March 21, 2017

How mapping the 'hospital microbiome' could prevent HACs

Daily Briefing

    Some researchers believe that mapping a hospital's microbiome could help to reduce hospital-acquired conditions (HACs), Allison Bond writes for The Atlantic.

    HACs are a persistent problem in hospitals: About 440,000 HACs occur in U.S. hospitals annually, costing nearly $10 billion. And that's despite efforts to keep hospitals, tools, and workers clean, Bond writes.

    That's why the University of Chicago (UC) launched the Hospital Microbiome Project.

    Researchers theorized that a hospital might have a distinctive microbiome just as the human gut has one. And understanding a hospital's mix of microbes, as well as how those microbes move throughout the facility, might help hospitals protect patients, the researchers said.

    For instance, Bond writes that while only a minority of bacteria in any given microbiome presents a risk of infection, many health care treatments—such as chemotherapy or antibiotics—can tweak the balance of microbes in a patient's body, "potentially turning the generally harmless bacteria or fungi into disease-causing agents."

    "If you can understand the patterns of microbial community composition and how these change over time, you can get a pretty good idea of how to prevent some of the transmission of pathogenic organisms," said John Chase, who has researched microbiomes at Northern Arizona University but is not involved in the Hospital Microbiome Project.

    UC project details

    While other initiatives have examined microorganisms living in buildings, the UC project is larger in scale than prior efforts. It's also the first to identify not only the type of microorganism—friendly or pathogenic—that live in a hospital setting but also to examine how location and environmental factors, such as humidity and human foot traffic, affect those microorganisms over time.

    The researchers launched the project to coincide with the opening of a new UC hospital pavilion in January 2013. Before the new building opened, researchers swabbed its surfaces to collect samples of omnipresent microorganisms such as bacteria, fungi, and viruses.

    They collected samples from two nursing stations and sites across 10 hospital rooms in the building. And they continued collecting samples during the first year that the hospital admitted patients. The researchers also gathered microbe samples from the air in the hospital and from staff members' bodies. To monitor the number of people in the building both day and night, the researchers also collected environmental information such as humidity and carbon dioxide levels.

    In a separate part of the project, the researchers also gathered similar data from a single room in a U.S. Army hospital in Germany.

    Preliminary findings

    According to The Atlantic, the project's results have not yet been published.

    But Brent Stephens, a Hospital Microbiome Collaborator, said the presence of certain types of bacteria found on human skin increased after the hospital opened, including some types of staphylococcusstreptococcus, and corynebacterium. In contrast, the presence of Pseudomonas—which are less often found on skin and can cause bladder, wound, and lung infections—decreased.

    The findings align with prior research showing that interactions between humans and the hospitals environment foster the exchange of bacteria, Bond writes.

    "The ultimate goal is to be able to understand whether there are communities of microbes that can affect human health and what kinds of conditions go into creating those communities," Chase said (Bond, The Atlantic, 1/11).

    Why nurses are key to preventing never events

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    Across the country, one in ten patients get a hospital-acquired condition during their hospital stay. Katherine Virkstis explains why no one is better equipped to prevent never events than nurses.

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