Outbreak simulation on the neonatal ward using silica nanoparticles with encapsulated DNA: unmasking of key spread areas

Background: Nosocomial infections pose a serious threat. In neonatal intensive care units (NICUs) especially, there are repeated outbreaks caused by micro-organisms without the sources or dynamics being conclusively determined. Aim: To use amorphous silica nanoparticles with encapsulated DNA (SPED) to simulate outbreak events and to visualize dissemination patterns in a NICU to gain a better understanding of these dynamics. Methods: Three types of SPED were strategically placed on the ward to mimic three different dissemination dynamics among real-life conditions and employee activities. SPED DNA, resistant to disinfectants, was sampled at 22 predefined points across the ward for four days and quantitative polymerase chain reaction analysis was conducted. Findings: Starting from staff areas, a rapid ward-wide SPED dissemination including numerous patient rooms was demonstrated. In contrast, a primary deployment in a patient room only led to the spread in the staff area, with no distribution in the patient area. Conclusion: This study pioneers SPED utilization in simulating outbreak dynamics. By unmasking staff areas as potential key trigger spots for ward-wide dissemination the revealed patterns could contribute to a more comprehensive view of outbreak events leading to rethinking of hygiene measures and training to reduce the rate of nosocomial infections in hospitals.