title: Efficacy of the Shinki bioclean room for preventing infection in neutropenic patients.
abstract: OBJECTIVE
  To investigate the effectiveness of a new type of bioclean room named Shinki bioclean room (SBCR) for the prevention of infection during neutropenia after intensive chemotherapy in comparison with a standard laminar air flow room (LAFR).
  
  
  BACKGROUND
  Recently, a new industrial technology, wherein a dust-free and aseptic environment is created by circulating air containing nanometre order ultra fine water droplets with abundant negative air ions, has been developed in Japan.
  
  
  METHODS
  The air cleanliness of SBCR was examined by measuring airborne particles and microorganisms. Bacteriological samples for environment culture were taken by means of exposed settle-plates. In addition, the frequency of pneumonia and fever higher than 38 degrees C were examined in 34 patients with acute leukaemia who received intensive chemotherapy in SBCR or LAFR.
  
  
  RESULTS
  The number of airborne particles (> or = 0.5 microm) was 70 particles/ft3, and that of airborne microorganisms was 0.0 colony forming unit/ft3 in SBCR, and neither bacteria nor fungi were detected. The numbers of colonies of bacteria and fungi on air settle-plates were fewer in the SBCR than in the LAFR regardless of the presence of patients or the nurse entering. The frequency of pneumonia during chemotherapy for acute leukaemia was lower in the SBCR group (0%, 0/19 cases) than in the LAFR group (27%, 4/15 cases) (P=0.0294) and the frequency of fever higher than 38 degrees C also tended to be lower in the SBCR group (53%, 10/19 cases) than in the LAFR group (80%, 12/15 cases) (P=0.0973).
  
  
  CONCLUSIONS
  The SBCR is equal or superior to LAFR in preventing infection during neutropenia. Other advantages for SBCR are a low level of noise (40 dB), easy control of temperature and humidity, and efficient removal of odour. In addition to the quiet and comfortable atmosphere, expected favourable effects of negative air ions may give higher quality of life for patients in SBCR than those in LAFR. Further studies will be needed to examine the safety, benefits and effects of the negative ion exposure.
authors.affiliation: Department of Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan. kaoris@hama-med.ac.jp
authors.forename: Kaori
authors.initials: K
authors.lastname: Shinjo
authors.forename: Akihiro
authors.initials: A
authors.lastname: Takeshita
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Yanagi
authors.forename: Kazuko
authors.initials: K
authors.lastname: Yokota
authors.forename: Kazumi
authors.initials: K
authors.lastname: Hirano
authors.forename: Mieko
authors.initials: M
authors.lastname: Suzuki
authors.forename: Kazunori
authors.initials: K
authors.lastname: Ohnishi
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Ohno
mesh_terms: D000391:Air Microbiology; D000970:Antineoplastic Agents / Q000009:adverse effects; D003428:Cross Infection / Q000517:prevention & control*; D004780:Environment, Controlled; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007938:Leukemia / Q000188:drug therapy; D009503:Neutropenia / Q000139:chemically induced; D009894:Opportunistic Infections / Q000517:prevention & control*; D010357:Patient Isolators
chemical_list: D000970:Antineoplastic Agents