Airborne bacterial dispersal during and after dressing and bed changes on burns patients

Sarah E. Bache, Michelle MacLean, George Gettinby, John G. Anderson, Scott J. MacGregor, Ian Taggart

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

It is acknowledged that activities such as dressing changes and bed sheet changes are high-risk events; creating surges in levels of airborne bacteria. Burns patients are particularly high dispersers of pathogens; due to their large, often contaminated, wound areas. Prevention of nosocomial cross-contamination is therefore one of the major challenges faced by the burns team. In order to assess the contribution of airborne spread of bacteria, air samples were taken repeatedly throughout and following these events, to quantify levels of airborne bacteria. Air samples were taken at 3-min intervals before, during and after a dressing and bed change on a burns patient using a sieve impaction method. Following incubation, bacterial colonies were enumerated to calculate bacterial colony forming units per m3 (cfu/m3) at each time point. Statistical analysis was performed, whereby the period before the high-risk event took place acted as a control period. The periods during and after the dressing and bed sheet changes were examined for significant differences in airborne bacterial levels relative to the control period. The study was carried out four times, on three patients with burns between 35% total burn surface area (TBSA) and 51% TBSA. There were significant increases in airborne bacteria levels, regardless of whether the dressing change or bed sheet change took place first. Of particular note, is the finding that significantly high levels (up to 2614 cfu/m3) of airborne bacteria were shown to persist for up to approximately 1 h after these activities ended. This is the most accurate picture to date of the rapidly changing levels of airborne bacteria within the room of a burns patient undergoing a dressing change and bed change. The novel demonstration of a significant increase in the airborne bacterial load during these events has implications for infection control on burns units. Furthermore, as these increased levels remained for approximately 1 h afterwards, persons entering the room both during and after such events may act as vectors of transmission of infection. It is suggested that appropriate personal protective equipment should be worn by anyone entering the room, and that rooms should be quarantined for a period of time following these events.
LanguageEnglish
Pages39-48
Number of pages10
JournalBurns
Volume41
Issue number1
Early online date20 Nov 2014
DOIs
Publication statusPublished - Feb 2015

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Bandages
Burns
Bacteria
Stem Cells
Air
Burn Units
Infectious Disease Transmission
Bacterial Load
Infection Control
Wounds and Injuries

Keywords

  • infection control
  • airborne
  • cross-contamination
  • nosocomial infection
  • dressing change
  • bed change

Cite this

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title = "Airborne bacterial dispersal during and after dressing and bed changes on burns patients",
abstract = "It is acknowledged that activities such as dressing changes and bed sheet changes are high-risk events; creating surges in levels of airborne bacteria. Burns patients are particularly high dispersers of pathogens; due to their large, often contaminated, wound areas. Prevention of nosocomial cross-contamination is therefore one of the major challenges faced by the burns team. In order to assess the contribution of airborne spread of bacteria, air samples were taken repeatedly throughout and following these events, to quantify levels of airborne bacteria. Air samples were taken at 3-min intervals before, during and after a dressing and bed change on a burns patient using a sieve impaction method. Following incubation, bacterial colonies were enumerated to calculate bacterial colony forming units per m3 (cfu/m3) at each time point. Statistical analysis was performed, whereby the period before the high-risk event took place acted as a control period. The periods during and after the dressing and bed sheet changes were examined for significant differences in airborne bacterial levels relative to the control period. The study was carried out four times, on three patients with burns between 35{\%} total burn surface area (TBSA) and 51{\%} TBSA. There were significant increases in airborne bacteria levels, regardless of whether the dressing change or bed sheet change took place first. Of particular note, is the finding that significantly high levels (up to 2614 cfu/m3) of airborne bacteria were shown to persist for up to approximately 1 h after these activities ended. This is the most accurate picture to date of the rapidly changing levels of airborne bacteria within the room of a burns patient undergoing a dressing change and bed change. The novel demonstration of a significant increase in the airborne bacterial load during these events has implications for infection control on burns units. Furthermore, as these increased levels remained for approximately 1 h afterwards, persons entering the room both during and after such events may act as vectors of transmission of infection. It is suggested that appropriate personal protective equipment should be worn by anyone entering the room, and that rooms should be quarantined for a period of time following these events.",
keywords = "infection control, airborne, cross-contamination , nosocomial infection, dressing change, bed change",
author = "Bache, {Sarah E.} and Michelle MacLean and George Gettinby and Anderson, {John G.} and MacGregor, {Scott J.} and Ian Taggart",
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Airborne bacterial dispersal during and after dressing and bed changes on burns patients. / Bache, Sarah E.; MacLean, Michelle; Gettinby, George; Anderson, John G.; MacGregor, Scott J.; Taggart, Ian.

In: Burns, Vol. 41, No. 1, 02.2015, p. 39-48.

Research output: Contribution to journalArticle

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T1 - Airborne bacterial dispersal during and after dressing and bed changes on burns patients

AU - Bache, Sarah E.

AU - MacLean, Michelle

AU - Gettinby, George

AU - Anderson, John G.

AU - MacGregor, Scott J.

AU - Taggart, Ian

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N2 - It is acknowledged that activities such as dressing changes and bed sheet changes are high-risk events; creating surges in levels of airborne bacteria. Burns patients are particularly high dispersers of pathogens; due to their large, often contaminated, wound areas. Prevention of nosocomial cross-contamination is therefore one of the major challenges faced by the burns team. In order to assess the contribution of airborne spread of bacteria, air samples were taken repeatedly throughout and following these events, to quantify levels of airborne bacteria. Air samples were taken at 3-min intervals before, during and after a dressing and bed change on a burns patient using a sieve impaction method. Following incubation, bacterial colonies were enumerated to calculate bacterial colony forming units per m3 (cfu/m3) at each time point. Statistical analysis was performed, whereby the period before the high-risk event took place acted as a control period. The periods during and after the dressing and bed sheet changes were examined for significant differences in airborne bacterial levels relative to the control period. The study was carried out four times, on three patients with burns between 35% total burn surface area (TBSA) and 51% TBSA. There were significant increases in airborne bacteria levels, regardless of whether the dressing change or bed sheet change took place first. Of particular note, is the finding that significantly high levels (up to 2614 cfu/m3) of airborne bacteria were shown to persist for up to approximately 1 h after these activities ended. This is the most accurate picture to date of the rapidly changing levels of airborne bacteria within the room of a burns patient undergoing a dressing change and bed change. The novel demonstration of a significant increase in the airborne bacterial load during these events has implications for infection control on burns units. Furthermore, as these increased levels remained for approximately 1 h afterwards, persons entering the room both during and after such events may act as vectors of transmission of infection. It is suggested that appropriate personal protective equipment should be worn by anyone entering the room, and that rooms should be quarantined for a period of time following these events.

AB - It is acknowledged that activities such as dressing changes and bed sheet changes are high-risk events; creating surges in levels of airborne bacteria. Burns patients are particularly high dispersers of pathogens; due to their large, often contaminated, wound areas. Prevention of nosocomial cross-contamination is therefore one of the major challenges faced by the burns team. In order to assess the contribution of airborne spread of bacteria, air samples were taken repeatedly throughout and following these events, to quantify levels of airborne bacteria. Air samples were taken at 3-min intervals before, during and after a dressing and bed change on a burns patient using a sieve impaction method. Following incubation, bacterial colonies were enumerated to calculate bacterial colony forming units per m3 (cfu/m3) at each time point. Statistical analysis was performed, whereby the period before the high-risk event took place acted as a control period. The periods during and after the dressing and bed sheet changes were examined for significant differences in airborne bacterial levels relative to the control period. The study was carried out four times, on three patients with burns between 35% total burn surface area (TBSA) and 51% TBSA. There were significant increases in airborne bacteria levels, regardless of whether the dressing change or bed sheet change took place first. Of particular note, is the finding that significantly high levels (up to 2614 cfu/m3) of airborne bacteria were shown to persist for up to approximately 1 h after these activities ended. This is the most accurate picture to date of the rapidly changing levels of airborne bacteria within the room of a burns patient undergoing a dressing change and bed change. The novel demonstration of a significant increase in the airborne bacterial load during these events has implications for infection control on burns units. Furthermore, as these increased levels remained for approximately 1 h afterwards, persons entering the room both during and after such events may act as vectors of transmission of infection. It is suggested that appropriate personal protective equipment should be worn by anyone entering the room, and that rooms should be quarantined for a period of time following these events.

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