Hospitals might thwart the spread of dangerous infections by taking a tip from Florence Nightingale and throwing open their windows. But while the Victorian nurse championed fresh air and cleanliness as a defence against infections, the incoming air might help control nasty pathogens by letting more microbes inside.
Jack Gilbert, a microbiologist at the US government’s Argonne National Laboratory in Illinois, offers the unconventional view that unwanted microbes might gain a foothold in hospitals because they had too little competition from other organisms. The idea mirrors that seen in the gut, where antibiotics can kill off the balanced and healthy community of bacteria, only to make way for hardier bugs that cause illness.
“When surgery first started 300 years ago, you would have people walking around with blood and pus all over their outfits. In that situation it makes a lot of sense to make the system very clean,” Gilbert said at the annual meeting of the American Association for the Advancement of Science in Vancouver. “But if you go into any wound infection clinic and speak to a surgeon, they are constantly sterilising the bejeebers out of their operating room. There is theoretically nothing there – they have scrubbed themselves with sterilising agents – but somehow, magically a pathogen gets into the person when they’re in the operating theatre and they get sick. “This is a situation where one organism from one person hasn’t had any competition from any other microbes on the skin or in the environment because there’s nothing else there,” he said.
Nightingale noted the virtues of open windows in her Notes on Nursing in 1859. “True nursing ignores infection, except to prevent it. Cleanliness, fresh air from open windows, are the only defence a true nurse either asks or needs,” she wrote.
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