1st Edition

Hospital Airborne Infection Control

By Wladyslaw Kowalski Copyright 2012
    370 Pages 55 B/W Illustrations
    by CRC Press

    370 Pages 55 B/W Illustrations
    by CRC Press

    Although nosocomial, or hospital-acquired, infections have been well cataloged and are fairly well understood, traditional solutions have failed to completely eliminate the problem. Even the most modern hospitals find themselves stymied by the persistence of these pathogens in hospital wards and operating rooms. The degree to which most of these infections are airborne is not known, but a growing body of evidence indicates that airborne transmission plays a role in many hospital-acquired infections.

    Addressing one of the most important topics in health care, Hospital Airborne Infection Control is the first book to deal with the control of airborne nosocomial infections in detail. It identifies all pathogens known or suspected to be airborne, along with their sources in hospital environments. It also summarizes all epidemiological evidence for airborne transmission. The text addresses respiratory, surgical site, burn wound, immunocompromised, pediatric, nursing home, and non-respiratory infections. In each category, an extensive number of examples show that inhalation is not the only airborne route by which infections may be transmitted.

    Noting that airborne transmission and surface contamination are virtually inseparable, the author emphasizes that both air and surface disinfection, including hand hygiene, are important factors in controlling the transmission of airborne disease. He also proposes a variety of new solutions and technologies, including ultraviolet, ionization, ozone, plasma, and vegetative air cleaning systems. A compendium of scientific and medical information, this book helps hospitals control nosocomial infections and outbreaks spread by the airborne route as well as by direct contact and contact with fomites or contaminated equipment.

    Airborne Nosocomial Infections
    Introduction
    Nosocomial Infection Epidemiology
    Airborne Nosocomial Pathogens
    Airborne Infection Categories
    Infection Control Precautions
    Infections in Health Care Workers
    Multidrug Resistance
    Toward Airborne Infection Control
    References

    Airborne Nosocomial Epidemiology
    Introduction
    Airborne Transmission Routes
    Epidemiological Principles
    Dosimetry of Airborne Disease
    Survival of Microbes Outside the Host
    Settling of Microbes in Air
    References

    Hospital Aerobiology
    Introduction
    Airborne Levels of Bacteria
    Airborne Levels of Fungal Spores
    Airborne Virus Levels
    References

    Airborne Nosocomial Microorganisms
    Introduction
    Airborne Nosocomial Pathogens
    Airborne Nosocomial Bacteria
    Airborne Nosocomial Viruses
    Airborne Nosocomial Fungi
    Database of Airborne Nosocomial Pathogens
    References

    Airborne Nosocomial Etiology
    Introduction
    Pathogen Aerosolization
    Aerobiological Pathways
    Airborne Transmission of Respiratory Infections
    Airborne Transport of Fungal Spores
    Shedding of Bacteria
    Shedding of Clostridium difficile Spores
    References

    Hospital Facilities
    Introduction
    Hospital Ventilation and Filtration Systems
    Hospital Zones and Rooms
    Pressurization Control
    References

    Ventilation and Dilution
    Introduction
    Ventilation Dilution
    The Steady State Model
    Transient Modeling
    Multizone Transient Modeling
    References

    Air Filtration
    Introduction
    Filters and Performance Curves
    Filtration of Airborne Nosocomial Pathogens
    HEPA and ULPA Filters
    Face Masks and Respirators
    References

    Hospital Disinfection
    Introduction
    Cleaning, Disinfection, and Sterilization
    Decontamination Methods
    Disinfectants and Antiseptics
    Disinfection of the Inanimate Environment
    References

    Hand Hygiene
    Introduction
    Skin Flora
    Etiology of Hand Contamination
    Strategies of Hand Hygiene
    Skin Antiseptics
    Handwashing Protocols
    Generic Handwashing Protocol
    References

    Respiratory Infections
    Introduction
    Respiratory Tract Infections (RTIs)
    Nosocomial Respiratory Infections
    Nosocomial Pneumonia
    Nosocomial Tuberculosis
    References

    Surgical Site Infections
    Introduction
    SSI Microbes
    Aerobiology of Operating Rooms
    Airborne SSIs
    Airborne SSI Etiology
    Control of Airborne SSIs
    References

    ICUs and Patient Rooms
    Introduction
    Intensive Care Units
    Patient Rooms and General Wards
    Hospital Laboratories
    Other Hospital Areas
    References

    Pediatric Nosocomial Infections
    Introduction
    Pediatric Bacterial Infections
    Pediatric Viral Infections
    Nurseries and Childcare Facilities
    References

    Immunocompromised and Burn Wound Infections
    Introduction
    Immunodeficiency Infections
    Burn Wound Infections
    Cancer Clinics
    References

    Nursing Homes
    Introduction
    Nursing Home Bacterial Infections
    Nursing Home Viral Infections
    Nursing Home Options
    References

    Procedural Controls and Guidelines
    Introduction
    Hygiene and Disinfection Procedures and Controls
    Infection Management Procedures
    Building and Facility Guidelines
    References

    Air and Surface Sampling
    Introduction
    Air Sampling with Settle Plates
    Air Sampling with an Air Sampler
    Surface Sampling
    Virus Detection and Sampling
    Air and Surface Disinfection Standards
    References

    UVGI Air Disinfection
    Introduction
    Airstream Disinfection
    Air Handling Units
    Recirculation Units
    Upper-Room Systems
    Barrier Systems
    UV Air Disinfection Field Trials
    Combination of UV and Filtration
    References

    UVGI Surface Disinfection
    Introduction
    UVGI Surface Disinfection Modeling
    Equipment Disinfection
    Whole Room Disinfection
    Floor Disinfection
    Overhead Surgical Site UV Systems
    Cooling Coil Disinfection
    References

    Alternative Air Cleaning Technologies
    Introduction
    PCO Systems
    Ozone
    Ionization
    Plasma and Corona Systems
    Pulsed Light
    Passive Solar Exposure
    Vegetation Air Cleaning
    Material Selectivity
    References

    Appendix: Database of Airborne Nosocomial Pathogens

    Index

    Biography

    Wladyslaw Kowalski, PhD, PE, has authored numerous articles related to air cleaning technology, biodefense, and hospital air disinfection, and has authored books and contributed chapters on these subjects, including the ASHRAE HVAC Design Manual for Hospitals and Clinics. He consults with hospitals on indoor air quality issues, including mold and bacterial contamination problems, and investigates hospital infection problems using air and surface sampling. Dr. Kowalski designs air disinfection systems for hospitals and commercial buildings and speaks at international conferences on disease control and air cleaning topics. He is also secretary of the Air Treatment Group of the International Ultraviolet Association (IUVA). He is currently engaged in research on ultraviolet germicidal irradiation (UVGI) and is developing new types of UVGI air and surface disinfection systems for the health care industry.