An Agent-based Modeling Approach to Estimate Pathogen Exposure Risks from Wheelchairs
Curated from The American Journal of Infection Control
Amanda M. Wilson, MS Marc P. Verhougstraete, Ph.D., Curtis J. Donskey, MD, Kelly A. Reynolds, Ph.D.
Published: June 27, 2020DOI:https://doi.org/10.1016/j.ajic.2020.06.204
Highlights Abstract; Consistent disinfection between wheelchair rides can protect future riders
- Efficacy of disinfection intervention depends on contamination magnitude
- Higher exposure reductions are seen when fewer patients are infected
Abstract Background
Contributions of contaminated wheelchairs to nosocomial pathogen transmission are relatively unknown. We aimed 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 ( C. difficile) and methicillin-resistant Staphylococcus aureus (MRSA) 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 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 an outbreak, high contamination conditions, disinfection, alone, is not enough to protect patients from wheelchair-mediated exposures.
Keywords
- difficile, MRSA, portable equipment, infection control, wheelchairs, fomites
Curated from The American Journal of Infection Control
