Despite the clean and sanitary appearance of most hospitals, microorganisms fill the buildings with the large number of patients coming through the doors. A new study investigated this matter in-depth and concluded their significant findings.

For the year of 2013, researchers from the University of Chicago took the opportunity to further study microbes as a hospital was opening in the area. This brand new hospital could provide researchers an avenue to scrutinise how human microbiomes colonise a hospital from studying the area two months prior to opening to the subsequent 10 months in service.

Golden opportunity for research

Jack Gilbert, study author and head of the Microbiome Center at the University of Chicago said, “It was a remarkable opportunity. Established hospitals already have lots of microbial colonisation already, and we would not have been able to figure out what was part of the building and what was delivered by the patients, doctors, and nurses.”

During the study period, they swabbed floors, computer mice, bedrails, pagers, handphones, as well as healthcare staff patients’ noses, hands and armpits. The skin and clothing of doctors, nurses and other hospital staff were also swabbed. In total, 6,523 samples were gathered in 10 patient rooms and two nurse stations on two floors.

Gilbert joked, “It was a bit awkward. People would have just arrived for treatment, and we’d say, ‘Excuse me, can I swab your armpit, nose and hand?’”

Reservoir for microorganisms

The dramatic change of microbes was evident just 24 hours after the hospital became operational. They found that patients picked up microorganisms present in their hospital rooms prior to their arrival – but, more importantly, their own microbes such as Staphyloccocus epidermidis and Staphylococcus aureus colonised over time.

Interestingly, the researchers noted that more bacteria were exchanged over summer possibly because of the increased humidity. It was also discovered that different surfaces hosted different kinds of microbes. For example, microbes on the telephones were different from those on computer mouses and door handles.

“That helps us consider the different surface materials and what their impact could be on the ecosystems,” said Gilbert.

Months after opening, more insidious organisms that had antibiotic-resistant genes and traits to boost their ability to colonise human tissue were also detected. Gilbert pointed out that this is most likely due to the hospital constantly being cleaned and people on antibiotics which forces the microbes to evolve and adapt well to the stressful environment.

Impact on hospitals globally

These results published on 24 May serve as a foundation to improve healthcare despite it being a preliminary and observational study.

“The key thing is that the environment must influence the patients’ health outcomes, but what this study shows is that the microbial exchange we have with the environment is continuous,” Gilbert explained. “How is that exchange influencing outcomes?”

Follow up questions and hypotheses can be conjured up with the availability of this large study. Furthermore, the rate of hospital acquired infections globally can be studied and better healthcare treatment can be given.

“We can now use this to design the most accurate intervention possible,” he said.

The current thinking is that hospitals are teeming with microorganisms but this research suggests that patients’ own homes could be potential sources of infections judging from the microorganisms they bring to the hospital. Gilbert recommends that rather than focusing on more potent sterilisation techniques, resources might be better spent on giving people probiotics and antibiotics prior to their hospital arrivals. MIMS

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