Vancouver canine sniffers have the right superbug detection stuff, study finds
Credit to Author: Pamela Fayerman| Date: Mon, 26 Aug 2019 07:01:31 +0000
A pair of springer spaniels working at Vancouver General Hospital are remarkably good at sniffing out contaminated areas where dangerous bacteria are lurking, a study shows. And their success appears to be reducing infections.
VGH called in the dogs three years ago and they alerted 391 times to odours from C. diff during 659 searches at the hospital from May 1, 2017, to Oct. 31, 2018, according to the study published today in the Canadian Journal of Infection Control.
C. diff — full name Clostridium difficile — is a leading cause of potentially deadly, infectious diarrhea in health facilities.
Their hyperacute sense of smell means the dogs can find germs lingering on surfaces even after hospital areas have been cleaned, thus leading to extra disinfection.
“It is a surprisingly high count for alerts. But it’s not just the number that’s surprising, it’s where the dogs made their alerts,” said Dr. Elizabeth Bryce, a Vancouver Coastal Health medical microbiologist and co-author of the study. VGH is a Coastal Health hospital.
Angus, a C. difficile-detecting dog.
The dogs found C. diff scents in washrooms, on medical equipment, in linen carts, in hospital beds, in family waiting areas, in hospital staff lockers and even in places no one thought about, like inside toilet paper dispensers.
“Now we are thinking about whether this is a toilet paper dispenser design issue that needs to be fixed or whether it’s the quality of the toilet paper or both,” Bryce said, noting that apparently when people with contaminated hands reach into the dispenser to pull the tissue down, they leave bacteria on the surface.
“The results highlight the impact of cross-transmission not only by health care workers but also by patients and the public,” the study says.
Medical equipment and other clutter stashed in hallways accounted for over half the alerts, “emphasizing the importance of decluttering to permit effective cleaning,” Bryce said
After the dogs sniff out the superbug, ultraviolet light robots are brought in to do quick disinfection. The light kills antibiotic-resistant germs like C. diff.
Although hospital officials are careful not to make a direct link, the latest data shows there were 45 new cases of C. diff infection in the Vancouver Coastal Health region in the third quarter of 2018, and that’s the lowest number for any quarter in the past five years, says spokeswoman Carrie Stefanson.
Angus, Dodger and their handlers are so good at their jobs that they’ve been asked to work in dozens of hospitals, even in Ontario. They have also been contracted to work in hospitals in the Fraser Health region. A third dog named Rudy is in training and may be used for another superbug — to sniff out MRSA (methicillin-resistant Staphylococcus aureus).
The dogs and their handlers search every unit in VGH once a month and also focus on medical units that have the worst outbreaks of the superbug, units with new superbug cases and those that have had a history of case clusters.
“The dogs and their handlers are absolutely invaluable,” Bryce said, adding that their mere presence is likely improving compliance with handwashing and other sanitation practices.
Bryce said medical dogs and their handlers need to have skills that go beyond knowing where and how to sniff. “They have to be comfortable in hospital environments, good around people, and the handlers have to have a lot of knowledge about infection prevention.”
Angus and his owner/handler Teresa Zurberg.
Handler Teresa Zurberg said Angus works four days a week in hospitals and is bored on weekends. The former Canadian Forces medic and dog trainer conceived the idea for a C. diff detection program with her husband after she got the superbug herself.
“Angus is so enthusiastic. He lives to go to work. He gets up at 4 a.m. every day to do that. He doesn’t believe in taking off Saturdays and Sundays,” she joked. The dogs alert their handlers with a few taps of their paw on a “positive” area and then sit to wait for their kibble treat.
Zurberg said no matter which hospital Angus is in, there are patterns in where he detects the odours — hallways, storage areas, staff lounges and lockers, patient beds and patient bathrooms.
The dogs have even sniffed out C. diff on the rolling carts carrying machines that nurses use to measure patient vital signs. Bryce said wiping down the machines more frequently with hydrogen peroxide disposable wipes will reduce the risk of bacterial transmission.
It is clear that nurses and other health professionals can transmit the bacteria on their gloved hands, which means staff must wash hands more and change their gloves between every task, Bryce said. Patients and their visitors need to do the same and they shouldn’t be shy about reminding health professionals to change their gloves.
Bryce said the fact that the spaniels found C. diff odours in staff lounges and lockers suggests staff may be moving the bacteria around on their hands, even when wearing gloves, and on disposable shoe covers.
“In hospitals, you can presume the floors are dirty, from an infection prevention perspective, so no one should be taking these disposable covers off their shoes and reusing them. The covers should be changed more often.”
Twitter: @MedicineMatters
What is Clostridium difficile?
A bacterium that can live in the bowel without causing harm. In healthy people, it may not pose a health risk. But for those taking antibiotics or with weak immune systems, the balance of healthy bacteria in the digestive system may be upset, allowing C. diff to multiply, producing toxins that lead to diarrhea, fever, abdominal cramping, dehydration and even death.
How is it transmitted?
The bacteria and their spores are shed in feces. People can acquire the bacteria by touching items or surfaces contaminated with feces and then touching their mouth or mucous membrane, if they do not wash their hands thoroughly.
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