Antimicrobial Curtains May Reduce Risk for Resistant Organism Transmission

Autor: Ethan Covey

Anesthesiology News

The use of certain antimicrobial curtains in hospital rooms has been found to greatly decrease the transmission of multidrug-resistant organisms (MDROs), according to a new study.

The researchers said this discovery might enable hospital staff to better manage the risk for infection among patients in their institutions (Infect Control Hosp Epidemiol 2019;40[2]:164-170). “This could be the source of transmission of MDROs within the health care setting,” said the study’s lead author Shik Luk, MD, in the Department of Pathology at Princess Margaret Hospital in Hong Kong.

The researchers worked with 10 hospitals in the Hong Kong Special Administration Region from November 2016 to November 2017. Two types of curtains were tested: a standard non-antimicrobial version; and antimicrobial curtain A (with built-in silver, hospital disposable curtain) and antimicrobial curtain B (with quaternary ammonium chlorides [QAC] plus polyorganosiloxane).

Each type was tested in rooms of patients with MDROs where antimicrobial curtains were changed upon discharge, and cubicles of a ward where antimicrobial curtains hung for three to six months, according to manufacturers’ recommendations. Culture samples were collected from each curtain twice per week for two weeks, and then weekly for the remainder of the study period.

Results showed that the standard curtain acquired MDROs within five days, but the median time to first contamination by MDROs was extended to 19 weeks for the antimicrobial curtains. In addition, the percentages of MDRO contamination were significantly lower for the antimicrobial curtains than the standard curtain: methicillin-resistant Staphylococcus aureus (MRSA), 0.5% vs. 24%; carbapenem-resistant Acinetobacter species, 0.2% vs. 22%; and multidrug-resistant Acinetobacter species, 0% vs. 13.2%.

Of note, whereas antimicrobial curtain B effectively reduced the microbial burden and MDRO contamination compared with the standard curtain, even after extended use, antimicrobial curtain A did not. “The efficacy of different brands of antimicrobial curtains can have a great variation,” Dr. Luk said.

In addition to reducing rates of infections, the investigators noted that use of such curtains may avert indirect hospital costs related to curtain changing and laundering. They estimated that the cost savings over a six-month period in an eight-bed cohort cubicle would be $1,476.39.

Dr. Luk was interested in further studies that would assess whether the use of antimicrobial curtains can decrease hospital acquisition of MDROs, or whether the use of such curtains could lead to the emergence of antimicrobial resistance.

The prospective pilot study tracked the contamination rate of 10 freshly laundered privacy curtains in the Regional Burns/Plastics Unit of the Health Services Center in Winnipeg, Canada. Even though the curtains had minimal contamination when they were first hung, the curtains that were hung in patient rooms became increasingly contaminated over time, and by day 14, 87.5% of the curtains tested positive for MRSA. In contrast, curtains that were not placed in patient rooms (controls) stayed clean for the entire 21 days.

None of the rooms where the curtains were placed were occupied by patients with MRSA. Four curtains were placed in a four-bed room; four were placed in two double rooms; and two controls were placed in areas without direct contact with patients or caregivers. The investigators obtained samples from areas where people touch curtains, suggesting that the increasing contamination resulted from direct contact.

By day 21, almost all curtains exceeded 2.5 CFU/cm², the requirement for food processing equipment cleanliness in some locations, such as the United Kingdom.