  Contacts between patients, patients and health care workers (HCWs) and among
HCWs represent one of the important routes of transmission of hospital-acquired
infections (HAI). A detailed description and quantification of contacts in
hospitals provides key information for HAIs epidemiology and for the design and
validation of control measures. We used wearable sensors to detect close-range
interactions ("contacts") between individuals in the geriatric unit of a
university hospital. Contact events were measured with a spatial resolution of
about 1.5 meters and a temporal resolution of 20 seconds. The study included 46
HCWs and 29 patients and lasted for 4 days and 4 nights. 14037 contacts were
recorded. The number and duration of contacts varied between mornings,
afternoons and nights, and contact matrices describing the mixing patterns
between HCW and patients were built for each time period. Contact patterns were
qualitatively similar from one day to the next. 38% of the contacts occurred
between pairs of HCWs and 6 HCWs accounted for 42% of all the contacts
including at least one patient, suggesting a population of individuals who
could potentially act as super-spreaders. Wearable sensors represent a novel
tool for the measurement of contact patterns in hospitals. The collected data
provides information on important aspects that impact the spreading patterns of
infectious diseases, such as the strong heterogeneity of contact numbers and
durations across individuals, the variability in the number of contacts during
a day, and the fraction of repeated contacts across days. This variability is
associated with a marked statistical stability of contact and mixing patterns
across days. Our results highlight the need for such measurement efforts in
order to correctly inform mathematical models of HAIs and use them to inform
the design and evaluation of prevention strategies.
