Hospital-acquired infection (or nosocomial infection) refers to an infection that is contracted from the environment or staff of a health care facility. The main source of pathogens in the hospital setting is people, be they other patients or health care professionals. A secondary, and no less important source, is the built environment. The importance of this secondary source has been highlighted in a Duke Health study.
The research has modeled a so-called “transmission triangle” within a health care setting. The points on the triangle are patients, the built environment that forms the hospital, and the health care professional. Each one of these is capable of infecting the patient through the transfer of pathogenic organisms.
This model is based on empirical research. Here samples were taken from surgical scrubs of health care staff; from the bodies of patients; and from various rooms and equipment. The items sampled included beds and trolley carts. The samples were taken from a hospital over a period of time. In total 2,185 samples were taken from the clothing worn by health care workers; 455 from patients; and 2,919 from hospital rooms frequented by patients.
The findings were interesting. The microorganisms recovered from the clothing of health care staff were often not present at the start of the shift; instead they accumulated over time. Several of these organisms had resistance to one or more antibiotics.
Using genetic sequencing the researchers were able to plot the path of transmission and this showed several instances where pathogens had been transferred to patients from health care workers. Similarly there were cases of transmission from room items to patients.
Outlining the implications of the findings, Dr. Deverick Anderson explains to Controlled Environments magazine: “This study is a good wake-up call that health care personnel need to concentrate on the idea that the health care environment can be contaminated.”
The medical doctor adds: “Any type of patient care, or even just entry into a room where care is provided, truly should be considered a chance for interacting with organisms that can cause disease.”
The findings reinforce the need for strict protocols, including practices such as hand sanitization. The key observations and recommendations have been presented to disease focused event run by the Infectious Diseases Society of America and other health care bodies.
