Influence of bed making on loads of airborne and surface-associated drug-resistant bacteria in patient rooms

• Published in: The Journal of hospital infection 2023-06, Vol.136, p.45-54
• Main Authors: Warnke, P., Pappisch, V.R., Frickmann, H., Podbielski, A.
• Format: Article
• Language: English
• Subjects: Airborne; Bacteria; Bed making; Humans; Methicillin-Resistant Staphylococcus aureus; Nosocomial; Patients' Rooms; Resistant; Staphylococcus; Staphylococcus aureus; Transmission
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2023.03.010

Limited information is available on the kinetics of airborne multi-drug-resistant bacteria after making patients' beds. Previous experience of bed making on loads of meticillin-resistant Staphylococcus aureus (MRSA) was re-evaluated with a substantial sample size and, for the first time, simultaneous examination of the environmental load of multi-drug-resistant Gram-negative bacteria (MDRGN) was undertaken. Airborne pathogen measurement was carried out in 26 rooms with patients with MRSA and 25 rooms with patients with MDRGN before (−1 min) and after (1 min, 15 min, 60 min) bed making at distances of 0 m and 3 m from the bed. Surface sampling was performed in the patients' surroundings. Factors of potential influence were recorded. Gram-positive non-pathogenic species dominated the air samples, while Gram-negative organisms constituted only 1.4%. Bed making shifted the proportions towards coagulase-negative staphylococci and S. aureus. A transient increase in MRSA in room air was detected in most samples 1 min and 15 min after bed making. MDRGN were detected in the air of two patient rooms. Surface samples showed that MRSA, but not MDRGN, was isolated regularly in the patient environment. Correlation between airborne and surface pathogen loads after bed making was demonstrated. The study results indicate the importance of wearing a face mask in combination with cautious handling techniques when making the beds of patients carrying multi-drug-resistant bacteria. If the carrier status of a patient is unknown, consideration should be given to protective measures for staff and other patients present during and shortly after bed making. Surface disinfection should not be started until at least 30 min after bed making.