Pilot study in Canada examines environmental and genomic solution for hospital acquired infections

Published: 7-Oct-2015

Aims to better evaluate newer healthcare technologies and improve the effectiveness of infection prevention measures


Canadian researchers aim to tackle healthcare associated infections (HAIs) in bone marrow patients in a US$400,000 pilot study using two complimentary and novel approaches.

HAIs are a major burden on patients and healthcare systems worldwide. Despite strict hygiene practices and other preventative measures in hospitals there are an estimated 220,000 cases with 8,000 deaths each year in Canada. Costs associated with HAIs are estimated to be more than US$15m a year for Vancouver Coastal Health (VCHA) alone.

Bone marrow patients (BMT) are one of the highest risk groups for HAIs since their immune systems are weakened during the course of their treatment, which makes them highly vulnerable to pathogens until their immune system recovers.

Dr Elizabeth Bryce, Regional Medical Director for Infection Prevention and Control, Vancouver Coastal Health; Dr Raewyn Broady, Director of the BMT programme; and Dr Linda Hoang, Medical Microbiologist at the BC Public Health Lab, part of the BC Centre for Disease Control, are leading the two-year study.

We hope to better understand the transmission dynamics of microbes between the patient, the healthcare worker and the environment

In this study, first, to reduce the bio-burden on all touch surfaces, three patient isolation rooms will be re-engineered with self-disinfecting surfaces containing copper-nickel and titanium dioxide and outfitted with contact-free motion activated devices, filtered water, and ultraviolet light in the bathroom.

Second, surveillance for pathogens in patients, healthcare workers and rooms will be addressed by microbiome profiling and the current standard of care microbial culturing.

The researchers anticipate gaining valuable insights into the role that the hospital environment (and healthcare staff) may have on the evolution of a BMT patient's microbiome during the transplant and recovery process. This in turn should provide ideas into improved methods to reduce HAIs for this group as well as informing general infection prevention strategies. Their hope is to gather enough evidence to establish a future large-scale study across Canada to reduce HAIs and ultimately decrease the morbidity and associated economic burden on healthcare spending.

'Infections cost patients and hospitals. By taking advantage of novel engineering along with advances in genomics, we hope to better understand the transmission dynamics of microbes between the patient, the healthcare worker and the environment,' says Dr Bryce. 'Clearer understanding of this relationship will allow us to better evaluate newer healthcare technologies and improve the effectiveness of infection prevention measures.'

Previous health economic evaluations on infection prevention and control programmes at Vancouver Coastal Health demonstrated that improved strategies can lead to significant HAI reductions and millions of dollars in cost avoidance – increasing optimisation of bed occupation, reduction in isolation cleaning, medication, and an increased returned time to nursing care.

'Incorporating microbiome surveillance into the multifaceted hospital environment including, patients, workers, and the rooms themselves provides a unique level of detail,' says Dr Alan Winter, President and CEO of Genome BC. 'We are pleased to be supporting a project that could prevent infection in some of the most susceptible patients in BC and beyond.'

This project, Prevention of Healthcare Associated Infections in Bone Marrow Transplant Patients, was funded by Genome BC's User Partnership Programme (UPP), the VGH & UBC Hospital Foundation and is also supported by the Public Health Agency of Canada.

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