Maintaining an environment free of germs is paramount in healthcare facilities. Typically, this is achieved through routine cleaning of floors, disinfection of high-touch point surfaces, changing beddings and curtains, and administering prophylactic antibiotics to patients, among many other aseptic measures.
While conventional methods of asepsis are quite beneficial, hospital-acquired infections have continued to pose a significant risk to the health of admitted patients. In addition to contaminated door knobs, walls, and equipment, one possible source of dangerous organisms that is often ignored is the hospital privacy curtain. Privacy curtains (also known as cubicle curtains) are a staple of healthcare environments and are necessary for hospitals and nursing homes to help maintain patient privacy and dignity. Maintaining privacy can provide higher quality rest and potentially lead to improved patient outcomes. Despite the obvious benefits, curtains must be handled appropriately to achieve their desired outcome.
Studies show that if curtain are improperly washed, they may not be effectively rid of pathogens. At times, facilities and maintenance personnel are not aware of the intended maintenance and sanitization schedule and contaminated curtains are allowed to stay in place. These curtains are frequently handled by healthcare personnel and patients, which can promote the spread of pathogens. In response to this issue, privacy curtains with antimicrobial properties have become a viable option for most hospitals to curtail the proliferation and spread of germs that can compromise the health of patients and hospital personnel. However, some experts have suggested that antimicrobial curtains pose significant problems, including the risk of facilitating the development of antibiotic-resistant microbes .
This article will elaborate on the pros and cons of antimicrobial privacy curtains in hospitals and allow healthcare professionals to decide which product best suites their facility.
What are the merits of antimicrobial privacy curtains?
Undoubtedly, antimicrobial privacy curtains have significantly impacted the degree of infection control in healthcare institutions. Some of the benefits of these curtains include:
• They help to prevent hospital-acquired infections: Hospital-acquired infections pose a significant threat to the quality of healthcare and the safety of patients in many centers. A study to determine the prevalence and time course of bacterial contamination on privacy curtains in 2 intensive care units and a medical ward with 30 rooms and 43 privacy curtains discovered that 95% of the total number of curtains demonstrated contamination on at least one occasion, including 21% with Methicillin Resistant Staphylococcus aureus within the duration of the study . The result of this study is significant because it reinforces the need for closely monitored curtain maintenance procedures to reduce the burden of microbes in hospitals.
In another similar study, an outbreak of group A streptococcus (GAS) in a tertiary referral center's Ear, Nose, and Throat ward was traced to the tracheostomy tube of a patient with Group A Streptococcus and generated a chain of transmission from the medical staff to a privacy curtain to other patients on the ward . Two patients on that ward with laryngeal cancer developed Group A Streptococcus-associated cellulitis within 48 hours of the outbreak, posing a significant risk to their health .
The utilization of antimicrobial cubicle curtains can potentially curtail the transmission of infections in hospitals similar to the cases listed above due to their intrinsic ability to prevent the growth of bacteria .
• They are resistant to contamination: Unlike conventional hospital curtains, antimicrobial privacy curtains are not easily contaminated. In a study carried out by American scientists, traditional and antimicrobial curtains were randomly fixed in 9 medical intensive care units (ICUs) and 21 surgical ICU rooms . The scientists subsequently cultured swabs samples from both curtains to determine their level of contamination . The results showed that antimicrobial curtains took longer to get contaminated than conventional privacy curtains, which in turns reduces the required frequency of washing. Once contaminated, the antimicrobial curtains also showed a lower level of contamination .
Another study by medical researchers from the Johns Hopkins University School of Medicine indicated that bacterial colonization of antimicrobial cubicle curtains is minimal . The study showed a significant reduction in the colony-forming units of Pseudomonas aeruginosa, Acinetobacter baumannii, methicillin-resistant Staphylococcus aureus (MRSA) or extended-spectrum-producing organisms (Escherichia coli or Klebsiella pneumoniae), which are pathogens that prove to be very difficult to control in healthcare settings . Even after one month of hanging these antimicrobial privacy curtains, there were lower contamination levels with these pathogens compared to the standard privacy curtains .
• Antimicrobial cubicle curtains are more effective for control of germs than disinfecting standard curtains: Standard laundry processes have been used for decades to reduce the burden of hospital-acquired pathogens with mixed results; a study carried out in a clinic setting on cultures obtained from the cubicle curtains before laundering, immediately after laundering and an interval of one and three weeks after laundering determined that the process of laundering was not 100% effective, as Coagulase-negative Staphylococcus and Micrococcus species were present even after laundry. Several studies have suggested that antimicrobial curtains prevent the growth of these deadly pathogens  . One study found that it took antimicrobial curtains 27.6 times longer to get contaminated when compared to regular curtains . The research showed that even after prolonged use in a busy clinical environment, antimicrobial privacy curtains effectively reduced the microbial load and MDRO (multi-drug resistant organism) contamination compared to the regular curtain .
What are the Cons of antimicrobial privacy curtains?
Although antimicrobial curtains are associated with many benefits, a few concerns have also been raised. They include:
• Possible risk of the development of antibiotic-resistant organisms: Some researchers have suggested that these antimicrobial privacy curtains may increase the risk of antimicrobial resistance . Studies have identified mechanisms of resistance to antimicrobial chemicals used in various types of coatings for curtains  . It can impact patient care as these drug-resistant pathogens may infect them. Additionally, antibiotic-privacy curtains could undermine the campaign against the indiscriminate use of antibiotics.
• Antimicrobial curtains are intrinsically toxic: The biocidal agents in antimicrobial coatings of privacy curtains in hospitals have been described as inherently toxic . It is an important characteristic required for their efficacy. These agents can harm humans, animals, and the environment if measures are not implemented to control their use adequately. Furthermore, studies indicate that some biocidal agents are more harmful to aquatic organisms than pathogens . It implies that washing these curtains could contaminate water bodies and harm marine animals.
• Additional research is needed to elucidate the association between antimicrobial privacy curtains and the development of antibiotic resistance. Some experts have advocated limited use of antimicrobial agents in coatings of hospital materials .
• Ultimately, there is a need to reach a balance between the benefits and risks associated with the use of antimicrobial privacy curtains. Further research and adherence to safety measures can help ensure that patient safety is guaranteed and the development of hospital-acquired infections is reduced significantly.
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