TORONTO - It sounds like a plot concocted by Alfred Hitchcock: cockroaches nestling inside oxygen masks in a hospital intensive care unit and crawling around in the light panels hanging from the ceiling.
But this was no horror film.
Swiss doctors have reported finding cockroaches in the ICU of the University of Geneva Hospitals in the summer of 2006. When the problem was first discovered, hospital workers spotted about 30 of the reviled bugs, the authors revealed in a report to the journal Emerging Infectious Diseases.
"The first time we saw that we were horrified. We said: 'My God! What's going on?"' Dr. Didier Pettit, senior author of the report and head of the hospital's infection control team, said from Geneva.
"We have very high standards of infection control in our ICU."
While the ICU had the cockroach problem, a few even fell from the ceiling onto the beds of patients hooked to mechanical breathing machines. But most of the creepy pests were found in doctors' offices in the unit, Pettit explained.
The culprit: Ectobius vittiventris, one of about 4,000 species of the bugs that have been identified worldwide.
Fortunately for the hospital, E. vittiventris is a field-dwelling cockroach that isn't adapted to living indoors. It can't reproduce inside buildings, the authors noted, so stopping the outbreak would be simple if they could figure out how the bugs were getting into the facility.
Investigators trying to crack the mystery eventually found the smoking gun - which in this case was a screwdriver.
Like many other modern buildings, the hospital has both sealed windows and explicit rules barring smoking in the facility.
But going out for a cigarette from ICU, which is located on the ground floor, involved walking about 500 metres to a hospital exit. And some of the doctors' offices were along the outside of the building, separated from a terrace by sealed patio-style doors.
The temptation, it seems, proved too great. Staff on the night shift were secretly prying open the doors so they could step out for a quick smoke break.
"It was mostly doctors but there were also some nurses who like to smoke," Pettit said, noting that it was only after infection control staff and a pest control firm started investigating the second wave of "invaders" that the smokers fessed up.
"It is really, really embarrassing, isn't it? That's what we told them: 'Listen, you are working in an ICU."'
Despite being busted, some staff at first argued against resealing the doors, noting that the cockroaches had congregated mainly in the offices. Their plea was flatly rejected.
"We cannot tolerate that. Can you imagine a family looking at this?" Pettit asked.
Cockroaches can cause health problems, the authors noted. They can trigger allergic reactions in some people and have been suggested as possible vehicles for the spread of multidrug-resistant bacteria.
Cockroaches that live and breed in hospitals have been found to have higher bacterial loads than their non-hospital brethren, the report said, citing earlier research that found up to 98 per cent of hospital cockroaches may carry "medically important" organisms on their surfaces or in their digestive tracts. The latter can be spread to people through contact with cockroach feces.
Cockroaches have been found to carry E. coli, Shigella, Staph and Strep bacteria, fungus and parasites among other pathogens.
Fortunately for the Geneva hospital and its ICU patients, the type of cockroach they found is considered to be harmless and to date has not been associated with human disease or transmission of pathogens.
And the hospital's infection control experts found no cases of allergic reactions or increases in hospital acquired infections linked to the cockroach problem.
Meanwhile, ICU staff have stopped going out for cigarette breaks via the doctors' offices, Pettit said, "Because we locked the doors and now they cannot open them anymore."
