The problem of healthcare-associated infections and antibiotic resistance risks putting advanced care as we know it at risk. Through innovative solutions aimed at stopping the spread of infection, RISE works together with Sahlgrenska and Getinge, among others, to minimize care-related infections and reduce the spread of antibiotic-resistant microbes in hospitals in the Clean Care project. The project investigates, among other things, how the air quality in operating theaters affects the risk of infections in patients.
Nearly one in every ten patients treated at hospital contract some sort of care-related infection. It is both a serious problem for patients and a major cost for hospitals, since additional days at hospital are required when this happens. Another aspect is antibiotic resistance, which, over time poses a serious risk to advanced health care.
Within the scope of the Clean Care project, RISE is coordinating collaboration between academia, industry and healthcare with the goal of developing and evaluating new technologies for infection prevention in clinical environments. It involves developing resource-efficient cleaning technology and functional surfaces that stand the test of time, optimising the environment in operating theatres and developing business models for innovative product solutions intended to reduce the spread of infection.
Optimised air quality study
Since August 2020, a study has been underway to investigate the environment in operating theatres at Sahlgrenska University Hospital's orthopaedic department in Mölndal, where the goal is optimised air quality in the operating theatre, systematic quality control and follow-up of patient outcomes. A platform module developed by Getinge in collaboration with Sahlgrenska and RISE is being used for data collection.
– “The platform collects data from sensors and reports the air quality in real time. Temperature, humidity, particles in the air, opening/closing of doors and the number of people in the operating theatre are measured for each surgery,” explains Josefin Caous, Project Manager at RISE.
After all data has been collected, there is follow-up on patient status for approximately one year after their surgery to check whether they have had any infections. Measurements are being taken at two operating theatres that have different ventilation systems.
– “The platform can be used for quality monitoring, product evaluation and later on, also for research,” explains Josefin Caous.
The number of bacterial strains that are resistant and cannot be treated is growing.
Advanced care is at risk
Doctors at Sahlgrenska emphasize how important it is to solve the problem of care-related infections and antibiotic resistance.
– “The number of bacterial strains that are resistant and untreatable is growing. It puts all advanced care, as we know it today, at risk. That’s why it is so important that we do something about it now,” says Henrik Malchau, Professor at the Orthopaedic Department at Sahlgrenska Academy and Chief Surgeon at the Orthopaedic Department at Sahlgrenska University Hospital.
– “WHO has described antibiotic resistance a silent tsunami which, sooner or later, will hit us all. As regards bacteria that present a risk during orthopaedic transplants, in other words ordinary skin bacteria, they are already resistant. It doesn’t present any risk to the public at large, but it can be devastating to a surgery,” explains Anette Erichsen Andersson, Associate Professor at the University of Gothenburg’s Institute of Health and Care Sciences.
Henrik Malchau emphasizes that the study underway at Sahlgrenska is a pilot project.
– “We don’t do enough surgeries for being able to make safe conclusions. For that, we would need a national study. Hopefully though, we can start analysing how important the operating theatre ventilation systems are, and what role they play in the spread of infection,” he says.
Aim is to demonstrate value
Josefin Caous adds that getting the measuring equipment installed in the operating theatres was a challenge.
– “For that, we need to enter the sterile zone, close to the patient. The equipment itself also needs to be sterile, and it cannot be in the way of the orthopaedic surgeon. It has to be easy to manage too, so that in can easily be implemented into the routines of healthcare professionals. Our goal is to be able to demonstrate its value. And for that, it’s worth the extra effort,” she says.
At Getinge as well, focus has been on the benefits of the platform.
– “We want everyone to be a winner with this solution,” says Jonas Andersson, Vice President, Infection Control at Getinge.
He says that in other places around the world, such as the USA, there is a financial incentive for closer collaboration between industry, healthcare and academia. He feels that this project could help Sweden take a step in that direction as well.
– “It’s not about selling a product pure and simple. It’s about collaboration, where we have looked at the research to find the key factors that can affect the routes of transmission, along with monitoring and evaluating the results. In other words, what we’re selling is a service, not a product,” he says.
We want everyone to be a winner with this solution
Collaboration between competencies
Sylwia Valleberger, who works with product support at Getinge, says that the project has required collaboration between a wide range of competencies.
– “We are a company with extensive knowledge in infection control. This project unites technology, research and product knowledge,” she says.
Simultaneous to running this new study, another study at operating theatres has been underway where air samples have been cultivated and analysed, along with taking swabs of both instruments and wounds to measure bacterial levels.
– “The study provides us with a good understanding of which bacteria are involved and where they come from. With more knowledge of the transmission routes, we can also learn how to block them,” says Annette Erichsen Andersson.
The study started during autumn 2019. However, just like with the platform study, it has been delayed because of the COVID-19 pandemic, during which most of the planned orthopaedic surgeries were cancelled.
– “The entire project has been disrupted by the pandemic, in that we haven’t had anywhere near the number of surgeries as usual. So, we need to interpret the results with this in mind and it’s important that the donors are aware of that too,” emphasizes Henrik Malchau.
Technology and domain knowledge increase the chances of success
Both Henrik Malchau and Annette Erichsen Andersson see the benefits of collaboration between healthcare, academia and industry.
– “Advancements in technology, together with our expertise in the realm of care increases the chances of achieving a much higher level of success with all of this,” says Annette Erichsen Andersson.
RISE has coordinated the entire Clean Care project from the very start, along with helping with other tasks, such as material evaluation. Both microbiologists and material scientists have contributed their knowledge and employees at RISE have managed three of the project’s five work areas.
The project is funded by Vinnova and Regional Development VGR.
