An agent-based modeling approach to estimate pathogen exposure risks from wheelchairs.

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An agent-based modeling approach to estimate pathogen exposure risks from wheelchairs.

Am J Infect Control. 2020 Jun 27;:

Authors: Wilson AM, Verhougstraete MP, Donskey CJ, Reynolds KA

Abstract
BACKGROUND: Contributions of contaminated wheelchairs to nosocomial pathogen transmission are relatively unknown. Our aim was to develop a model predicting pathogen exposures for patients utilizing wheelchairs and estimate exposure reduction potential of wheelchair disinfection between rides.
METHODS: An agent-based model was informed by wheelchair location data from a connected 215-bed acute care and 250-bed long-term care facility. Simulated scenarios varied in frequencies of patient wheelchair contamination and wheelchair disinfection in between trips. Clostridioides difficile (C. difficile) and methicillin-resistant Staphylococcus aureus (MRSA) concentrations on patient hands at the end of wheelchair trips were estimated. Exposure reductions due to disinfection, assuming low real-world efficacies (50%, 70%, and 90%), were compared.
RESULTS: In the simulation, when few patients introduced contamination to wheelchairs, disinfection in between patients 50% of the time decreased baseline (no disinfection) estimated exposures for the 50th wheelchair rider by >99.999%. When patients had a 50% chance of being contaminated before the wheelchair ride, disinfection did not reduce exposures consistently.
DISCUSSION: The efficacy of disinfection in between patient rides as an exposure mitigation strategy likely depends on the frequency of infected patient wheelchair use.
CONCLUSIONS: During outbreak, high contamination conditions, disinfection, alone, is not enough to protect patients from wheelchair-mediated exposures.

PMID: 32603850 [PubMed - as supplied by publisher]