An agent-based modeling approach to estimate pathogen exposure risks from wheelchairs - 19/01/21
, Marc P. Verhougstraete, PhD a, Curtis J. Donskey, MD b, c, Kelly A. Reynolds, PhD aHighlights |
• | Consistent disinfection between wheelchair rides can protect future riders. |
• | Efficacy of disinfection intervention depends on contamination magnitude. |
• | Higher exposure reductions are seen when less patients are infected. |
Résumé |
Background |
Contributions of contaminated wheelchairs to nosocomial pathogen transmission are relatively unknown. Our aim was to develop a model predicting pathogen exposures for patients utilizing wheelchairs and estimate exposure reduction potential of wheelchair disinfection between rides.
Methods |
An agent-based model was informed by wheelchair location data from a connected 215-bed acute care and 250-bed long-term care facility. Simulated scenarios varied in frequencies of patient wheelchair contamination and wheelchair disinfection in between trips. Clostridioides difficile and methicillin-resistant Staphylococcus aureus concentrations on patient hands at the end of wheelchair trips were estimated. Exposure reductions due to disinfection, assuming low real-world efficacies (50%, 70%, and 90%), were compared.
Results |
In the simulation, when few patients introduced contamination to wheelchairs, disinfection in between patients 50% of the time decreased baseline (no disinfection) estimated exposures for the 50th wheelchair rider by >99.999%. When patients had a 50% chance of being contaminated before the wheelchair ride, disinfection did not reduce exposures consistently.
Discussion |
The efficacy of disinfection in between patient rides as an exposure mitigation strategy likely depends on the frequency of infected patient wheelchair use.
Conclusions |
During outbreak, high contamination conditions, disinfection, alone, is not enough to protect patients from wheelchair-mediated exposures.
Le texte complet de cet article est disponible en PDF.Key Words : C difficile, MRSA, Portable equipment, Infection control, Fomites
Plan
| Disclosure: Amanda Wilson reports grants from GOJO Industries Inc., grants from Zoono USA, outside the submitted work. Dr Reynolds reports grants from EcoLab, grants from Gojo Industries, grants from EnviroMaster, grants from Excel, Inc, grants from GHSP, outside the submitted work. Dr Donskey reports grants from Clorox, grants from PDI, grants from Pfizer, outside the submitted work. Dr Verhougstraete has nothing to disclose. |
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| Conflicts of interest: None to report. |
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| Under a Creative Commons Zero v1.0 Universal license (CC-BY), code can be accessed at: wheelchair_model. |
Vol 49 - N° 2
P. 206-214 - février 2021 Retour au numéro
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