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Decreasing Airborne Contamination Levels in High-Risk Hospital Areas Using a Novel Mobile Air-Treatment Unit

Published online by Cambridge University Press:  02 January 2015

V. Bergeron ,
G. Reboux ,
J. L. Poirot  and
N. Laudinet
V. Bergeron*
Affiliation:
Ecole Normale Supérieure de Lyon, Laboratoire de Physique, Lyon, France
G. Reboux
Affiliation:
Centre Hospitalier Universitaire, Laboratoire de Parasitologie-mycologie, Besançon, France
J. L. Poirot
Affiliation:
Hôpital Saint-Antoine, Laboratoire de Parasitolgie-mycologie, Paris, France
N. Laudinet
Affiliation:
AirlnSpace SAS, Montigny-le-Bretonneux, France
*
Ecole Normale Supérieure de Lyon, Laboratoire de Physique CNRS UMR 5672, 46 allée d'ltalie 69007 Lyon, France ([email protected])
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Abstract

Objective.

To evaluate the performance of a new mobile air-treatment unit that uses nonthermal-plasma reactors for lowering the airborne bioburden in critical hospital environments and reducing the risk of nosocomial infection due to opportunistic airborne pathogens, such as Aspergillus fumigatus.

Methods.

Tests were conducted in 2 different high-risk hospital areas: an operating room under simulated conditions and rooms hosting patients in a pediatric hematology ward. Operating room testing provided performance evaluations of removal rates for airborne contamination (ie, particles larger than 0.5 μm) and overall lowering of the airborne bioburden (ie, colony-forming units of total mesophilic flora and fungal flora per cubic meter of air). In the hematology service, opportunistic and nonpathogenic airborne fungal levels in a patient's room equipped with an air-treatment unit were compared to those in a control room.

Results.

In an operating room with a volume of 118 m3, the time required to lower the concentration of airborne particles larger than 0.5 μm by 90% was decreased from 12 minutes with the existing high-efficiency particulate air filtration system to less than 2 minutes with the units tested, with a 2-log decrease in the steady-state levels of such particles (P<.01). Concurrently, total airborne mesophilic flora concentrations dropped by a factor of 2, and the concentrations of fungal species were reduced to undetectable levels (P<.01). The 12-day test period in the hematology ward revealed a significant reduction in airborne fungus levels (P<.01), with average reductions of 75% for opportunistic species and 82% for nonpathogenic species.

Conclusion.

Our data indicate that the mobile, nonthermal-plasma air treatment unit tested in this study can rapidly reduce the levels of airborne particles and significantly lower the airborne bioburden in high-risk hospital environments.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 10 , October 2007 , pp. 1181 - 1186
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007 

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References

1. Williams, REO. Epidemiology of airborne staphylococcal infection. Bacterid Rev 1966;30:660–670.Google Scholar
2. Kuehn, TH. Airborne infection control in health care facilities. J Solar Energy Eng 2003;125:366–371.Google Scholar
3. Beggs, CB. The airborne transmission of infection in hospital buildings: fact or fiction? Indoor and Built Environ 2003;12:9–18.Google Scholar
4. Anjali, J. The impact of the environment on infections in healthcare facilities. The Center for Health Design Issue Paper 1. Concord, CA: The Center for Health Design, 2006;1:16.Google Scholar
5. Alberti, C, Bouakline, A, Ribaud, P, et al. Relationship between environmental fungal contamination and the incidence of aspergillosis in haematology patients. J Hosp Infect 2001;48:198–206.Google Scholar
6. Leenders, AC, van Belkum, A, Behrendt, M, Lun'endijk, A, Verbrugh, HA. Density and molecular epidemiology of Aspergillus in air and the relationship to outbreaks of Aspergillus infection. J Clin Microbiol 1999;37:1752–1757.Google Scholar
7. Iwen, PC, Davis, JC, Reed, EC, Winfield, BA, Hinrichs, SH. Airborne fungal spore monitoring in a protective environment during hospital construction, and correlation with an outbreak of invasive aspergillosis. Infect Control Hosp Epidemiol 1994;15:303–306.Google Scholar
8. Alexakis, PG, Feldon, PG, Wellisch, M, Richter, RE, Finegold, SM. Airborne bacterial contamination of operative wounds. West J Med 1976;124:361–369.Google Scholar
9. Whyte, W, Hodgson, R, Tinkler, J. The importance of airborne bacterial contamination of wounds. J Hosp Infect 1982;3:123–135.Google Scholar
10. Hambraeus, A. Aerobiology in the operating room—a review. J Hosp Infect 1988;11:68–76.Google Scholar
11. Duhaime, AC, Bonner, K, McGowan, KL, Schut, L, Sutton, LN, Plotkin, S. Distribution of bacteria in the operating room environment and its relation to ventricular shunt infections: a prospective study. Childs Nerv Syst 1991;7:211–214.Google Scholar
12. Friberg, B, Friberg, S, Burman, LG. Correlation between surface and air counts of particles carrying aerobic bacteria in operating rooms with turbulent ventilation: an experimental study. J Hosp Infect 1999;42:61–68.Google Scholar
13. Centers for Disease Control and Prevention. Guidelines for prevention of nosocomial pneumonia. MMWR Recomm Rep 1997;46(RR-1):1–79.Google Scholar
14. Centers for Disease Control and Prevention. Guidelines for environmental infection control in health-care facilities: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep 2003;52(RR-10):1–48.Google Scholar
15. Sheretz, RJ, Belani, A, Kramer, BS, et al. Impact of air filtration on nosocomial Aspergillus infections: unique risk of bone marrow transplant recipients. Am J Med 1987;83:709–718.Google Scholar
16. Passweg, JR, Rowlings, PA, Atkinson, KA, et al. Influence of protective isolation on outcome of allogeneic bone marrow transplantation for leukemia. Bone Marrow Transplant 1998;21:1231–1238.Google Scholar
17. Hahn, T, Cummings, M, Michalek, AM, Lipman, BJ, Segal, BH, McCarthy, PL. Efficacy of high-efficiency particulate air filtration in preventing aspergillosis in immunocompromised patients with hematologic malignancies. Infect Control Hosp Epidemiol 2002;23:525–531.Google Scholar
18. Lutz, BD, Jin, J, Rinaldi, MG, et al. Outbreak of invasive Aspergillus infection in surgical patients, associated with a contaminated air-handling system. Clin Infect Dis 2003;37:786–793.Google Scholar
19. Munoz, P, Guinea, J, Pelaez, T, et al. Nosocomial invasive aspergillosis in a heart transplant patient acquired a break in the HEPA air filtration system. Transpl Infect Dis 2004;6:50–54.Google Scholar
20. Kumari, DNP, Haji, TC, Keer, V, Hawkey, PM, Duncanson, V, Flower, E. Ventilation grilles as a potential source of methicillin-resistant Staphylococcus aureus causing an outbreak in an orthopaedic ward at a district general hospital. J Hosp Infect 1998;39:127–133.Google Scholar
21. McDonald, LC, Walker, M, Carson, L, et al. Outbreak of Acinetobacter spp. bloodstream infections in a nursery associated with contaminated aerosols and air conditioners. Pediatr Infect Dis J 1998;17:716–722.Google Scholar
22. Uduman, SA, Farrukh, AS, Nath, KNR, et al. An outbreak of Serratia marcescens infection in a special-care baby unit of a community hospital in United Arab Emirates: the importance of the air conditioner duct as a nosocomial reservoir. J Hosp Infect 2002;52:175–180.Google Scholar
23. Perraud, M, Nicolle, MC, Chiarello, E, Tissot-Guerraz, F, Cetre, JC, Sepetjan, M. Air filtration and prevention of aspergillary pneumopathies. Nouvelle Revue Française d'Hématologie 1992;34:295–299.Google Scholar
24. Rutala, W, Jones, SM, Worthington, JM, Reist, PC, Weber, DJ. Efficacy of portable filtration units in reducing aerosolized particles in the size range of Mycobacterium tuberculosis . Infect Control Hosp Epidemiol 1995;16:391–398.Google Scholar
25. Loo, VG, Bertrand, C, Dixon, C, et al. Control of construction-associated nosocomial aspergillosis in an antiquated hematology unit. Infect Control Hosp Epidemiol 1996;17:360–364.Google Scholar
26. Miller-Leiden, S, Lobascio, C, Nazaroff, WW. Effectiveness of in-room air filtration and dilution ventilation for tuberculosis infection control. Air Waste 1996;46:869–882.Google Scholar
27. Rosenbaum, RA, Benyo, JS, O'Connor, RE, et al. Use of a portable forced air system to convert existing hospital space into a mass casualty isolation area. Ann Emerg Med 2004;44:628–634.Google Scholar
28. Engelhart, S, Hanfland, J, Glasmacher, A, Krizek, L, Schmidt-Wolf, IGH, Exner, M. Impact of portable air filtration units on exposure of haematology-oncology patients to airborne Aspergillus fumigatus spores under field conditions. J Hosp Infect 2003;54:300–304.Google Scholar
29. Shaughnessy, RJ, Sextro, RG. What is an effective portable air cleaning device? A review. J Occup Environ Hyg 2006;3:169–181.Google Scholar
30. Kapustina, EA, Volodina, EV. Air decontamination and fine filtration system “Potok 150MK.” Aviakosm Ekolog Med 2004;38:57–58.Google Scholar
31. Griffiths, WD, Bennett, A, Speight, S, Parks, S. Determining the performance of a commercial air purification system for reducing airborne contamination using model micro-organisms: a new test methodology. J Hosp Infect 2005;61:242–247.Google Scholar
32. Mainelis, G, Gorny, RL, Reponen, T, et al. Effect of electrical charges and fields on injury and viability of airborne bacteria. Biotechnol Bioeng 2002;79:229–241.Google Scholar
33. Yao, M, Mainelis, G, An, HY. Inactivation of microorganisms using electrical fields. Environ Sä Technol 2005;39:3338–3344.Google Scholar
34. Nelson, GO, Bergman, W, Miller, HH, Taylor, RD, Richards, CP, Biermann, AH. Enhancement of air filtration using electric fields. Am Ind Hyg Assoc J 1978;39:472–479.Google Scholar
35. International Organization for Standardization (ISO). ISO 14644-1 Cleanrooms and associated controlled environments—part 1. Classification of air cleanliness. May 1, 1999. Available at: http://www.iso.org. Accessed October 12, 2004.Google Scholar
36. International Organization for Standardization (ISO). ISO 14644-2 Cleanrooms and associated controlled environments—part 2. Specifications for testing and monitoring to prove continued compliance with ISO 14644-1. September 15, 2000. Available at: http://www.iso.org. Accessed October 12, 2004.Google Scholar
37. International Organization for Standardization (ISO). ISO 14698-1 Cleanrooms and associated controlled environments biocontamination control—part 1. General principles and methods. September 1, 2003. Available at: http://www.iso.org. Accessed October 12, 2004.Google Scholar
38. French Air Handling, Air-Conditioning, and Refrigeration Equipment Manufacturers' Association . Traitment de l'air en milieu hospitalier. Les guides pratiques UNICLIMA. SEPAR, April 1997. Available at: http://www.uniclima.org. Accessed October 12, 2004.Google Scholar
39. Maus, R, Goppelsroder, A, Umhauer, H. Survival of bacterial and mold spores in air filter media. Atmos Environ 2001;35:105–113.Google Scholar
40. Price, DL, Simmons, RB, Crow, SA, Ahearn, DG. Mold colonization during use of preservative-treated and untreated air filters, including heap filters from hospitals and commercial locations over an 8-year period (1996-2003). J Ind Microbiol Biotechnol 2005;32:319–321.Google Scholar
41. Memarzadeh, F, Manning, AP. Comparison of operating room ventilation systems in the protection of the surgical site. ASHRAE Transactions 2002;108:3–15.Google Scholar
42. Beggs, CB, Noakes, CJ, Sleigh, PA, Fletcher, LA, Siddiqi, K. The transmission of tuberculosis in confined spaces: an analytical review of alternative epidemiological models. Int J Tuberc Lung Dis 2003;7:1015–1026.Google Scholar