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. 1975 Dec;75(3):445–474. doi: 10.1017/s0022172400024505

Airborne infection in a fully air-conditioned hospital. IV. Airborne dispersal of Staphylococcus aureus and its nasal acquisition by patients.

O M Lidwell, B Brock, R A Shooter, E M Cooke, G E Thomas
PMCID: PMC2130366  PMID: 1059710

Abstract

Studies in a newly built hospital furnished with complete air conditioning where most of the patients are nursed in 6-bed rooms showed that the transfer of air from one patient room to another was very small, especially when there was substantial flow of air in a consistent direction between the patient rooms and the corridor, and that the direct transfer of airborne particles was even less. There was, however, no evidence of any reduction in the rates of nasal acquisition of Staphylococcus aureus compared with those to be found in naturally ventilated hospitals. The numbers of Staph. aureus found in the air of a given room that appeared to have originated from patient carriers in other rooms were many times greater than could be accounted for by direct airborne transfer. Although there was evidence that many carriers were not detected, detailed study showed that this excess transfer to the air of other rooms was genuine. It seems probable on the basis of investigations in this hospital and elsewhere that this excess transfer occurs indirectly, through dispersal from the clothing of the nursing and medical staff into the air of another room of strains with which their outer clothes have become contaminated while dealing with patients. Reduction in direct airborne transfer of micro-organisms from one room to another, whether by ventilation or other means, can only be of clinical advantage if transfer by other routes is, or can be made, less than that by the direct airborne route.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BOE J., SOLBERG C. O., VOGELSANG T. M., WORMNES A. PERINEAL CARRIERS OF STAPHYLOCOCCI. Br Med J. 1964 Aug 1;2(5404):280–281. doi: 10.1136/bmj.2.5404.280. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. DAVIES R. R., NOBLE W. C. Dispersal of bacteria on desquamated skin. Lancet. 1962 Dec 22;2(7269):1295–1297. doi: 10.1016/s0140-6736(62)90849-8. [DOI] [PubMed] [Google Scholar]
  3. Foord N., Lidwell O. M. Airborne infection in a fully air-conditioned hospital. I. Air transfer between rooms. J Hyg (Lond) 1975 Aug;75(1):15–30. doi: 10.1017/s0022172400047033. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Foord N., Lidwell O. M. Airborne infection in a fully air-conditioned hospital. II. Transfer of airborne particles between rooms resulting from the movement of air from one room to another. J Hyg (Lond) 1975 Aug;75(1):31–44. doi: 10.1017/s0022172400047045. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hambraeus A. Transfer of Staphylococcus aureus via nurses' uniforms. J Hyg (Lond) 1973 Dec;71(4):799–814. doi: 10.1017/s0022172400023068. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Infections acquired in medical wards. A report from the Public Health Laboratory Service. J Hyg (Lond) 1965 Dec;63(4):457–477. doi: 10.1017/s0022172400045356. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. KINGSTON D., LIDWELL O. M., WILLIAMS R. E. The epidemiology of the common cold. III. The effect of ventilation, air disinfection and room size. J Hyg (Lond) 1962 Sep;60:341–352. doi: 10.1017/s0022172400020453. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Lidwell O. M., Davies J., Payne R. W., Newman P., Williams R. E. Nasal acquisition of Staphylococcus aureus in partly divided wards. J Hyg (Lond) 1971 Mar;69(1):113–123. doi: 10.1017/s002217240002132x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Lidwell O. M., Polakoff S., Davies J., Hewitt J. H., Shooter R. A., Walker K. A., Gaya H., Taylor G. W. Nasal acquisition of Staphylococcus aureus in a subdivided and mechanically ventilated ward: endemic prevalence of a single staphylococcal strain. J Hyg (Lond) 1970 Sep;68(3):417–433. doi: 10.1017/s0022172400042327. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Lidwell O. M., Polakoff S., Jevons M. P., Parker M. T. Staphylococcal infection in thoracic surgery: experience in a subdivided ward. J Hyg (Lond) 1966 Sep;64(3):321–337. doi: 10.1017/s0022172400040602. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Lidwell O. M., Towers A. G., Ballard J., Gladstone B. Transfer of micro-organisms between nurses and patients in a clean air environment. J Appl Bacteriol. 1974 Dec;37(4):649–656. doi: 10.1111/j.1365-2672.1974.tb00489.x. [DOI] [PubMed] [Google Scholar]
  12. Noble W. C. The dispersal of staphylococci in hospital wards. J Clin Pathol. 1962 Nov;15(6):552–558. doi: 10.1136/jcp.15.6.552. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. PARKER M. T., JOHN M., EMOND R. T., MACHACEK K. A. ACQUISITION OF STAPHYLOCOCCUS AUREUS BY PATIENTS IN CUBICLES. Br Med J. 1965 Apr 24;1(5442):1101–1105. doi: 10.1136/bmj.1.5442.1101. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Polakoff S., Richards I. D., Parker M. T., Lidwell O. M. Nasal and skin carriage of Staphylococcus aureus by patients undergoing surgical operation. J Hyg (Lond) 1967 Dec;65(4):559–566. doi: 10.1017/s0022172400046088. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. SHOOTER R. A., GIRLING J. A., MATTHIAS J. Q., WILLIAMS R. E. Staphylococcal infection in a medical ward. Br Med J. 1960 Jun 25;1(5190):1923–1924. doi: 10.1136/bmj.1.5190.1923. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. SHOOTER R. A., SMITH M. A., GRIFFITHS J. D., BROWN M. E., WILLIAMS R. E., RIPPON J. E., JEVONS M. P. Spread of staphylococci in a surgical ward. Br Med J. 1958 Mar 15;1(5071):607–613. doi: 10.1136/bmj.1.5071.607. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. SHOOTER R. A., THOM B. T., DUNKERLEY D. R., TAYLOR G. W., PARKER M. T., JOHN M., RICHARDS I. D. PRE-OPRATIVE SEGREGATION OF PATIENTS IN A SURGICAL WARD. Br Med J. 1963 Dec 21;2(5372):1567–1569. doi: 10.1136/bmj.2.5372.1567. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Smylie H. G., Davidson A. I., Macdonald A., Smith G. Ward design in relation to postoperative wound infection. I. Br Med J. 1971 Jan 9;1(5740):67–72. doi: 10.1136/bmj.1.5740.67. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Speers R., Jr, Shooter R. A., Gaya H., Patel N. Contamination of nurses' uniforms with Staphylococcus aureus. Lancet. 1969 Aug 2;2(7614):233–235. doi: 10.1016/s0140-6736(69)90003-8. [DOI] [PubMed] [Google Scholar]
  20. WILLIAMS R. E., JEVONS M. P., SHOOTE R. A., THOM B. T., NOBLE W. C., LIDWELL O. M., WHITE R. C., TAYLOR G. W. Isolation for the control of staphylococcal infection in surgical wards. Br Med J. 1962 Aug 4;2(5300):275–282. doi: 10.1136/bmj.2.5300.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. WILLIAMS R. E., JEVONS M. P., SHOOTER R. A., HUNTER C. J., GIRLING J. A., GRIFFITHS J. D., TAYLOR G. W. Nasal staphylococci and sepsis in hospital patients. Br Med J. 1959 Oct 10;2(5153):658–662. doi: 10.1136/bmj.2.5153.658. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Whyte W., Howie J. G., Eakin J. E. Bacteriological observations in a mechanically ventilated experimental ward and in two open-plan wards. J Med Microbiol. 1969 Aug;2(3):335–345. doi: 10.1099/00222615-2-3-335. [DOI] [PubMed] [Google Scholar]

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