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.
Original language | English (US) |
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Pages (from-to) | 206-214 |
Number of pages | 9 |
Journal | American Journal of Infection Control |
Volume | 49 |
Issue number | 2 |
DOIs | |
State | Published - Feb 2021 |
Keywords
- C difficile
- Fomites
- Infection control
- MRSA
- Portable equipment
ASJC Scopus subject areas
- Epidemiology
- Health Policy
- Public Health, Environmental and Occupational Health
- Infectious Diseases