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Open hospital windows to cut risk of bacterial infection
Microbiologist says following Florence Nightingale's lead and throwing open ward windows will allow in microbes to compete with dangerous pathogens
22nd February 2012 - A microbiologist says hospital managers should take note of what Florence Nightingale said a century and a half ago - that open windows were the hallmark of a healthy ward.
Jack Gilbert, who works at Argonne National Laboratory, Illinois, in the US, puts forward the view that natural ventilation is good for health and that too much scrubbing and sanitising can eradicate 'good' microbes and allow dangerous pathogens to reign free in the hospital environment.
The British born microbiologist spoke recently at a meeting of the American Association for the Advancement of Science (AAAS) in Vancouver, Canada, where he raised the example of the 'lady of the lamp', who championed the virtues of good hospital ventilation in her Notes on Nursing of 1859. "She opened up all the windows in the Crimean War hospitals and did reduce the infection rate in her patients," Jack Gilbert tells BootsWebMD.
In his talk, he referred to a study published last month by Jessica Green of the University of Oregon, which found that air-conditioned hospitals, which were not naturally ventilated, had a less diverse population of microbes, but more hazardous pathogens.
In essence his argument is that when microbes are allowed to mix with others, they end up having to compete for resources. This suggests that there might be an explanation for the high number of infections from so-called 'super-bugs' when hospitals are subjected to scrupulous cleaning. Left without competition, it only takes a single 'bad' bacteria or microbe to undo all the good work done by hospital workers sanitising the environment.
'Good' microbe spray
Jack Gilbert says that preliminary experiments with mice suggest that wounds coated with a layer of 'good' bacteria can help stave off the harmful effects of dangerous ones. This raises the possibility of deliberately applying good microbes to cut infection rates. "There may be a role for having a microbiological spray that I could put on to surfaces to prevent infections developing," he says.
He continues: "In a surgical situation, the surgeon scrubs up, cleans himself thoroughly, and makes sure he has no bad organisms on him when he moves into the theatre." He adds that keeping the theatre very clean is key, but "maybe there's a role to have a solution that they use in the surgery which actually promotes this bacterial barrier, that could actually prevent pathogenic bacteria from infecting in the surgical environment".
None of this would have made much sense to Florence Nightingale, but perhaps her cutting-edge approach to Victorian nursing could still resonate in some of the modern thinking on hospital-borne infections.