Background: Contributions of contaminated wheelchairs to nosocomial pathogen transmission are relatively unknown. Our aim was 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 and methicillin-resistant Staphylococcus aureus 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 in 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 outbreak, high contamination conditions, disinfection, alone, is not enough to protect patients from wheelchair-mediated exposures.
Keywords: C difficile; Fomites; Infection control; MRSA; Portable equipment.
Copyright © 2020 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.