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 Controljournal_title
American journal of infection controlauthors
Wilson AM,Verhougstraete MP,Donskey CJ,Reynolds KAdoi
10.1016/j.ajic.2020.06.204subject
Has Abstractpub_date
2021-02-01 00:00:00pages
206-214issue
2eissn
0196-6553issn
1527-3296pii
S0196-6553(20)30586-1journal_volume
49pub_type
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