D'Arcy, N; (2014) Exploring the nature and diversity of microorganisms in healthcare and educational settings. Doctoral thesis , UCL (University College London).

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Abstract

Many human populations spend approximately 90 % of their time indoors, yet relatively little is known about the microbial communities associated with indoor environments. This is despite knowledge that these microorganisms can contribute to adverse health effects, including the acquisition of healthcare-associated infections, which cause significant morbidity and mortality. The concept of the ‘indoor microbiome’ is relatively new and to date, few studies have been field-based, systematic and long-term. Hospitals in particular, are unique environments which have been shown to drive microbial evolutionary processes as they contain a different sub-set of the human population. The study of the hospital microbiome could have important implications for healthcare and infection control. This thesis explores a range of methods for investigating microorganisms in different indoor environments, including a classroom and outpatient’s waiting areas and wards in a hospital. Results show that the classroom is much more heavily contaminated in terms of total viable counts (TVCs) of bacteria recovered than the hospital environment. This was thought to be attributed to the absence of a strict cleaning regime in the classroom. High-touch items were less contaminated than other objects, likely due to them being obvious cleaning targets. Potential pathogens, including a number of Enterobacteriaceae were cultured from the classroom, outpatient’s waiting area and ward. Virus nucleic acid was recovered from an outpatient’s area, including norovirus and rotavirus RNA. Adenovirus DNA was frequently isolated throughout a 3 month screening protocol and there appeared to be evidence to suggest that a viral marker may be more appropriate than TVCs for identifying viral contamination. Human-associated bacteria were found to be dominant on a hospital ward over a 12 month longitudinal screening study and the presence of numerous bacterial taxa, which may be of concern in the context of paediatrics and immunodeficient patients, was also demonstrated.

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