Association between nanoparticle-impregnated textiles and reduced ventilator-associated pneumonia rates in the ICU: An interrupted time-series analysis.

BACKGROUND

Hospital clothing harbors bacteria causing healthcare-associated infections (HAIs). This study evaluated the association between silver, copper, and zinc oxide nanoparticle-impregnated textiles and HAI rates in an intensive care unit (ICU) setting.

METHODS

A quasi-experimental ecological study in a 25-bed tertiary ICU compared. HAI rates across a 15-month baseline and 15-month intervention period using Wilcoxon rank-sum tests, autoregressive integrated moving average (ARIMA) interrupted time-series analysis, and multivariable Poisson regression model adjusted for time trend, bundle compliance, hand hygiene and ventilator utilization ratio. Antimicrobial efficacy was assessed via standardized microbiological methods.

RESULTS

Patient characteristics did not differ between phases (SAPS3 P = .148). Ventilator-associated pneumonia (VAP) rates decreased from 4.84 to 2.36 events/1,000 ventilation-days (17 vs 7 events; Wilcoxon, P = .045). Poisson regression estimated a 49% reduction in VAP incidence rate (IRR = 0.51; 95% CI: 0.08-3.40; non-significant). ARIMA analysis did not detect a significant intervention effect (P = .817). Other HAI rates were unchanged. In vitro, bacterial reductions were 76.1% for Staphylococcus aureus, 52.4% for Escherichia coli, and 47.1% for Pseudomonas aeruginosa.

CONCLUSIONS

Nanoparticle-impregnated textiles were feasibly implemented in an ICU and associated with reduced VAP rates. These hypothesis-generating findings support nanotechnology as a potential adjunct for HAI prevention, warranting future large-scale trials.