram – rods for an average of 22.7 isolates/instrument and 2.5 isolates/site. Using combined standard laboratory and molecular techniques, only 8 instruments yielded a total of 16 yeast isolates. After incubating 3 weeks at 22°C, 61 molds were isolated from 12 instruments. All of the mycotic isolates could be considered either opportunistic/pathogenic or allergenic. There was a general non-uniform distribution of microorganisms with the mouth-pieces having the highest concentrations and the bells having the lowest. Conclusion: This pilot study demonstrated that the internal components of musical wind instruments (woodwind and brass) harbor opportunistic, pathogenic, and allergenic microorganisms. The highest concentrations of microorganisms were consistently at the mouth-piece end. The close proximity of contaminated BMI mouth-pieces to the oral cavity facilitates local and systemic dissemination of these pathogens.