Bioaerosol concentrations generated from toilet flushing in a hospital-based patient care setting

Antimicrobial Resistance and Infection Control

Volumn 7, Issue 1, 2018, Pages

  Knowlton, Samantha D ^a   Boles, Corey L ^a   Perencevich, Eli N ^a,b   Diekema, Daniel J ^a,b   Nonnenmann, Matthew W ^a  

^a UNIVERSITY OF IOWA   (United States)

^b UNIVERSITY OF IOWA HEALTH CARE   (United States)

Author keywords

Aerosol; Bacteria; Bioaerosol; Exposure; Flushing; Health care; Infection; Toilet

Indexed keywords

AIR SAMPLING; AIRBORNE PARTICLE; ARTICLE; BIOAEROSOL; CONCENTRATION (PARAMETERS); DISEASE ASSOCIATION; DISEASE TRANSMISSION; FECES; HUMAN; INFECTIOUS AGENT; PARTICLE SIZE; PATIENT CARE; PRIORITY JOURNAL; TOILETING; ADVERSE DEVICE EFFECT; AEROSOL; BACTERIUM; BATHROOM EQUIPMENT; HOSPITAL; HOSPITAL EQUIPMENT; INDOOR AIR POLLUTION; MEDICAL DEVICE CONTAMINATION; MICROBIOLOGY; SANITATION; TIME FACTOR; UNITED STATES;

AEROSOLS; AIR MICROBIOLOGY; AIR POLLUTION, INDOOR; BACTERIA; BATHROOM EQUIPMENT; EQUIPMENT AND SUPPLIES, HOSPITAL; EQUIPMENT CONTAMINATION; HOSPITALS; HUMANS; PATIENT CARE; TIME FACTORS; TOILET FACILITIES; UNITED STATES; WATER MICROBIOLOGY;

EID: 85041092717     PISSN: None     EISSN: 20472994     Source Type: Journal    
DOI: 10.1186/s13756-018-0301-9     Document Type: Article

References (37)

1. Klevens RM, Edwards JR, Richards CL Jr, Horan TC, Gaynes RP, Pollock DA, Cardo DM. Estimating health care-associated infections and deaths in US hospitals, 2002. Public Health Rep. 2007;122(2):160-6.
2. Hassan M, Tuckman HP, Patrick RH, Kountz DS, Kohn JL. Cost of hospital-acquired infection. Hosp Top. 2010;88:82-9.
3. Essentials of Public Reporting of Healthcare-Associated Infections: A Tool Kit [ http://www.cste2.org/webpdfs/06107498EssentialsToolKit.pdf ]. Access 15 May 2017.
4. Levy SB. Factors impacting on the problem of antibiotic resistance. J Antimicrob Chemother. 2002;49:25-30.
5. Huslage K, Rutala WA, Weber DJ. A quantitative approach to defining "high-touch" surfaces in hospitals. Infect Control Hosp Epidemiol. 2010;31:850-3.
6. Weinstein RA, Hota B. Contamination, disinfection, and cross-colonization: are hospital surfaces reservoirs for nosocomial infection? Clin Infect Dis. 2004;39:1182-9.
7. Io M. Emerging infections: microbial threats to health in the United States. Washington, DC: The National Academies Press; 1992.
8. Otter JA, Yezli S, French GL. The role played by contaminated surfaces in the transmission of nosocomial pathogens. Infect Control Hosp Epidemiol. 2011;32:687-99.
9. Weber DJ, Rutala WA, Miller MB, Huslage K, Sickbert-Bennett E. Role of hospital surfaces in the transmission of emerging health care-associated pathogens: norovirus, Clostridium Difficile, and Acinetobacter species. Am J Infect Control. 2010;38:S25-33.
10. Fekety R, Kim K-H, Brown D, Batts DH, Cudmore M, Silva J. Epidemiology of antibiotic-associated colitis: isolation of Clostridium Difficile from the hospital environment. Am J Med. 1981;70:906-8.
11. Drees M, Snydman DR, Schmid CH, Barefoot L, Hansjosten K, Vue PM, Cronin M, Nasraway SA, Golan Y. Prior environmental contamination increases the risk of acquisition of vancomycin-resistant enterococci. Clin Infect Dis. 2008;46:678-85.
12. Malamou-Ladas H, O'farrell S, Nash J, Tabaqchali S. Isolation of Clostridium Difficile from patients and the environment of hospital wards. J Clin Pathol. 1983;36:88-92.
13. Neely AN, Maley MP. Survival of enterococci and staphylococci on hospital fabrics and plastic. J Clin Microbiol. 2000;38:724-6.
14. Shaughnessy MK, Micielli RL, DePestel DD, Arndt J, Strachan CL, Welch KB, Chenoweth CE. Evaluation of hospital room assignment and acquisition of Clostridium Difficile infection. Infect Control Hosp Epidemiol. 2011;32:201-6.
15. Best EL, Fawley WN, Parnell P, Wilcox MH. The potential for airborne dispersal of Clostridium Difficile from symptomatic patients. Clin Infect Dis. 2010;50:1450-7.
16. Sudharsanam S, Swaminathan S, Ramalingam A, Thangavel G, Annamalai R, Steinberg R, Balakrishnan K, Srikanth P. Characterization of indoor bioaerosols from a hospital ward in a tropical setting. Afr Health Sci. 2012;12:217-25.
17. Roberts K, Smith CF, Snelling AM, Kerr KG, Banfield KR, Sleigh PA, Beggs CB. Aerial dissemination of Clostridium Difficile spores. BMC Infect Dis. 2008;8:1.
18. Li C-S, Hou P-A. Bioaerosol characteristics in hospital clean rooms. Sci Total Environ. 2003;305:169-76.
19. Pastuszka J, Marchwinska-Wyrwal E, Wlazlo A. Bacterial aerosol in Silesian hospitals: preliminary results. Pol J Environ Stud. 2005;14:883.
20. Greene V, Vesley D, Bond R, Michaelsen G. Microbiological contamination of hospital air I. Quantitative studies. Appl Microbiol. 1962;10:561-6.
21. Augustowska M, Dutkiewicz J. Variability of airborne microflora in a hospital ward within a period of one year. Ann Agric Environ Med. 2006;13:99-106.
22. Darlow H, Bale W. Infective hazards of water-closets. Lancet. 1959;273:1196-200.
23. Newsom S. Microbiology of hospital toilets. Lancet. 1972;300:700-3.
24. Mendes MF, Lynch DJ. A bacteriological survey of washrooms and toilets. J Hyg. 1976;76:183-90.
25. Johnson D, Lynch R, Marshall C, Mead K, Hirst D. Aerosol generation by modern flush toilets. Aerosol Sci Technol. 2013;47:1047-57.
26. Gerba CP, Wallis C, Melnick JL. Microbiological hazards of household toilets: droplet production and the fate of residual organisms. Appl Microbiol. 1975;30:229-37.
27. Best EL, Sandoe J, Wilcox M. Potential for aerosolization of Clostridium Difficile after flushing toilets: the role of toilet lids in reducing environmental contamination risk. J Hosp Infect. 2012;80:1-5.
28. Jessen C: Luftbarne mikroorganismer forekomst og bekaempelse [in danish]. Copenhagen; 1955.
29. Barker J, Jones M. The potential spread of infection caused by aerosol contamination of surfaces after flushing a domestic toilet. J Appl Microbiol. 2005;99:339-47.
30. Macher JM. Positive-hole correction of multiple-jet impactors for collecting viable microorganisms. Ann Agric Environ Med. 1989;50:561-8.
31. ACGIH. Bioaerosols: assessment and control. ACGIH: Cincinnati; 1999.
32. Hinds WC: Aerosol technology: properties, behavior, and measurement of airborne particles. 2: New York: Wiley; 1999.
33. Möhler O, Georgakopoulos DG, Morris CE, Benz S, Ebert V, Hunsmann S, Saathoff H, Schnaiter M, Wagner R. Heterogeneous ice nucleation activity of bacteria: new laboratory experiments at simulated cloud conditions. Biogeosciences. 2008;5:1425-35.
34. Bauer H, Giebl H, Hitzenberger R, Kasper-Giebl A, Reischl G, Zibuschka F, Puxbaum H. Airborne bacteria as cloud condensation nuclei. J Geophys Res. 2003;108(D21):4658. https://doi.org/10.1029/2003JD003545.
35. Willshaw GA, Thirlwell J, Jones AP, Parry S, Salmon RL, Hickey M. Vero cytotoxin-producing Escherichia Coli O157 in beefburgers linked to an outbreak of diarrhoea, haemorrhagic colitis and haemolytic uraemic syndrome in Britain. Lett Appl Microbiol. 1994;19:304-7.
36. Nonnenmann M, Bextine B, Dowd S, Gilmore K, Levin J. Culture-independent characterization of bacteria and fungi in a poultry bioaerosol using pyrosequencing: a new approach. J Occup Environ Hyg. 2010;7:693-9.
37. O'Brien KM, Chimenti MS, Farnell M, Tabler T, Bair T, Bray JL, Nonnenmann MW. High throughput genomic sequencing of bioaerosols in broiler chicken production facilities. Microb Biotechnol. 2016;9:782-91.