Environmental microorganisms and infection transmission in healthcare buildings

医疗保健获得性感染(HCAI)仍然是一个世界性的问题，抗生素耐药性意味着治疗感染正变得越来越具有挑战性。越来越多的证据表明，建筑环境在感染的传播途径中发挥着重要作用。特别是，接触传播会受到医院环境表面污染的影响，这也会受到空气中微生物流行的影响。虽然人们越来越多地意识到环境和微生物污染之间的关系，但很少有量化数据来评估空气和表面污染之间的相互作用。此外，大多数研究都是从微生物学或临床角度进行的，并没有完全描述物理环境或正在进行的活动的特征。因此，没有足够的数据来对关系充满信心，也没有足够的数据来理解这种关系是如何随时间变化的。本项目旨在通过建立医院微生物传播与医院环境设计和运营之间的量化关系来填补这一知识空白。这将导致评估环境对感染风险的作用的新方法，支持未来的设计和行动，如清洁。PHD与EPSRC HECOIRA医疗影响伙伴关系项目EP/P023312/1保持一致。该研究的主要目标是：在受控条件下，量化空气和表面上微生物之间的关系。这将涉及生物气雾室对一系列条件的研究，包括生物气溶胶来源、微生物种类、通风流量以及温度和湿度，以量化微生物的浓度和活性随时间的变化，并建立沉积、蒸发和存活率。描述医院环境中空气和表面微生物负荷的瞬时关系。这将涉及在两个医院病房进行大量微生物和环境采样和活动监测研究，以发展空气和表面污染随时间、身体状况和活动的时间序列变化。应用感染风险数学模型中的经验关系，评估清洁程序、手卫生和环境之间的关系，以确定医院病房环境中特定事件的潜在感染风险。该项目与EPSRC在建筑环境和医疗技术方面的优先事项保持一致。通过将微生物方法与物理环境及其运行的数据相结合，该项目将提供新的见解，为未来医疗保健小区的设计和运营提供信息，并支持有关患者护理的临床决策。

Healthcare acquired infection (HCAI) remains a problem worldwide and antibiotic resistance means that treating infections is becoming increasingly challenging. There is increasing evidence that the built environment plays an important role in the transmission pathway for infections. In particular, contact transmission can be influenced by the contamination of surfaces in the hospital environment, which is also influenced by the prevalence of microorganisms in the air. While there is growing awareness of the relationships between the environment and microbial contamination, there is very little quantitative data to assess the interactions between air and surface contamination. Moreover the majority of studies have been conducted from a microbiology or clinical perspective and do not fully characterise the physical environment or the activities that are taking place. As such there is not sufficient data to be confident in relationships and to understand how this varies with time.This project aims to fill this gap in knowledge by establishing quantitative relationships between microogansmisms in hospitals and the design and operation of the hospital environment. This will lead to new approaches to assess the role of the environment on infection risk, supporting both future design and actions such as cleaning. The PhD is aligned to the EPSRC HECOIRA Healthcare Impact Partnership Project EP/P023312/1.The key objectives of the study are:Quantify the relationships between microorgansims on the air and on surfaces over time under controlled conditions. This will involve bioaerosol chamber studies for a range of conditions including bioaerosol source, microorganism species, ventilation flow rate, and temperature and humidity, to quantify concentration and viability of microorganisms with time and establish deposition, evaporation and survival rates.Characterise transient relationships between air and surface microbial burden in a hospital environment. This will involve substantial microbial and environmental sampling and activity monitoring studies in two hospital wards to develop time series variations in air and surface contamination with time, physical conditions and activity. Apply empirical relationships within mathematical models of infection risk to evaluate the relationships between cleaning procedures, hand hygiene and the environment on potential infection risks for specific events in hospital ward settings. The project aligns to EPSRC priorities in Built Environment and Healthcare Technology. By integrating microbial methodologies with data on the physical environment and its operation, the project will give new insights to inform future healthcare estates design and operation as well as support clinical decisions over patient care.