Are There Bad ICU Rooms? Temporal Relationship between Patient and ICU Room Microbiome, and Influence on Vancomycin-Resistant Enterococcus Colonization

Abstract

This study found that intensive care unit (ICU) room microbial signatures diverged from their baseline quickly: within 2 weeks, individual ICU rooms had lost distinguishing characteristics and were as similar to other ICU rooms as they were to their former selves. Patient turnover within rooms accelerated this drift.

Human microbiome and microbiota identification for preventing and controlling healthcare-associated infections: A systematic review

“…They also observed further correlations with the entrance of the new occupancy and activity explained in the rooms, which may represent the main cause of contamination from human-related microbial communities ( 71 ). As well as the previous study, also Freedberg et al highlighted, in their conclusions, that the microbial community in a healthcare setting may be altered by multiple environmental factors, such as seasonal shifts, solar exposure, and temperature ( 61 ). Another study focused on temporal variation is that of Schwab et al which evaluated the implications of seasonal variations specifically on nosocomial bloodstream infections (BSIs).…”

“…The rooms' microbiota slowly diverged from baseline and it appeared similar to that of neighboring rooms; however, the speed of this divergence seemed to be associated with the patients' turnover. Moreover, analyzing VRE-colonization, the authors confirmed environment-patient interactions, indeed when they showed a different VRE status in a time of 3/9 days both become VRE-positive ( 61 ).…”

“…Since the gut microbiota of an individual can shape the local environmental surfaces, Freedberg et al collected 304 samples from ICU patients at the time of ICU admission, 80 of which were defined as eligible to be compared with ICU rooms' microbiota. In addition to these evaluations, Enterococcaceae resulted to be overrepresented in all samples and vancomycin-resistant Enterococcus (VRE) was identified specifically in 28% of the eligible patients ( 61 ).…”

“…This further suggests the need to improve environmental hygiene by using a wider spectrum of cleaning or adding beneficial microbes that compete with the pathogenic ones, replacing them ( Figure 4 ). In addition, performing intermedia cleaning during patients' hospitalization rather than only terminal cleanings as proposed by Freedberg et al ( 61 ), or implementing cleaning procedures for those elements for which are not envisaged or, moreover, using instrumentation/structures/elements done with materials easier to clean as sustained by Gudokova et al ( 67 ) may be further aids to HAIs-bacteria management.…”