Airport door handles and the global spread of antimicrobial-resistant bacteria: a cross sectional study

Schaumburg, Frieder; Köck, Robin; Leendertz, Fabian H.; Becker, Karsten

doi:10.1016/j.cmi.2016.09.010

Cited by 16 publications

(10 citation statements)

References 5 publications

(5 reference statements)

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“…In addition, there are numerous highly contaminated surfaces that are frequently touched by passengers at airports and inside aircrafts (Ikonen et al., ). Self‐service check‐in screens, gate bench armrests, water fountain buttons and door handles at airports, as well as seats, tray tables, and handles of lavatories in aircrafts, are all known to have high microbial contamination (McKernan, Burge, Wallingford, Hein, & Herrick, ; Schaumburg, Köck, Leendertz, & Becker, ; Zhao et al., ).…”

Section: Introductionmentioning

confidence: 99%

Hand‐Hygiene Mitigation Strategies Against Global Disease Spreading through the Air Transportation Network

et al. 2019

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The risk for a global transmission of flu-type viruses is strengthened by the physical contact between humans and accelerated through individual mobility patterns. The Air Transportation System plays a critical role in such transmissions because it is responsible for fast and long-range human travel, while its building components-the airports-are crowded, confined areas with usually poor hygiene. Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) consider hand hygiene as the most efficient and cost-effective way to limit disease propagation. Results from clinical studies reveal the effect of hand washing on individual transmissibility of infectious diseases. However, its potential as a mitigation strategy against the global risk for a pandemic has not been fully explored. Here, we use epidemiological modeling and data-driven simulations to elucidate the role of individual engagement with hand hygiene inside airports in conjunction with human travel on the global spread of epidemics. We find that, by increasing travelers engagement with hand hygiene at all airports, a potential pandemic can be inhibited by 24% to 69%. In addition, we identify 10 airports at the core of a cost-optimal deployment of the hand-washing mitigation strategy. Increasing hand-washing rate at only those 10 influential locations, the risk of a pandemic could potentially drop by up to 37%. Our results provide evidence for the effectiveness of hand hygiene in airports on the global spread of infections that could shape the way public-health policy is implemented with respect to the overall objective of mitigating potential population health crises.

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Section: Introductionmentioning

confidence: 99%

Hand‐Hygiene Mitigation Strategies Against Global Disease Spreading through the Air Transportation Network

et al. 2019

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“…Recent microbiome and metagenome-based analyses support the notion that the surface microbiomes of human inhabited built environments are closely connected to the human microbiome (Afshinnekoo et al, 2015; Flores et al, 2011; Hsu et al, 2016; Lax et al, 2014; Meadow et al, 2014; Schaumburg et al, 2016). This raises the possibility that microbiological analysis of built environment surfaces could provide information of public health utility; for example the surface may serve as a sentinel for microbial species, strains, genes or gene variants of interest.…”

Section: Introductionmentioning

confidence: 89%

Primary health clinic toilet/bathroom surface swab sampling can indicate community profile of sexually transmitted infections

Giffard

Andersson

et al. 2017

PeerJ

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BackgroundThe microbiome of built environment surfaces is impacted by the presence of humans. In this study, we tested the hypothesis that analysis of surface swabs from clinic toilet/bathroom yields results correlated with sexually transmitted infection (STI) notifications from corresponding human populations. We extended a previously reported study in which surfaces in toilet/bathroom facilities in primary health clinics in the Australian Northern Territory (NT) were swabbed then tested for nucleic acid from the STI agents Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. This was in the context of assessing the potential for such nucleic acid to contaminate specimens collected in such facilities. STIs are notifiable in the NT, thus allowing comparison of swab and notification data.MethodsAn assumption in the design was that while absolute built environment loads of STI nucleic acids will be a function of patient traffic density and facility cleaning protocols, the relative loads of STI nucleic acids from different species will be largely unaffected by these processes. Another assumption was that the proportion of swabs testing positive for STIs provides a measure of surface contamination. Accordingly, “STI profiles” were calculated. These were the proportions that each of the three STIs of interest contributed to the summed STI positive swabs or notifications. Three comparisons were performed, using swab data from clinics in remote Indigenous communities, clinics in small-medium towns, and a single urban sexual health clinic. These data were compared with time and place-matched STI notifications.ResultsThere were significant correlations between swab and notifications data for the both the remote Indigenous and regional data. For the remote Indigenous clinics the p values ranged from 0.041 to 0.0089, depending on data transformation and p value inference method. Further, the swab data appeared to strongly indicate known higher relative prevalence of gonorrhoeae in central Australia than in northern Australia. Similarly, the regional clinics yielded p values from 0.0088–0.0022. In contrast, swab and notifications data from the sexual health clinic were not correlated.DiscussionStrong correlations between swab and notifications were observed. However, there was evidence for limitations of this approach. Despite the correlation observed with the regional clinics data, one clinic yielded zero positive swabs for C. trachomatis, although this STI constituted 25.1% of the corresponding notifications. This could be ascribed to stochastic effects. The lack of correlation observed for sexual health clinic data was also likely due to stochastic effects. It was concluded that toilet/bathroom surface swab sampling has considerable potential for public health surveillance. The approach may be applicable in situations other than primary health clinics, and for targets other than STIs.

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“…Recent microbiome and metagenome-based analyses support the notion that the surface microbiomes of human inhabited built environments are closely connected to the human microbiome (Afshinnekoo et al 2015;Flores et al 2011;Hsu et al 2016;Lax et al 2014;Meadow et al 2014;Schaumburg et al 2016). This raises the possibility that microbiological analysis of built environment surfaces could provide information of public health utility; for example the surface may serve as a sentinel for microbial species, strains, genes or gene variants of interest.…”

Section: Introductionmentioning

confidence: 97%

Peer Review #1 of "Primary health clinic toilet/bathroom surface swab sampling can indicate community profile of sexually transmitted infections (v0.1)"

2017

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Background. The microbiome of built environment surfaces is impacted by the presence of humans. In this study, we tested the hypothesis that analysis of surface swabs from clinic bathroom/toilets yields results correlated with sexually transmitted infection (STI) notifications from corresponding human populations. We extended a previously reported study in which surfaces in toilet/bathroom facilities in primary health clinics in the Australian Northern Territory (NT) were swabbed then tested for nucleic acid from the sexually transmitted infection (STI) agents Chlamydia trachomatis, Neisseria gonorrhoea and Trichomonas vaginalis. This was in the context of assessing the potential for such nucleic acid to contaminate specimens collected in such facilities. STIs are notifiable in the NT, thus allowing comparison of swab and notification data. Methods. An assumption in the design was that while absolute built environment loads of STI nucleic acids will be a function of patient traffic density and facility cleaning protocols, the relative loads of STI nucleic acids from different species will be largely unaffected by these processes. Another assumption was that the proportion of swabs testing positive for STIs provides a measure of surface contamination. Accordingly, "STI profiles" were calculated. These were the proportions that each of the three STIs of interest contributed to the summed STI positive swabs or notifications. Three comparisons were performed, using swab data from clinics in remote Indigenous communities, clinics in small-medium towns, and a single urban sexual health clinic. These data were compared with time and place-matched STI notifications. Results. There was significant correlations between swab and notifications data for the both the remote Indigenous and regional data. For the remote Indigenous clinics the p values ranged from 0.041 to 0.0089, depending on data transformation and p value inference method. Further, the swab data appeared to strongly indicate known higher relative prevalence of gonorrhoea in central Australia than in northern Australia. Similarly,

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Airport door handles and the global spread of antimicrobial-resistant bacteria: a cross sectional study

Cited by 16 publications

References 5 publications

Hand‐Hygiene Mitigation Strategies Against Global Disease Spreading through the Air Transportation Network

Hand‐Hygiene Mitigation Strategies Against Global Disease Spreading through the Air Transportation Network

Primary health clinic toilet/bathroom surface swab sampling can indicate community profile of sexually transmitted infections

Peer Review #1 of "Primary health clinic toilet/bathroom surface swab sampling can indicate community profile of sexually transmitted infections (v0.1)"

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