Consulting-Specifying Engineer - September 2007 - (Page 36)

Suggested Reading on Superbug Control By Michael G. Ivanovich, Editor-in-Chief While reading this article on superbugs, you probably have been wondering how to kill them. Designing infection control systems for hospitals requires integrating HVAC and air-pressure-control systems with dedicated infection-control systems, and minimizing unplanned airflows through building envelopes and interior spaces. It can also mean, as Forest Fencl describes in his sidebar on p. 34, applying ultraviolet germicidal lights. To help engineers research and apply infection-control systems, engineers can obtain the documents below as a starting point, and look to future articles in CSE. Design guides “Guideline for Hand Hygiene in Health-Care Settings,” Centers for Disease Control Mobidity and Morality Weekly Report, 25 Oct. 2002: 1-44. “Guidelines for design and construction of hospital and health care facilities,” American Institute of Architects (2006) Available at www.aia.org/aah_gd_hospcons. “Guidelines for Environmental Infection Control in Health Care Facilities,” Centers for Disease Control (2003) Available at www.cdc.gov/ncidod/dhqp/gl_environinfection.html. “HVAC design manual for hospitals and clinics,” American Society of Heating, Refrigerating and Air-Conditioning Engineers. (2003) Available at www.ashrae.org. Technical articles Fencl, Forrest B. “UVC Energy: How Does It Work?” HPAC Engineer ing (2007) Available at www.hpac.com. Kowalski, W. “Air-Treatment Systems for Controlling HospitalAcquired Infections,” HPAC Engineering (2007). Streifel, Andrew J. “Pressure Management in Health-Care Facilities,” HPAC Engineering (2006). Miscellaneous Hayden II, Charles S., G. Scott Earnest and Paul A. Jensen, “Development of an Empirical Model to Aid in Designing Airborne Infection Isolation Rooms,” Journal of Occupational and Environmental Hygiene (2007). March, David. “‘Superbug’ Outside Hospital Poses Risk to Caregivers Inside,” The JHU Gazette 18 Sept. 2006. Available at http://www jhu.edu/~gazette/2006/18sep06/18superb.html. Miller, Shelly, et. al. “Efficacy of Ultraviolet Irradiation in Controlling the Spread of Tuberculosis,” Centers for Disease Control and the National Institute for Occupational Safety and Health 19 Oct. 2002. Available at www.cdc.gov/niosh/reports/contract/pdfs/ ultrairrTB.pdf. Saravia, Stefan A., Peter C. Raynor and Andrew J. Streifel, “A performance assessment of airborne infection isolation rooms,” American Journal of Infection Control 35.5 (2007): 324-331. Continued from p.32 that are effective, dramatically reducing virus yields or providing good relief of symptoms in patients, but the drugs ultimately have limited usefulness, because viruses that escape the initial inhibition are frequently drug-resistant (Huang, 2005). The rapid development of drug resistance by retroviruses and RNA viruses is due to their high mutation rates. That is, viruses can mutate into viruses faster than new vaccines can be developed. Indeed, it is not unreasonable to propose that the large diversity of RNA viruses is in large part due to their high mutation rates, which allow them to mutate and adapt to new niches very rapidly. A recent report on the global prevalence of adamantane-resistant influenza A viruses indicated a significant increase of drug resistance, from 1.8% during the 2001-02 influenza season to 12.3% during the 2003-04 season (Bright et al, 2005). Vaccines can become ineffective due to slight changes in the viruses. Over the past decade, the increasing incidence of serious fungal infections, along with increased antifungal drug use, has led to the emergence of drug-resistant fungal pathogens. Antifungal drug resistance has been reported by a number of researchers in pathogenic fungi including Histoplasma capsulatum, Cryptococcus neoformans, and other fungal species (VandenBossche et al, 1998). Although such fungal infections are not normally nosocomial, they are associated with human immunodeficiency virus (HIV) and, also illustrate how hospital treatment may enhance some community-acquired infections. Antifungal drug resistance has become an increasing problem with the development of a larger compendium of antifungal agents. Fungal diseases are increasing among patients infected with (HIV) type 1. Increasing evidence suggests that prolonged use of these antifungal drug treatments results in both clinical and microbiologic resistance (Ampel et al, 1996). Community spread Microbes that exist environmentally or as endogenous microflora in humans may develop drug resistance and when such infections hail from the community rather than from hospitals, they are referred to as community-acquired infections. Increasing drug resistance has occurred among such community-acquired microbes such as Haemophilus, Cardiobacterium, members of the Enterobacteriaceae, Pseudomonas species and others (Baddour et al, 2005). MRSA has been reported in prisons, sports facilities and residential homes. The MRSA superbug is no longer confined to hospitals and new strains are killing young, healthy people (Moellering, 2006). Necrotising fasciitis, better known as a flesh-eating disease, will kill one in five patients even with treatment. The CDC has warned that outbreaks from small pets like hamsters, mice and rats have sickened many people in various states with dangerous multidrug-resistant bacteria. Farm animals also have been found to be infected and these carriers provide yet another reservoir, outside of communities and hospital environments, in which superbugs may develop drug resistance and Continued to p.69 36 Consulting-Specifying Engineer • SEPTEMBER, 2007 http://www.aia.org/aah_gd_hospcons http://www.cdc.gov/ncidod/dhqp/gl_environinfection.html http://www.ashrae.org http://www.hpac.com http://jhu.edu/~gazette/2006/18sep06/18superb.html http://www.cdc.gov/niosh/reports/contract/pdfs/ultrairrTB.pdf http://www.cdc.gov/niosh/reports/contract/pdfs/ultrairrTB.pdf

Table of Contents Feed for the Digital Edition of Consulting-Specifying Engineer - September 2007

Contents M/E Roundtable Cover Story: Airborne Superbugs Third-Party Liability Back to School Product Spotlight Codes & Standards Professional Practices How To New Products Jobs/Cliassifieds Specifier’s Notebook Pure Power Supplement New Technologies, Same Old Transmission Problems Wireless Battery Recharging Solar Concentration Renewables Tracking System A Mighty Wind The Importance of Load Bank Testing Quality Power for Security Systems

Consulting-Specifying Engineer - September 2007

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.