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Author:
Glenys Harrington
Email:
infexion@ozemail.com.au
Organisation:
Infection Control Consultancy (ICC)
State:
Hi Gerald,
This may in part answer your question although I have not been able to get hold of the full article.
Publication – M.F. King, C.J. Noakes, P.A. Sleigh, M.A. Camargo-Valero. Bioaerosol Deposition in Single and Two-Bed Hospital Rooms: A Numerical and Experimental Study. Building and Environment. 2012.
Extract about the article from Infection Control Today(ICT).
Hospital superbugs can float on air currents and contaminate surfaces far from infected patients beds, according to University of Leeds researchers. The results of the study, which was funded by the Engineering and Physical Sciences Research Council (EPSRC), may explain why, despite strict cleaning regimes and hygiene controls, some hospitals still struggle to prevent bacteria moving from patient to patient.
It is already recognized that hospital superbugs, such as MRSA and C. difficile, can be spread through contact. Patients, visitors or even hospital staff can inadvertently touch surfaces contaminated with bacteria and then pass the infection on to others, resulting in a great stress in hospitals on keeping hands and surfaces clean.
But the University of Leeds research showed that coughing, sneezing or simply shaking the bed linens can send superbugs into flight, allowing them to contaminate recently cleaned surfaces.
PhD student Marco-Felipe King used a biological aerosol chamber, one of a handful in the world, to replicate conditions in one- and two-bedded hospital rooms. He released tiny aerosol droplets containing Staphyloccus aureus from a heated mannequin simulating the heat emitted by a human body. He placed open petri dishes where other patients beds, bedside tables, chairs and washbasins might be and then checked where the bacteria landed and grew.
The results confirmed that contamination can spread to surfaces across a ward. The level of contamination immediately around the patients bed was high but you would expect that. Hospitals keep beds clean and disinfect the tables and surfaces next to beds, says Dr. Cath Noakes, from the Universitys School of Civil Engineering, who supervised the work. However, we also captured significant quantities of bacteria right across the room, up to 3.5 meters away and especially along the route of the airflows in the room.
We now need to find out whether this airborne dispersion is an important route of spreading infection, adds co-supervisor Dr. Andy Sleigh.
The researchers are hoping that computer modeling will help them determine the risk. The findings have been compared to airflow simulations of the mock hospital rooms and the research team have shown that they are able to accurately predict how airborne particles can be deposited on surfaces.
Using our understanding of airflow dynamics, we can now use these models to investigate how different ward layouts and different positions of windows, doors and air vents could help prevent microorganisms being deposited on accessible surfaces, says King.
The international design and engineering firm Arup, which designs hospitals, part sponsored the study. Phil Nedin, director and global healthcare business leader at Arup, says: We are looking at healthcare facilities of the future and it is important that we look at key issues such as infection control. Being involved in microbiological studies that inform airflow modeling in potentially infectious environments allows us to get a clear understanding of the risks in these particular environments.
The paper, Bioaerosol Deposition in Single and Two-Bed Hospital Rooms: A Numerical and Experimental Study, was published in the journal Building and Environment.
This research is funded by an EPSRC Challenging Engineering grant held by Dr. Cath Noakes. Marco-Felipe Kings PhD was also partially sponsored by Arup.
http://www.infectioncontroltoday.com/news/2012/10/superbugs-ride-air-current
regards
Glenys
Thanks Rosie, Michael and all for your responses.
I was hoping for a study that at least attempted to demonstrate that common skin pathogens do get dispersed quite significantly by fans… understandably, this is an obvious “common sense” thing to ICPs but surprisingly, to the general public (and even for some nurses), this doesn’t click.
This generation demands for evidence for everything (and rightly so if we can back ourselves up with that).
It would be great if a study was done whereby MSSA/MRSA positive patients cared for in 2 controlled environments, either a vinyl floor single room or a carpeted single room, then utilised fans (which have been cleaned) and we compared culture plates (or an air sampling device fit for this) placed vertically in the direct air stream of the fans (one at a closer proximity to the fan and maybe another placed past the patient)… obviously this needs more looking into! 🙂
I am not a fan (pardon the pun!) of fans nor do I like carpets in a healthcare setting but there hasn’t been any strong supportive evidence to support what would be seen as obvious IC concerns.
I guess cleaning and a risk assessment would be the way to go for now.
Thanks again for all comments/feedback.
Regards,
Gerald
Gerald Chan
Coordinator Infection Control
St John of God Murdoch Hospital
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>>> “Lee, Rosie” 26/10/2012 7:46 AM >>>
Hi Gerald
I would agree Michael. It is not possible to have a study proving every item does not result in infection. Using infection control principles blowing air in a ward environment cannot be a good principle. If a patient is heavily colonised with an antibiotic resistant organism (ARO) then blowing skin squames will result in contamination. There are many studies indicating contamination linked to AROs in particular MRSA across the ward. Risk assessment may have to be used.
Regards
Rosie
Rosie Lee
RN. BSc. CICP
Coordinator Infection Prevention & Management
SMH Service – Royal Perth Hospital
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Hi Gerard
I recall seeing a study years ago, I think UK based so maybe in JHI, that showed MRSA in dust on portable fans. Never have seen anything that linked increase in MRSA or HAI directly to portable fans, though; that would be epidemiologically difficult to show, I think. Too many other variables.
Doesn’t mean fans are not bad, though. 🙂 Especially when not maintained well. Ask if they cleaned thoroughly (meaning the fan blades) between each patient use. I suspect not!
Cheers
Michael
Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
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Dear all,
I’m looking for evidence to back us up on not having fans in patient rooms (especially seeing that summer is around the corner).
I can’t seem to locate any supportive articles on this.
Has there been any studies done that demonstrate an increased rate of infection/colonisation (MRSA, MSSA, etc.) through fan usage in a healthcare setting?
Cheers,
Gerald
Gerald Chan
Coordinator Infection Control
St John of God Murdoch Hospital
100 Murdoch Drive
MURDOCH. WA 6150
P: 9366 1552
M: 0405 495 906 (7804)
F: 9311 4685
W: http://www.sjog.org.au/murdoch
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