Association between nanoparticle-impregnated textiles and reduced ventilator-associated pneumonia rates in the ICU: an interrupted time-series analysis

Abstract Background Hospital clothing often harbors bacteria that cause healthcare-associated infections (HAIs). This study evaluated the association between silver, copper, and zinc oxide nanoparticle-impregnated textiles and HAI rates in an ICU setting. Methods A quasi-experimental ecological study was conducted in a 25-bed ICU of a tertiary academic hospital. HAI rates during a 15-month baseline and a 15-month intervention period were compared using Wilcoxon rank-sum tests, ARIMA interrupted time-series analysis, and a multivariable Poisson regression model adjusted for time trend, bundle compliance, hand hygiene compliance, and ventilator utilization ratio. Antimicrobial efficacy was assessed via standardized microbiological methods. Results Patient characteristics did not differ between phases (SAPS3 p=0.148). VAP rates decreased from 4.84 to 2.36 events/1,000 ventilation-days (17 vs. 7 events; Wilcoxon, p=0.045). Poisson regression estimated a 49% reduction in VAP incidence rate (IRR=0.51; 95% CI: 0.08–3.40), though not statistically significant. ARIMA analysis did not detect a significant intervention effect (p=0.817). Other HAI rates were unchanged. In vitro, nanoparticle-treated fabrics showed bacterial reduction of 76.1% for Staphylococcus aureus, 52.4% for Escherichia coli, and 47.1% for Pseudomonas aeruginosa. Conclusions Nanoparticle-impregnated textiles were feasibly implemented in an ICU and associated with reduced VAP rates. These hypothesis-generating findings support nanotechnology as a potential adjunct for HAI prevention, warranting future large-scale, adequately powered trials.