The effect of unidirectional airflow on health care-associated infections in burn intensive care unit: An interrupted time-series analysis

Healthcare-associated infections (HCAIs) can cause severe complications in patients in the burn intensive care unit (BICU). To avoid biological patient contamination, healthcare facilities use unidirectional airflow with filtered air flows from the ceiling towards the floor. The impact of unidirectional systems on BICU patients' HCAIs are ambiguous. On October 1, 2020, the affiliated hospital of Jiangnan University moved from an old hospital, to a newly hospital. The BICU used unidirectional airflow from January 2018 to September 2020, but not October 2020 to November 2022. The study examined how unidirectional systems affect HCAIs. By conducting a 59-month monitoring and measurement of HCAIs, compared to a 33-month period in the BICU with unidirectional airflow, there was a noticeable rise in health care-associated pathogens colonization, methicillinresistant staphylococcus aureus infection, carbapenem-resistant enterobacteriaceae infection, carbapenemresistant acinetobacter baumannii infection, single-species colonization, multi-species colonization, and average consumption of antibiotics during the 26 months in the BICU without unidirectional airflow. Rates of pathogen infection did not rise. The variation in temperature, humidity, pressure difference, and noise were greater in the non- unidirectional flow BICU compared to the unidirectional flow BICU. Additionally, the unidirectional flow BICU had lower humidity and noise, and a greater pressure difference compared to the non- unidirectional flow BICU. The findings support the efficacy of unidirectional airflow in the BICU to reduce the rates of pathogen, single species and multi-species colonization and multidrug-resistant organisms infections. Additionally, when promoting the use of unidirectional airflow in the BICU, the impact of environmental meteorological indicators should also be taken into consideration.