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Pathogens and Size Characterization of Aerosols Generated during Aerosol Generating Procedure in COVID 19 Positive Patient Intensive Care Units
SHRUTI CHOUDHARY, Tracey Bach, Meghan Wallace, Carey-Ann Burnham, Michael Durkin, Jennie Kwon, Hilary Babcock, Stephen Liang, Pratim Biswas, Washington University in St Louis
Abstract Number: 393
Working Group: Infectious Aerosols in the Age of COVID-19
Abstract
The airborne transmission of infectious diseases in the health care settings especially in Intensive care units during commonly identified aerosol-generating procedures (AGP) such as Bronchoscopy, High Flow Nasal Cannula (HFNC), Opti flow, Tracheostomy always remains a concern for health care workers. There are a limited number of studies that report possible pathogens and number concentration of aerosols present in the air during the AGPs in COVID 19 positive patient ICUs. Aerosol capture and real-time size characterization of aerosols were performed in the ICU for 15 minutes during Bronchoscopy (n=2), HFNC (n=6), Opti flow (n=5), Tracheostomy (n=3), patient on Ventilator (n=10), Bilevel Positive Airway Pressure (BiPAP) (n=1), changing HFNC to BiPAP (n=1), changing BiPAP to AIRVO (n=1). The bacterial culture analyses of the collected samples reported Staphylococcus epidermidis, Staphylococcus capitis, Staphylococcus haemolyticus, Aspergillus fumigatus, Bacillus subtilis during bronchoscopy; Staphylococcus capitis during HFNC; corynebacterium coyleae during opti flow; Corynebacterium tuberculostearicum, Staphylococcus hominis, Staphylococcus epidermidis during patient on Ventilator. Number size distribution and mass concentration of the aerosols generated during the AGPs were compared with the baseline level among which Bronchoscopy emitted highest number of aerosols in the size range 10 nm to 1µm. Procedures such as HFNC, Opti flow, changing from BiPAP to AIRVO also reported an increase in certain size range of 20-100nm and 200 to 500nm. Thus, the results show that viable pathogens generated from the AGPs are present in the ICU rooms and that increase in number concentration of the aerosols can be an indicator for the pathogens present in the ICU room when compared with the baseline measurements. Cloud-based distributed real-time PM sensing of the aerosols in ICU and other health care settings are also described.