An agent-based modeling approach to estimate pathogen exposure risks from wheelchairs.

Abstract:

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.

journal_name

Am J Infect Control

authors

Wilson AM,Verhougstraete MP,Donskey CJ,Reynolds KA

doi

10.1016/j.ajic.2020.06.204

subject

Has Abstract

pub_date

2021-02-01 00:00:00

pages

206-214

issue

2

eissn

0196-6553

issn

1527-3296

pii

S0196-6553(20)30586-1

journal_volume

49

pub_type

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