Rethinking Sterile: The Hospital Microbiome

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Rethinking Sterile: The Hospital Microbiome

Abstract and Introduction

Introduction


When the University of Chicago's new hospital pavilion opened in February 2013, it looked pristine. Floors shone, and stainless steel gurneys gleamed in the new Center for Care and Discovery. Even after the doors opened and the first patients were admitted, surfaces still looked largely sterile. It was exactly as it seemed a hospital should be: as devoid of microbial life as humans could possibly make it.

Jack Gilbert's data told a different story. Gilbert, an environmental microbiologist at Argonne National Laboratory, and his platoon of graduate students, postdocs, and research assistants descended on the hospital several times each day, even before it opened to the public. Armed with cotton swabs, they focused their efforts on the floors devoted to surgery and oncology. Each team member took samples from floors, beds, linens, sinks, computers, nurses' stations, air vents, and more. If you could name it, Gilbert's team rubbed it with a cotton swab to obtain a small sample of the microbes living there.

They repeated this process several times a day for more than a year as part of the Hospital Microbiome Project, an $850,000 endeavor funded by the Alfred P. Sloan Foundation to learn more about the microbial community, or microbiome, in various hospital environments—how microorganisms transfer between humans and surfaces, and how the microbiomes develop over time. The researchers believe they can potentially reduce hospital-acquired infections by understanding the array of microorganisms that live in hospital environments, identifying the operational characteristics of buildings that influence these microbiomes, and tweaking indoor ecosystems to help prevent the spread of pathogens. A future portion of the study will involve in-depth analysis of the microbiome of a single room at an Army hospital in Germany over 16 months.

"When a pathogen invades, it doesn't do this in isolation; it does this in the context of thousands of other species," Gilbert says. "Very few studies have examined the rest of the communities that exist in hospitals."

A few researchers are beginning to look at hospitals as ecosystems unto themselves. "Scientists want to study the ecosystem of the hospital to understand which microbes show up where," says Jonathan Eisen, a microbial ecologist at the University of California, Davis.

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