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Association between nanoparticle-impregnated textiles and reduced ventilator-associated pneumonia rates in the ICU:
Diego R Falci1, Ariane Monteiro1, Leonardo Ferraz1
1Pontifical Catholic University of Rio Grande do Sul - PUCRS, São Lucas Hospital of PUCRS, Porto Alegre, Brazil.
Background:
Hospital clothing harbors bacteria causing healthcare-associated infections (HAIs). This study evaluated the association between silver, copper, and zinc oxide nanoparticle-impregnated textiles and HAI rates in an intensive care unit (ICU) setting.
Methods:
A quasi-experimental ecological study in a 25-bed tertiary ICU compared. HAI rates across a 15-month baseline and 15-month intervention period using Wilcoxon rank-sum tests, autoregressive integrated moving average (ARIMA) interrupted time-series analysis, and multivariable Poisson regression model adjusted for time trend, bundle compliance, hand hygiene and ventilator utilization ratio. Antimicrobial efficacy was assessed via standardized microbiological methods.
Results:
Patient characteristics did not differ between phases (SAPS3 P = .148). Ventilator-associated pneumonia (VAP) rates decreased from 4.84 to 2.36 events/1,000 ventilation-days (17 vs 7 events; Wilcoxon, P = .045). Poisson regression estimated a 49% reduction in VAP incidence rate (IRR = 0.51; 95% CI: 0.08-3.40; non-significant). ARIMA analysis did not detect a significant intervention effect (P = .817). Other HAI rates were unchanged. In vitro, bacterial reductions were 76.1% for Staphylococcus aureus, 52.4% for Escherichia coli, and 47.1% for Pseudomonas aeruginosa.
Conclusions:
Nanoparticle-impregnated textiles were feasibly implemented in an ICU and associated with reduced VAP rates. These hypothesis-generating findings support nanotechnology as a potential adjunct for HAI prevention, warranting future large-scale trials.
