Lessons learned from Florence Nightingale could prevent the spread of harmful bugs by allowing “friendly” bacteria into hospitals, an expert has claimed.
Sterile conditions in wards and operating theatres may be doing more harm than good by wiping out organisms that keep dangerous microbes at bay, Dr Jack Gilbert believes.
Florence Nightingale, the 19th-century “mother” of modern nursing, advocated cleanliness, but also plentiful fresh air for patients.
Dr Gilbert, who heads an international project to construct a bacterial “field guide” of all the world’s known bugs, thinks she was right, despite knowing nothing about microbial diversity.
The scientist, who is British but based at the Argonne National Laboratory near Chicago, said: “There’s a good bacterial community living in hospitals and if you try to wipe out that good bacterial community with sterilisation agents and excessive antibiotic use you actually lay waste to this green field of protective layer.
“This is going back to Florence Nightingale, [who] said if you have an open window where air from the environment is coming in... you’ll have less illness.
“You let in bacteria from outside, and you dilute the pathogens [harmful infectious agents] or you don’t allow the pathogens to establish themselves, because there is too much competition for nutrients and energy that bacteria need to survive.”
He cited a study published last month by Dr Jessica Green, from the University of Oregon.
She carried out an experiment in which bacteria samples were taken from clinic rooms with their windows open or closed.
The rooms with open windows had a more diverse range of microbial types. The sealed and artificially ventilated rooms had less variety of bugs, and more of the kinds of bacteria that could be harmful.
Dr Gilbert delivered his message at the annual meeting of the American Association for the Advancement of Science (AAAS) in Vancouver, Canada.
He said he had a colleague who carried out field operations in Venezuela using unsterilised surgical instruments that were scrubbed with soap and water.
“He sees less acquired infections from surgery in that environment than they do in Chicago,” he added. Florence Nightingale spoke of the need for fresh air in her Notes On Nursing, dated 1860.
She wrote: “Always air from the air without, and that, too, through those windows through which the air comes freshest.”
Microbiologist Professor Mark Enright from the University of Bath said: “I do think that opening windows is a good thing. Air flow is a good thing in hospitals, you don’t want pockets where organisms can pool and swarm and pass on.”
But he described the idea that hospitals were too clean as “quite an extreme view”.