Related Experiment Videos
Isolation care of infection-prone burn patients
Abstract:
An experimental and clinical study of spread of colonisation between burn patients, and their susceptibility to infection, was performed. Burn patients' polymorphonuclear neutrophil granulocytes (PMN) functioned poorly, particularly during the second week after injury which coincided with maximum growth of bacteria in the burn wound. Patients with large burns often dispersed S. aureus and Ps. aeruginosa but also beta-hemolytic Streptococcus to the air of their rooms. Airborne transfer of these bacteria was practically eliminated by nursing in single isolation rooms with plenum ventilation. In such rooms, cross-contamination was carried mainly via clothes. Patients with small burns sometimes were important sources of such contamination although they dispersed little bacteria to the air. A thorough change of barrier dress after close contact nursing delayed the first exogenous S. aureus colonisation until after the time of greatest impairment in PMN functions. A further reduction in cross-contamination would be possible with barrier garments impermeable to fluids and bacteria on points of contact, as shown in experiments with plastic apron as protective dress. Measurements of penetration through fabrics of particles suspended in air, commercially used, did not correlate to the performance of garments made from the fabrics in experimental nursing and clinical use. Bacteria were shown to penetrate fabrics through rubbing, particularly when wet where the microcolonies present on the cloth were separated into smaller units. An instrument was designed which measured such penetration, and was used to select fabrics for barrier garments. Tightly fitting barrier garments increased the disperal of bacteria from clothes worn underneath them. The wearing of barrier garments should therefore be restricted to close contact nursing. An open-roofed plastic patient isolator was designed and built. It did not appreciably reduce cross-contamination and gave psychological and practical problems. It seemed not to be a realistic alternative to better protective garments in isolation rooms.
Insights
Burn patients with impaired immune function spread bacteria. Isolation rooms and fluid-impermeable barrier garments effectively reduced cross-contamination, enhancing patient safety and infection control.
Area of Science:
- Infection Control
- Burn Patient Care
- Microbiology
Background:
- Burn patients exhibit impaired polymorphonuclear neutrophil granulocyte (PMN) function, particularly during the second week post-injury, coinciding with peak bacterial growth in wounds.
- Patients with extensive burns can disperse pathogenic bacteria like Staphylococcus aureus, Pseudomonas aeruginosa, and beta-hemolytic Streptococcus into the environment.
Purpose of the Study:
- To investigate the spread of colonization and infection susceptibility in burn patients.
- To evaluate methods for reducing bacterial cross-contamination in burn units.
Main Methods:
- Experimental and clinical observations of bacterial dispersion and colonization in burn patients.
- Assessment of isolation room effectiveness and barrier garment performance in preventing cross-contamination.
- Development and utilization of an instrument to measure fabric penetration by bacteria.
Main Results:
- Single isolation rooms with plenum ventilation significantly reduced airborne bacterial transfer.
- Cross-contamination in isolation rooms was primarily mediated by clothing; fluid-impermeable barrier garments further reduced transfer.
- Tightly fitting garments increased bacterial dispersal from underlying clothing, suggesting restricted use during close contact nursing.
Conclusions:
- Optimized isolation environments and appropriate barrier garments are crucial for minimizing cross-contamination in burn care.
- Careful selection of barrier fabrics and judicious use of garments are essential for effective infection control.
- Patient isolators, as tested, did not offer a practical alternative to improved garment technology and isolation rooms.