Viability of Pseudomonas aeruginosa in cough aerosols generated by persons with cystic fibrosis

Background Person-to-person transmission of respiratory pathogens, including Pseudomonas aeruginosa, is a challenge facing many cystic fibrosis (CF) centres. Viable P aeruginosa are contained in aerosols produced during coughing, raising the possibility of airborne transmission. Methods Using purpose-built equipment, we measured viable P aeruginosa in cough aerosols at 1, 2 and 4 m from the subject (distance) and after allowing aerosols to age for 5, 15 and 45 min in a slowly rotating drum to minimise gravitational settling and inertial impaction (duration). Aerosol particles were captured and sized employing an Anderson Impactor and cultured using conventional microbiology. Sputum was also cultured and lung function and respiratory muscle strength measured. Results Nineteen patients with CF, mean age 25.8 (SD 9.2) years, chronically infected with P aeruginosa, and 10 healthy controls, 26.5 (8.7) years, participated. Viable P aeruginosa were detected in cough aerosols from all patients with CF, but not from controls; travelling 4 m in 17/18 (94%) and persisting for 45 min in 14/18 (78%) of the CF group. Marked inter-subject heterogeneity of P aeruginosa aerosol colony counts was seen and correlated strongly (r=0.73–0.90) with sputum bacterial loads. Modelling decay of viable P aeruginosa in a clinic room suggested that at the recommended ventilation rate of two air changes per hour almost 50 min were required for 90% to be removed after an infected patient left the room. Conclusions Viable P aeruginosa in cough aerosols travel further and last longer than recognised previously, providing additional evidence of airborne transmission between patients with CF.

Reducing building information fragmentation : a BIM-specifications approach

The world of Construction is changing, so too are the expectations of stakeholders regarding strategies for adapting existing resources (people, equipment and finances), processes and tools to the evolving needs of the industry. Building Information Modelling (BIM) is a data-rich, digital approach for representing building information required for design and construction. BIM tools play a crucial role and are instrumental to current approaches, by industry stakeholders, aimed at harnessing the power of a single information repository for improved project delivery and maintenance. Yet, building specifications - which document information on material quality, and workmanship requirements - remain distinctly separate from model information typically represented in BIM models. BIM adoption for building design, construction and maintenance is an industry-wide strategy aimed at addressing such concerns about information fragmentation. However, to effectively reduce inefficiencies due to fragmentation, BIM models require crucial building information contained in specifications. This paper profiles some specification tools which have been used in industry as a means of bridging the BIM-Specifications divide. We analyse the distinction between current attempts at integrating BIM and specifications and our approach which utilizes rich specification information embedded within objects in a product library as a method for improving the quality of information contained in BIM objects at various levels of model development.