Abstract
BackgroundIn recent years there has been renewed interest in the use of air ionizers to control the spread of infection in hospitals and a number of researchers have investigated the biocidal action of ions in both air and nitrogen. By comparison, the physical action of air ions on bacterial dissemination and deposition has largely been ignored. However, there is clinical evidence that air ions might play an important role in preventing the transmission of Acinetobacter infection. Although the reasons for this are unclear, it is hypothesized that a physical effect may be responsible: the production of air ions may negatively charge items of plastic medical equipment so that they repel, rather than attract, airborne bacteria. By negatively charging both particles in the air and items of plastic equipment, the ionizers minimize electrostatic deposition on these items. In so doing they may help to interrupt the transmission of Acinetobacter infection in certain healthcare settings such as intensive care units.MethodsA study was undertaken in a mechanically ventilated room under ambient conditions to accurately measure changes in surface potential exhibited by items of plastic medical equipment in the presence of negative air ions. Plastic items were suspended on nylon threads, either in free space or in contact with a table surface, and exposed to negative ions produced by an air ionizer. The charge build-up on the specimens was measured using an electric field mill while the ion concentration in the room air was recorded using a portable ion counter.ResultsThe results of the study demonstrated that common items of equipment such as ventilator tubes rapidly developed a large negative charge (i.e. generally >-100V) in the presence of a negative air ionizer. While most items of equipment tested behaved in a similar manner to this, one item, a box from a urological collection and monitoring system (the only item made from styrene acrylonitrile), did however develop a positive charge in the presence of the ionizer.ConclusionThe findings of the study suggest that the action of negative air ionizers significantly alters the electrostatic landscape of the clinical environment, and that this has the potential to cause any Acinetobacter-bearing particles in the air to be strongly repelled from some plastic surfaces and attracted to others. In so doing, this may prevent critical items of equipment from becoming contaminated with the bacterium.
Highlights
In recent years there has been renewed interest in the use of air ionizers to control the spread of infection in hospitals [1] and a number of researchers have investigated the biocidal action of ions in both air [2,3,4,5,6,7,8,9] and nitrogen [2,10]
The reasons for the results observed by Kerr et al [1] are unclear, it is hypothesized that the air ions may have negatively charged items of plastic medical equipment in the ward, such as patient ventilator tubes, so that they repelled, rather than attracted, airborne bacteria
Widespread aerial dissemination of bacteria is thought to occur within the clinical environment [15,16] due to activities such as bed making, and this has been implicated in a number of outbreaks of Acinetobacter infection [17,18,19]
Summary
In recent years there has been renewed interest in the use of air ionizers to control the spread of infection in hospitals and a number of researchers have investigated the biocidal action of ions in both air and nitrogen. The reasons for this are unclear, it is hypothesized that a physical effect may be responsible: the production of air ions may negatively charge items of plastic medical equipment so that they repel, rather than attract, airborne bacteria. By negatively charging both particles in the air and items of plastic equipment, the ionizers minimize electrostatic deposition on these items. The reasons for the results observed by Kerr et al [1] are unclear, it is hypothesized that the air ions may have negatively charged items of plastic medical equipment in the ward, such as patient ventilator tubes, so that they repelled, rather than attracted, airborne bacteria. In order to test this hypothesis we designed the experimental study to investigate the behaviour of items of plastic medical equipment in the presence of negative air ions and to assess the likely impact on the precipitation of airborne particles
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