Impact of Passive Air Treatment on Microbial Contamination in a Controlled Chamber Environment

Abstract

Microbial pathogens commonly transmitted through the aerosol route to surfaces, equipment, and hands in the clinical setting leads to costly and life threatening hospital-acquired infections (HAIs). Even with improved hand hygiene and surface disinfection, HAIs continue to persist in healthcare environments, warranting consideration of novel interventions to reduce the transmission risk of HAIs. This study quantitated the efficacy of ion generating passive air treatment (PAT) against viruses (MS2), bacteria (Escherichia coli), and bacterial spores (Bacillus thuringiensis) in a controlled environmental setting. Microorganisms were seeded into a 2.72 m3 chamber using a positive pressure nebulizing device to generate aerosolized droplets. The PAT unit was then turned on and seeded organisms were collected at various time points using impingers to concentrate the organisms into sterile aqueous solution. The microorganisms were enumerated using approved standard protocols developed in the Environment, Exposure Science, and Risk Assessment Center's laboratory at The University of Arizona. Three experiments were conducted to challenge the PAT unit. Experiment one evaluated the efficacy of the PAT unit over a single 10-minute period on microbial inactivation from the airborne environment following a single seeding; additionally, experiment one aimed to determine the efficacy of the PAT unit against viruses, bacteria, and bacterial spores on environmental surfaces; experiment two evaluated the efficacy of the PAT unit running continuously over a period of 6 hours following a single seeding; and experiment three evaluated the efficacy of the PAT unit running two continuously over a period of 5.25 hours following two seeding events. Bacterial spores from pre- and post-treatment with the PAT unit were collected and analyzed by scanning electron microscopy to assess structural differences. After a single seeding and 10 minutes of continuous treatment of the PAT unit, normalized average microbial log10 reductions of post-treatment compared to pre-treatment air concentrations were 1.67, 0.59, and 1.04 for MS2, B. thuringiensis spores, and E. coli, respectively. Differences in average log10 reductions between the control unit and the PAT unit were statistically significant for MS2 (p=0.009) and B. thuringiensis (p=0.0455), but not for E. coli (p=0.0565). The geometric mean log10 surface concentrations of MS2, B. thuringiensis, and E. coli after a single seeding and 10 minutes of continuous treatment of the PAT unit were 7.30 PFU/100 cm2, 5.90 CFU/100 cm2, and 2.74 CFU/100 cm2, respectively, compared to exposure of the control unit, 8.59 PFU/100 cm2, 6.03 CFU/100 cm2, and 4.96 CFU/100 cm2, respectively. There was a statistically significant difference between the mean log10 surface concentrations following 10 minutes of treatment with the control unit compared to the PAT unit for E. coli (p=0.002), but not for MS2 (p=0.3358) or B. thuringiensis (p=0.0866). After a single seeding and 6-hours of continuous treatment of the PAT unit, normalized average microbial log10 reductions of MS2 and B. thuringiensis were 1.43 and 1.32, respectively. The difference in average log10 reduction of all post-treatment samples between the control unit and the PAT unit was statistically significant for B. thuringiensis (p=0.0008) but not for MS2 (p=0.2568). After two seedings and 5.25 hours of continuous treatment of the PAT unit, normalized average microbial log10 reductions of MS2 and B. thuringiensis were 1.59 and 1.26, respectively. There was a statistically significant difference in the average log10 reductions between the control unit and the PAT unit for MS2 (p=0.002) and B. thuringiensis (p=0.0003). Scanning electron microscopy analysis identified visual modification to B. thuringiensis spores following treatment with the PAT unit. In this study, the tested ion generating PAT unit was effectively able to reduce airborne microbial concentrations between 1-2 log10 in a controlled chamber environment within 10 minutes and up to 6 hours of treatment. The implications of this study suggest that ion producing PAT systems may represent a beneficial supplement to cleaning and disinfection practices in the reduction of pathogen contamination from the airborne and fomite-airborne routes.