Is there a relationship between airborne and surface microbes in the critical care environment?

Smith, J. and Adams, C.A. and King, M.F. and Noakes, C.J. and Robertson, C. and Dancer, S.J. (2018) Is there a relationship between airborne and surface microbes in the critical care environment? Journal of Hospital Infection. ISSN 1532-2939 (https://doi.org/10.1016/j.jhin.2018.04.003)

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Abstract

Objective This study attempted firstly to correlate environmental contamination of air and surfaces in the intensive care unit (ICU); and secondly, to examine any association between environmental contamination and ICU-acquired staphylococcal infection. Design We screened patients, air and surfaces on 10 sampling days in a mechanically ventilated 10-bed ICU during 10 months. Methods Near-patient hand-touch sites (n=500) and air (n=80) were screened for total colony count and Staphylococcus aureus using dipslides, settle plates (passive air sampling) and an MAS-100 slit-sampler (active air sampling). 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. Results Overall, 235 of 500 (47%) surfaces failed the standard for aerobic counts (≤2.5 cfu/cm2). Half of passive air samples (20 of 40: 50%) failed the ‘Index of Microbial Air’ contamination (2 cfu/9cm plate/hr), and 15/40 (37.5%) active air samples failed the clean air standard (