Does Art spread Superbugs?

Superbugs in hospitals have everyone scared; and for good reason. Doctors and researchers fear that these bacteria may become entrenched in hospitals, threatening the very patients that go there for treatment.

Understanding Superbugs is important for Designers. Jain Malkin in her new book wrote: "Infection control is such a big issue today; it has to be the No. 1 thing that architects and designers understand."

To see if the art in hospitals might cause infections I contacted an expert: Mark D. Winton, MD. Dr. Winton is a board-certified specialist in infectious disease. When I worked as a Family Practice doctor I always referred the cases that stumped me to him. The following is based on an email interview we had this week:

Can art prints contribute in any meaningful way to the spread of hospital-acquired infections?

Not that I am aware of. They are no more potential fomites than the walls.

Should hospitals attempt to disinfect art prints? If so, how?

No disinfection is needed. The chance of art prints retaining resistant organisms is very small. The pigments in paint (and inks) tend to be antibacterial in nature.

How likely is other hospital art (sculpture, water walls, backlit panels, paintings) to contribute to hospital acquired infections?

Very low risk.

What are the major contributors to all hospital-acquired infections, especially with superbugs?

• Instrumentation (putting devices in patients)
• Poor hand washing

Based on the etiology, Urinary tract infections from Gram-Negative rods is common, and bloodstream infections by coagulase-negative Staphylococcus, Enteric GNR, and fungi, nosocomial pneumonias related to ventilators, it seems as if the major reason is instrumentation.

Hospital staff hands I would think would be common. Doctors are notorious for poor hand washing.

Overuse of antibiotics contributes.

Hospital equipment, such as foley catheters, IV catheters, thermometers and Blood Pressure cuffs.

Methicillin-resistant Staphylococcus aureus (MRSA) infections in the hospital seem to be related to invasive procedures, and to colonized hospital staff, rather than to floors, walls, sculptures, desk surfaces or glass doors.

Clostridium difficile spores tend to be gravity driven to collect on the floor, or carpets. They tend to be focused on the floors and beds in patient rooms, not in common areas like cafeterias or lobbies. I don't know of any outbreaks involving these areas.

Carpet can hold on to molds like Aspergillus, and can cause problems in immunocompromised hosts. We used to see a lot of carpet on the floors and walls in hospitals, but not so much any more.

The current issue of The New Yorker has an article called "Superbugs: The new generation of resistant infections is almost impossible to treat". click here to read it. That is where I found the illustration by Bruce McCall at the top of this post.

Note: there were many technical terms used in the interview. I've provided hyperlinks to explain them. Just click on the underlined words.

Comments

[Debra Harris, Ph.D.]

I agree with the sentiment of Jain Malkin’s comment that infection control is one of the most important things that architects and designers understand. In regard to Dr. Winton's comments - I sincerely hope we are not seeing a lot of carpet on the walls!

Seriously though, C. difficile and MRSA are indiscriminate when it comes to taking up residence on a surface and can live on those surfaces for weeks. I have collected data that showed bacteria residing on smooth flooring that was not found on adjacent carpeting in a patient corridor/nursing station area. Any floor or table or object in a patient room may harbor pathogens if not adequately cleaned and disinfected.

You have to remember that technology continues to press forward in spite of ourselves. Synthetic carpets (rolled goods and tiles) with non-permeable backings are successfully used in hospitals all across the country. Some hospitals prefer to use smooth surface flooring because they believe that it is more cleanable and is perceived to be more clean by those occupying the building.

However, there are other issues in regard to the indoor environment and attributes of various flooring materials to consider when specifying hospital flooring. Molds, like Aspergillus will grow on anything when the indoor environmental conditions are right and there is a food source. Again, proper maintenance is key to a healthy indoor patient environment.

[Odor]

The Food and Drug Administration (FDA) has notified manufacturers of fluoroquinolone antimicrobial drugs that a boxed warning on the increased risk of tendinitis and tendon rupture is necessary. A boxed warning on a drug's label calls attention to serious or life-threatening risks.