We in healthcare and health tech know how deadly nosocomial or hospital-acquired infections are. Current CDC estimates are that in US hospitals, there are 1.7 million infections and 99,000 associated deaths each year (up from a previous estimate of 75,000) PatientCareLink. Most of us know that visiting a patient in a hospital room means also making sure hands are washed, clothes and shoes are clean, and that we bring a container of industrial strength bleach wipes for cleaning surfaces versus flowers.

However, it was news to this Editor that few studies have been done on the actual hospital room environment–the microbiome–and how the microbes in the room interact with the patient and the staff.  Sue Barnes, an RN who spent 30 years as the National Leader for Infection Prevention for Kaiser Permanente, reviews a newly published study in Science Translational Medicine (24 May, abstract available only). The study collected bacterial cultures from the ‘patient zone’ around the bed, every surface in the hospital room, and swabbed the hands and noses of patients and staff, along with the shoes, shirts, and cell phones of staff members. The problem is much more complex than simple cleaning.

• Patient skin and the microbial makeup of room surfaces became more similar over time. Non-ambulatory patients were less so, as they had less contact with external surfaces.
• The longer patients were in the room, the more genetic resistance to antibiotics the organisms acquired. This is despite the lack of association with antibiotics save topicals. The author suggests that regular cleaning may be the reason–only the strongest survive.
• The hospital room is most threating to the most vulnerable, such as babies in a neonatal ICU
• “In the Lax study, several bacterial samples taken more than 71 days apart were identical,  (more…)