Study doc­u­ments how a hos­pi­tal’s mi­cro­biome de­vel­ops

Modern Healthcare - - OUTLIERS ASIDES & INSIDES -

One hos­pi­tal’s germ his­tory could be another’s in­fec­tion-fight­ing trea­sure. A year­long study of mi­cro­bial di­ver­sity at the Univer­sity of Chicago Medicine’s new Cen­ter for Care and Dis­cov­ery tracked the fa­cil­ity’s mi­cro­biome as it de­vel­oped, aim­ing to de­ter­mine which en­vi­ron­men­tal fac­tors most af­fect mi­cro­bial com­mu­ni­ties within a hos­pi­tal.

Be­gin­ning two months be­fore the hos­pi­tal opened in Fe­bru­ary 2013, re­searchers with the Hos­pi­tal Mi­cro­biome Project took weekly sam­ples from 187 sites, more than 10,000 sam­ples in to­tal from pa­tients, staff, pa­tient rooms, nurses sta­tions, drains and vents.

“Be­fore it opened, the hos­pi­tal had a rel­a­tively low di­ver­sity of bac­te­ria,” study au­thor Jack Gil­bert, di­rec­tor of the Mi­cro­biome Cen­ter at the Univer­sity of Chicago, told the Chicago Tri­bune. Once the peo­ple ar­rived, “the bac­te­ria from their skin took over.”

On a pa­tient’s first day, germs tended to move from sur­faces to the pa­tient, but af­ter that germs moved from the pa­tient to the room, with a pa­tient’s germ makeup over­tak­ing the room in 24 hours. The study also found that the longer a pa­tient was in a room the more drug-re­sis­tant germs be­came.

Two find­ings were un­ex­pected. In the heat and hu­mid­ity of sum­mer, staff mem­bers shared more bac­te­ria with each other. Sec­ond, the ef­fect of treat­ments— an­tibi­otics, chemo­ther­apy or surgery—was min­i­mal.

In­tra­venous or oral an­tibi­otics had lit­tle ef­fect on the skin mi­cro­biome, Gil­bert told UChicagoNews. “But when a pa­tient re­ceived a top­i­cal an­tibi­otic, then, as ex­pected, it wiped out the skin mi­crobes.”

The study, pub­lished in May in the jour­nal Sci­ence Trans­la­tional Medicine, “may pro­vide con­text to fu­ture stud­ies of the trans­mis­sion of hos­pi­tal-ac­quired in­fec­tions,” the au­thors said.

The Univer­sity of Chicago’s Jack Gil­bert and his team doc­u­mented the mi­cro­bial di­ver­sity at the hos­pi­tal.

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