GERMS ON HOLD
Building walls against deadly microbes-literally
By Michelle Ciriacruz
In an age where the antibiotic resistance of pathogenic microbes is becoming a deadly problem. In a generation where prevention is starting to be seen as the real cure, as treatment and medicines do what they can but do little against the growing need for them. In a new century and a new millennium, but a time where places meant to fight diseases still spread diseases themselves.
These images connect, but not in the negative sense, for they could point to a solution but which has yet gained little support and awareness here.
In a sense, "hospital-acquired disease" is a contradiction in terms. People go to hospitals for medical care, for which they expect improved health. That hospitals could be responsible for making them sick, or sicker, would boggle the minds of most people who are not "in" on hospital-related dilemmas.
Hospitals, and other medical care institutions, however, are truly convenient vectors for pathogenic microorganisms, in the fact that we make them so by bringing our sick, sick of a variety and a multitude of diseases and ailments, in these places.
This is inevitable, but it can also be countered with strict safety guidelines, protocols, and adherence to discipline. Enlisting the help of our environment can also prevent it.
Which a British nurse in the mid-nineteenth century found out and took to practicing meticulously.
When Florence Nightingale, known for helping make medical care serve those who seek it and not do more ruin to them, was faced with the appalling state of nursing care in those days, she worked to make these concepts accepted.
A movie, starring Jaclyn Smith, recounted the challenges Nightingale had to overcome in her struggles to make medicine less harsh on its dependents.
In one of those challenges, she was faced with a string of casualties in her wards, strangely happening in the same bed. She was baffled, but where the medical doctors would just shrug at the seemingly dead end of their expertise, she looked into all possible angles for the answer.
She looked at the walls.
It was then that she hit on the idea that the very construction and design of a building could be making it easier for diseases to jump from one person to another.
She realized that the bed was right beside an air vent, where wounded-and therefore more vulnerable to infections-patients were breathing in air coming from the rooms below where patients with infectious diseases were being attended to.
She moved the bed away, and was rewarded with a reduced death rate in her wards.
What she did was practical and simple. We have gone a long way in techniques since then. Besides the sophisticated protocols for our protection against the infectious world, advances in the manufacture of antiseptics, devices with antimicrobial action, and walls that germs can't seem to cling to have not been lacking.
In so far as the case may be here, what is lacking is the awareness and advocacy of these systems.
Numerous studies have already verified the danger of pathogenic spores settling down or inside air-conditioning systems, out of sight niches in ceilings or walls, cracks in the floors, which could be dispersed if disturbed, especially by construction activities, and come into contact with patients or personnel.
Inept handling of infectious matter and lax observance of safety protocols are not just the chief culprits in nosocomial infections. Sometimes the very walls are guilty.
Microbes have a way of finding resting spaces where opportunities to their advantage eventually drop by.
Given the continuing incidence of nosocomial infection outbreaks in the country, more tools or weapons against them are obviously needed, which in industrialized countries, have been part of the armamentarium against infectious outbreaks for years, nay decades.
Air-conditioning filters and wall coatings with antimicrobial properties certainly would be very valuable as preventive measures.
The following are examples of these products or systems.
A filtration technology for air cleansing, developed by HBA laboratories, a company based in France, reportedly is effective against bacteria such as Staphylococcus aureus and Pseudomonas aeruginosa, or molds such as Candida albicans and Aspergillus niger.
And just as this filter is self-biodecontaminating, walls, or rather the paint or coating on them, could also be self-sterilizing.
The series of coatings designed by the England-based Construction Specialists Limited (C/S Group) is supposed to actively inhibit the buildup of any form of bacteria or fungi and is resistant to MRSA (methicillin-resistant staphylococcus aureus).
The formulation of these coatings turns out to be inimical to these microbes. Within one to five hours, the cell walls of microbial creatures that attach to the coating disintegrate, letting out the insides of the individual cells onto it, where they are also chemically destroyed.
The Institute of Biological Sciences of the University of the Philippines at Los Baños conducted an analysis of the antimicrobial action of the coatings.
Its report of analysis describes its method thus: "A slide coated with the sample was placed on a petri dish containing a thin layer of seeded agar medium. The slide was then overlaid with the same seeded agar medium to a depth of equal or less than one millimeter above the top of the slide. After 10 days of incubation at room temperature, the plates were observed for growth inhibition or extent of growth of the test organisms."
Of the 10 microorganisms tested (Staphylococcus aureus, Enterococcus faecalis, Escheriachia coli, Salmonella typhi, Pseudomonas aeruginosa, Bacillus subtilis, Saccharomyces cerevisiae, Aspergillus niger, Trichoderma harzianum, and Penicillium chrysogenum), only Enterococcus faecalis was seen to be unaffected by the coating.
The growth of all the rest was either inhibited or restricted.
Few hospitals or medical institutions here seem to have taken up these systems in their construction and design, however.
Dr. Arcadio Tamayo, medical director of the University of Perpetual Help Medical Center, explains that as much as hospitals would love to acquire these systems, cost is a primary deterrent. "The economics of that will have to be the determinant factor for hospital administrators," he says.
Convenience is also a major consideration. "If it's something like a floor wax or Lysol that you can spray and then prevent infection, and it's a one-time application-or once a year, then it may be considered," he continues.
Tamayo also hopes for more research to be done on the systems available now. "Ang mahirap dito, they really have to come out with more research material."
With more scientific studies, these systems would be seen as less of commercial products and more of a legitimate member of a hospital's preventive measures against nosocomial infections.
And the places where we go for treatment and cure could be more than just settings for these goals.
Buildings housing medical facilities are really just walls, floors, ceilings built from various construction materials. These are things that are designed to form into rooms, hallways, stairs, etc.
But they could be more than that.
They could be a solution to dilemma-our dilemma of keeping infection outbreaks in our medical facilities at bay.
Aseptic Coatings
Construction Specialists (UK) Limited manufactures nontoxic paints and coatings especially designed for buildings and facilities that need to be kept sterile. Among these are:
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Wallglaze. Used extensively for walls and ceilings to prevent colonization of Salmonella in food processing and preparation areas. The C/S Group says that the first special HIV-AIDS wards at the Middlesex Hospital in London were coated with Wallglaze to reduce the risk of secondary infection.
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Wallflex. For areas that require stringent hygiene maintenance such as category 1 and 2 laboratories, pharmaceutical rooms, operating theaters, and medical sterile areas. It uses elastopolymeric sealants around junctions and fixtures for a totally seamless system. The C/S Group says this eliminates cracks around interfaces that ordinarily becomes a potential breeding ground for bacteria.
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Wallshield. For periodically wet areas like laboratories, food preparation areas, showers and toilets.
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Armourglaze. For areas that require high chemical resistance and are subjected to aggressive cleaning, like category 3 and 4 laboratories, mortuaries, pharmaceutical clean rooms, and agricultural establishments.
The C/S Group is represented in the Philippines by Norfolk International.
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