Smith, J, Adams, CE, King, MF orcid.org/0000-0001-7010-476X et al. (3 more authors) (2018) Is there an association between airborne and surface microbes in the critical care environment? Journal of Hospital Infection, 100 (3). e123-e129. ISSN 0195-6701
Abstract
Background: There are few data and no accepted standards for air quality in the intensive care unit (ICU). Any relationship between airborne pathogens and hospital-acquired infection (HAI) risk in the ICU remains unknown.
Aim: First, to correlate environmental contamination of air and surfaces in the ICU; second, to examine any association between environmental contamination and ICU-acquired staphylococcal infection.
Methods: Patients, air, and surfaces were screened on 10 sampling days in a mechanically ventilated 10-bed ICU for a 10-month period. Near-patient hand-touch sites (N = 500) and air (N = 80) were screened for total colony count and Staphylococcus aureus. Air counts were compared with surface counts according to proposed standards for air and surface bioburden. Patients were monitored for ICU-acquired staphylococcal infection throughout.
Findings: Overall, 235 of 500 (47%) surfaces failed the standard for aerobic counts (≤2.5 cfu/cm²). Half of passive air samples (20/40: 50%) failed the ‘index of microbial air’ contamination (2 cfu/9 cm plate/h), and 15/40 (37.5%) active air samples failed the clean air standard (<10 cfu/m³). Settle plate data were closer to the pass/fail proportion from surfaces and provided the best agreement between air parameters and surfaces when evaluating surface benchmark values of 0–20 cfu/cm². The surface standard most likely to reflect hygiene pass/fail results compared with air was 5 cfu/cm². Rates of ICU-acquired staphylococcal infection were associated with surface counts per bed during 72h encompassing sampling days (P = 0.012).
Conclusion: Passive air sampling provides quantitative data analogous to that obtained from surfaces. Settle plates could serve as a proxy for routine environmental screening to determine the infection risk in ICU.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. This is an author produced version of a paper published in Journal of Hospital Infection. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Hospital-acquired infection; Hospital environment; Air; Bacterial transmission; Environmental contamination; Staphylococcus aureus; MRSA |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Engineering & Physical Sciences (Leeds) > School of Civil Engineering (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 06 Apr 2018 16:00 |
Last Modified: | 09 Apr 2019 00:43 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.jhin.2018.04.003 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:129341 |