Critically ill patients will benefit from single isolated laminar-air-flow wards by improving the environmental microbial composition

Background: Hospital-associated infection (HAI) is an important issue in intensive care units (ICUs). We still lack direct evidence on whether the ICU patients and/or the medical system can benefit from single isolated laminar-air-flow (LAF) wards.

Methods: High-touched-surface (HTS) swabs from 5 sites in two kinds of wards with different ventilation systems were longitudinally collected for 16 S rRNA sequencing and Type IIB restriction site-associated DNA sequencing for Microbiome (2bRAD-M). Samples were collected for 3 months. The clinical data of patients admitted to different wards during the sampling time and the whole year were collected and compared.

Results: The α-diversity of single wards with isolated LAF was significantly higher than open regions without LAF (p<0.01). β-diversity analysis showed differences between different wards and similarities among the same region. We also identified 3 genera attributed to the most difference between the two kinds of wards. 2bRAD-M analysis further revealed community divergence among different HTS sites. There was an overlap between HTS microbiome profiling and the clinically cultivated pathogens of patients with HAI. People in single wards had a better outcome than those in open regions (p<0.05), indicating that single wards had a protective effect for critically ill patients.

Conclusion: Overall, there was a prominent difference in the microbiome community between single wards and open regions. Single wards had more balanced communities which may lead to better outcomes for patients. For critically ill patients, single ward is recommended when arranging and constructing.