Fogging low concentrated organic acid in a fattening pig unit - Effect on animal health and microclimate

INTRODUCTION AND OBJECTIVE

In intensive pig production aerial contaminates are potential hazards for the health of animals and humans. In this study, the effect of fogging a low concentrated tartaric acid solution on pigs' health, environmental and hygiene parameters were evaluated in an inhabited fattening unit.

MATERIALS AND METHOD

Pigs were housed in separate units (control group n=109 and experimental group n=110). During the whole fattening period, twice a week at 48 hour intervals, a 0.1% tartaric acid solution was aerosolized by a cold-fogging system for 20 minutes in the experimental unit. Environmental parameters were spot-checked on days of fogging. Sedimentation dust and surfaces were analysed for bacterial and fungal load. Dust particle size distribution was assessed. Pigs were clinically examined weekly. Standard meat examination at an abattoir was extended by individual quantification of lung alterations.

RESULTS

The fogging procedure had no influence on ammonia concentrations. A significant reduction of mould, but not of bacteria, was found in sedimentation dust, and bacterial and mould scores of surface samples were improved. A significant reduction of particle size classes 1.6-2.0 µm, 4.0-5.0 µm, 7.5-10 µm, as well as 10-15 µm was observed. The high sound level of the fogging machine (82-102 dB) led to higher activity and pen-mate directed behaviour. More skin alterations, conjunctivitis and sneezing were recorded in the experimental group. Gross pathological lung alterations did not differ between both groups.

CONCLUSIONS

Although fogging of tartaric acid is limited to a concentration of 0.1% due to its irritating effect on the respiratory mucosa, reduction of microbial load can be achieved, but it would be enhanced by using more powerful fogging systems.

Effects of alcohol-based hand hygiene solutions on breath alcohol detection in the emergency department

This study aimed to investigate the effects of alcohol-based hand hygiene solution (ABHS) use by care providers on point-of-care alcohol breath analyzer interpretation under different clinically relevant conditions. Among each test condition (foam vehicle with immediate testing, gel vehicle with immediate testing, allowing hands to dry after the use of ABHS, and donning gloves after the use of ABHS), alcohol was detected in breath at 1 minute after use of ABHS. Because the use of ABHS by individuals administering breath alcohol detection may result in false-positive detection of alcohol, staff using these devices should consider traditional hand hygiene with soap and water.

Reduction in bacterial contamination of hospital textiles by a novel silver-based laundry treatment

Treating hospital patient textiles with ionic silver after each washing results in a significant decrease in microbial contamination. Although further study is needed to better understand the role textiles play in hospital-acquired infections and to quantify the influence of silver textile treatment on health care-associated infection risk and patient outcomes, ionic silver treatment of textiles may prove useful in hospital-acquired infection reduction strategies.

Quantification of particles of lethal mercury in mouse viscera: high-resolution study of mercury in cells and tissues

To investigate the early visceral distribution of mercury (Hg), we have intraperitoneally injected a lethal dose of HgCl2 that killed BALB/c mice within 2-4 min. Scanning electron microscopy coupled with X-ray microanalysis (SEM-XRM) was used to detect and quantify Hg in situ in different organs. The highest density of Hg was seen in the liver (60.99 ±24.9 Hg particles per mm2 of tissue); this density was three and six times higher than those of renal or splenic Hg, respectively. Hg was scarce in the lungs and absent in the brain. Considering the relative weights of mouse viscera, our quantitative data show that the liver captured 89% of the visceral Hg; the kidneys captured 8.5% and the spleen just 1.7%. SEM-XRM revealed that most of the visceral Hg was associated with resident macrophages, a few Hg dots being detected on the surface of erythrocytes. We conclude that: (i) most intraperitoneally injected Hg was captured by liver Kupffer cells within minutes of injection; (ii) a 10-fold lower density of Hg particles was observed in the kidneys, and a 50-fold lower deposition of Hg was found in the spleen; (iii) SEM-XRM is an adequate method to quantify microparticles of Hg in tissues and cells.

Hand hygiene using a new hand-cleansing formulation without sanitizers: Effect on Staphylococcus aureus removal and recovery of properties against skin damage

BACKGROUND

Staphylococcus aureus is known to form a biofilm and colonize on damaged skin of the hands. We investigated changes in the quantity of S aureus on the hands and changes in skin damage when using a hand-cleansing formulation with potassium oleate but without a sanitizer (formulation A), which is highly effective in removing S aureus biofilm and causes minimal skin damage.

MATERIAL AND METHODS

The participants (14 medical staff members) used 2 types of hand-cleansing formulations (formulations A and B), each for 4 weeks. S aureus of the hands was cultured from swab samples on agar plates. Surface of hands was measured using an ultraviolet light microscope.

RESULTS AND DISCUSSION

The quantity of S aureus after using formulation A for 4 weeks was 10(1.08 ± 0.05) CFU/mL, a statistically significant decrease from the quantity of S aureus (10(1.59 ± 0.19) CFU/mL) just before use (P = .029). Also, dryness of hand surfaces decreased. With formulation B, the quantity of S aureus did not significantly change from before to after use (P > .05). This presumably occurs because formulation A gently removes S aureus biofilm.

CONCLUSIONS

Formulation A removed S aureus from the hands of participants, and skin damage on the hands improved.

Systemic TAK-242 prevents intrathecal LPS evoked hyperalgesia in male, but not female mice and prevents delayed allodynia following intraplantar formalin in both male and female mice: The role of TLR4 in the evolution of a persistent pain state

OBJECTIVE

Pain resulting from local tissue injury or inflammation typically resolves with time. Frequently, however, this pain may unexpectedly persist, becoming a pathological chronic state. Increasingly, the innate and adaptive immune systems are being implicated in the initiation and maintenance of these persistent conditions. In particular, Toll-like receptor 4 (TLR4) signaling has been shown to mediate the transition to a persistent pain state in a sex-dependent manner. In the present work, we explored this contribution using the TLR4 antagonist, TAK-242.

METHODS

Male and female C57Bl/6 mice were given intravenous (IV), intrathecal (IT), or intraperitoneal (IP) TAK-242 prior to IT delivery of lipopolysaccharide (LPS), and tactile reactivity was assessed at regular intervals over 72-h. Additional groups of mice were treated with IP TAK-242 prior to intraplantar formalin, and flinching was monitored for 1-h. Tactile reactivity was assessed at 7-days after formalin delivery.

RESULTS

LPS evoked TNF release from male and female macrophages and RAW267.4 cells, which was blocked in a concentration dependent fashion by TAK-242. In vivo, IT LPS evoked tactile allodynia to a greater degree in male than female mice. TAK-242, given by all routes, prevented development of IT LPS-induced tactile allodynia in male animals, but did not reverse their established allodynia. TLR4 deficiency and TAK-242 treatment attenuated IT LPS-induced allodynia in male, but not female mice. In the formalin model, pre-treatment with TAK-242 did not affect Phase 1 or Phase 2 flinching, but prevented the delayed tactile allodynia in both male and unexpectedly in female mice (Phase 3).

CONCLUSIONS

Together, these results suggest that TAK-242 is a TLR4 antagonist that has efficacy after systemic and intrathecal delivery and confirms the role of endogenous TLR4 signaling in triggering the development of a delayed allodynia in both male and female mice.

Effectiveness of an extended period of flashing lights and strategic signage to increase the salience of alcohol-gel dispensers for improving hand hygiene compliance

BACKGROUND

Multiple factors affect compliance with hand hygiene, including conspicuity of alcohol-gel dispensers. Previous studies have shown that flashing lights increase hand hygiene compliance; however, the durability of this effect has not been studied.

METHODS

We affixed flashing lights to hand sanitizer dispensers for a total of 6 weeks. Regression analysis was used to compare compliance rates between the beginning and end of the intervention. Our secondary objective was to determine whether compliance rates in cold weather could be improved by adding a sign separated in time and space from the dispensers.

RESULTS

Flashing lights improved hand hygiene compliance from 11.8% to 20.7%, and this effect was unchanged over the 6-week study period. Fully charged lights resulted in a greater compliance increase. A preemptive sign did not have a significant effect on hand hygiene rates nor did absolute temperatures.

CONCLUSIONS

Flashing lights are a simple, inexpensive way of improving hand hygiene. Brighter lights appear to have a greater effect; however, this must be balanced with annoyance in specific settings. Temperature did not have a significant effect; however, this may be because the relationship does not fit a linear model. Other interventions, such as signs, may need to be tailored specifically to individual hospital environments.

Reduction in Nosocomial Transmission of Drug-Resistant Bacteria After Introduction of an Alcohol-Based Handrub

Objective:

To assess quantitatively the clinical impact of using an alcohol-based handrub (ABHR) in the hospital environment, measuring impact as the incidence of new, nosocomial isolates of drug-resistant organisms.

Design:

An observational survey from 1998 to 2003 comparing the first 3 years of no ABHR use with the 3 years following, when an ABHR was provided for hand hygiene.

Setting:

An inner-city, tertiary-care medical center.

Intervention:

At baseline, an antimicrobial soap with 0.3% triclosan was provided for staff hand hygiene. The intervention was placement in all inpatient and all outpatient clinic rooms of wall-mounted dispensers of an ABHR with 62.5% ethyl alcohol. Data were collected on change in the incidence of three drug-resistant bacteria.

Results:

During the 6 years of the survey, all new, nosocomially acquired isolates of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Clostridium difficile-associated diarrhea were recorded. On comparison of the first 3 years with the final 3 years, there was a 21% decrease in new, nosocomially acquired MRSA (90 to 71 isolates per year; P = .01) and a 41% decrease in VRE (41 to 24 isolates per year; P < .001). The incidence of new isolates of C. difficile was essentially unchanged.

Conclusion:

In the 3 years following implementation of an ABHR, this hospital experienced the value of reductions in the incidence of nosocomially acquired drug-resistant bacteria. These reductions provide clinical validation of the recent CDC recommendation that ABHRs be the primary choice for hand decontamination. (Infect Control Hosp Epidemiol 2005;26:650-653)

Transfer and Decontamination of S. aureus in Transmission Routes Regarding Hands and Contact Surfaces

Hand hygiene, cleaning and disinfection are pre-requirements for hygiene management in hospital settings and the food industry. In order to facilitate risk management, different contamination scenarios and interventions need to be evaluated. In the present study data on transfer rates and reductions of Staphylococcus aureus were provided in an experimental set-up using artificial skin. Using this methodology, test persons were not exposed with pathogenic bacteria. An exposure assessment model was developed and applied to evaluate different contamination routes and hygiene interventions. The transfer rates of S. aureus from inoculated VITRO-SKIN^® to fomites were calculated from blotting series. The VITRO-SKIN^® was more prone to spread bacteria than fomites. When different surfaces were cleaned, the reduction of S. aureus varied between <1 and 7 log CFU. It could not be concluded that a certain coupon material, cleaning agent, cleaning wipe, soiling or humidity consistently resulted in a high or low reduction of S. aureus. The reduction of S. aureus and E. coli during hand washing was evaluated on artificial skin, VITRO-SKIN^®. The reduction of E. coli on VITRO-SKIN^® was similar to the log reduction obtained when washing human hands. The S. aureus count on a human hand was both calculated in different scenarios describing different contamination routes starting from a contaminated hand using the exposure assessment model, and measured on an experimental setup using VITRO-SKIN^® for validation. A linear relationship was obtained between the analysed level of S. aureus and the calculated level. However, the calculated levels of S. aureus on the VITRO-SKIN^® in the scenarios were 1–1.5 log lower than the analysed level. One of the scenarios was used to study the effect of interventions like hand washing and cleaning of surfaces.

Visitor characteristics and alcohol-based hand sanitizer dispenser locations at the hospital entrance: Effect on visitor use rates

BACKGROUND

Hospital visitors' hand hygiene (HH) is an important aspect of preventing health care-associated infections, but little is known about visitors' use of alcohol-based hand sanitizers (AHS). The study aim was to examine if use of AHS is influenced by visitor characteristics and the location of AHS within the lobby of a large hospital.

METHODS

An observational study was conducted with AHS placed in 3 different locations. The data included visitor characteristics and if AHS were used.

RESULTS

The results suggest that visitors are 5.28 times (95% confidence interval [CI], 3.68-7.82) more likely to use AHS when dispensers are located in the middle of the lobby with limited landmarks or barriers, 1.35 times more likely to use the AHS in the afternoon compared with the morning, or when they are younger visitors (adjusted odds ratio, 1.47; 95% CI, 1.09-1.97). Individuals in a group are more likely (adjusted odds ratio, 1.39; 95% CI, 1.06-1.84) to use AHS.

DISCUSSION

In addition to location, time of day, and age, there is a group effect that results in visitors being more likely to use AHS when in a group. The increased use related to groups may serve as a mechanism to encourage visitor HH.

CONCLUSIONS

The results suggest future research opportunities to investigate the effect of group dynamics and social pressure on visitor AHS use and to identify strategies for improving visitor HH.

Management of a hospital outbreak of extensively drug-resistant Acinetobacter baumannii using a multimodal intervention including daily chlorhexidine baths

BACKGROUND

Extensively drug-resistant Acinetobacter baumannii (XDR-Ab) is an increasingly important cause of healthcare-associated infection. Uncertainties remain concerning optimal control measures for healthcare-associated outbreaks.

AIM

To describe the epidemiology and control of an XDR-Ab outbreak that involved multiple units of a large hospital from March 2012 to January 2014.

METHODS

Case-finding included screening of rectum, groin, throat, nose, wounds, iatrogenic portals of entry, and catheterized sites. Antimicrobial susceptibility was evaluated by disc diffusion and E-test. Resistance genes were detected by polymerase chain reaction. Clonality was assessed by pulsed-field gel electrophoresis. Charts of cases were reviewed to identify risk factors for invasive infection. Control measures included isolation and cohorting of cases, hand hygiene reinforcement, environmental decontamination, and source control with daily baths using wipes pre-impregnated with chlorhexidine gluconate.

FINDINGS

A single clonal strain of XDR-Ab colonized or infected 29 patients. Five patients died of XDR-Ab bacteraemia. Transmission occurred primarily on two wards. Colonization was detected at all anatomical screening sites; only 57% (16/28) of cases were rectal carriers. Advanced malignancy was a risk factor for bacteraemia (relative risk: 5.8; 95% confidence interval: 1.2-27.0). Transmission ended following implementation of the multimodal control strategy. No additional nosocomial cases occurred during the following 20 months.

CONCLUSION

Our study highlights the need to screen multiple anatomic sites to diagnose carriage and identifies risk factors for XDR-Ab bacteraemia. A multimodal intervention that included daily chlorhexidine baths for cases was rapidly followed by the termination of the outbreak. Hospitals should consider similar interventions when managing future XDR-Ab outbreaks.

Disinfectant choices in veterinary practices, shelters and households: ABCD guidelines on safe and effective disinfection for feline environments

OVERVIEW

Regardless of whether a pathogen is viral, bacterial, parasitic, fungal or an emerging unknown, the mainstay of infectious disease control is hygiene, and the cornerstone of good hygiene is effective disinfection.

CHALLENGES AND CURRENT CHOICES

Certain pathogens present a challenge to kill effectively: parvovirus, protozoal oocysts, mycobacteria, bacterial spores and prions resist most disinfectants but can be eliminated through heat, especially steam, which will kill protozoal oocysts. Heat is the safest and most effective disinfectant, but cannot be universally applied. Temperatures in washing machines and dishwashers should be at least 60 °C to eliminate pathogenic spores and resistant viruses. Enveloped viruses are susceptible to most disinfectants; of the non-enveloped viruses, parvovirus is recognised as being the most difficult to eradicate. Sodium hypochlorite is recommended for many applications: cleaning of floors, laundry, food preparation surfaces and utensils. Skin scrubs and rubs containing alcohols are more effective than those containing chlorhexidine, and less subject to contamination.

DISINFECTANTS TO AVOID

Deficiency of the enzyme UDP-glucuronosyl transferase renders the cat susceptible to the toxic effects of phenol-based disinfectants (including many essential oils), so these should be avoided in feline environments. Quaternary ammonium compounds (eg, benzalkonium chloride) are also probably best avoided.

THE FUTURE

Veterinary disinfection approaches in the future may include use of ultraviolet radiation and, increasingly, silver.

Hydrogen peroxide vapor room disinfection and hand hygiene improvements reduce Clostridium difficile infection, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and extended-spectrum β-lactamase

We report a statistically significant reduction in Clostridium difficile infection (from 1.38 to 0.90 cases per 1,000 patient days), vancomycin-resistant enterococci (from 0.21 to 0.01 cases per 1,000 patient days), and extended-spectrum β-lactamase-producing gram-negative bacteria (from 0.16 to 0.01 cases per 1,000 patient days) associated with the introduction of hydrogen peroxide vapor for terminal decontamination of patient rooms and improvements in hand hygiene compliance.

Legionnaires' Disease Outbreak at a Long-Term Care Facility Caused by a Cooling Tower Using an Automated Disinfection System--Ohio, 2013

On July 9, 2013, an outbreak of Legionnaires' disease (LD) was identified at Long-Term Care Facility A in central Ohio. This article describes the investigation of the outbreak and identification of the outbreak source, a cooling tower using an automated biocide delivery system. In total, 39 outbreak LD cases were identified; among these, six patients died. Water samples from a cooling tower were positive for Legionella pneumophila serogroup 1, reactive to monoclonal antibody 2, with matching sequence type to a patient isolate. An electronic control system turned off cooling tower pumps during low-demand periods, preventing delivery of disinfectant by a timed-release system, and leading to amplification of Legionella in the cooling tower. Guidelines for tower maintenance should address optimal disinfection when using automated systems.

Safety of daily ethanol locks for urinary catheters in critically ill children: a pilot study

Catheter-associated urinary tract infections represent a significant medical burden in critically ill children. Ethanol locks have been shown to be effective and safe for central line-associated bloodstream infection prevention and we propose utilizing this strategy for urinary catheters. Because this has never been done, we evaluated its safety with a pilot study hypothesizing that ethanol locks in urinary catheters would result in negligible alcohol absorption and negligible irritation of the bladder.

Effect of liming on sulfate transformation and sulfur gas emissions in degraded vegetable soil treated by reductive soil disinfestation

Reductive soil disinfestation (RSD), namely amending organic materials and mulching or flooding to create strong reductive status, has been widely applied to improve degraded soils. However, there is little information available about sulfate (SO4(2-)) transformation and sulfur (S) gas emissions during RSD treatment to degraded vegetable soils, in which S is generally accumulated. To investigate the effects of liming on SO4(2-) transformation and S gas emissions, two SO4(2-)-accumulated vegetable soils (denoted as S1 and S2) were treated by RSD, and RSD plus lime, denoted as RSD0 and RSD1, respectively. The results showed that RSD0 treatment reduced soil SO4(2-) by 51% and 61% in S1 and S2, respectively. The disappeared SO4(2-) was mainly transformed into the undissolved form. During RSD treatment, hydrogen sulfide (H2S), carbonyl sulfide (COS), and dimethyl sulfide (DMS) were detected, but the total S gas emission accounted for <0.006% of total S in both soils. Compared to RSD0, lime addition stimulated the conversion of SO4(2-) into undissolved form, reduced soil SO4(2-) by 81% in S1 and 84% in S2 and reduced total S gas emissions by 32% in S1 and 57% in S2, respectively. In addition to H2S, COS and DMS, the emissions of carbon disulfide, methyl mercaptan, and dimethyl disulfide were also detected in RSD1 treatment. The results indicated that RSD was an effective method to remove SO4(2-), liming stimulates the conversion of dissolved SO4(2-) into undissolved form, probably due to the precipitation with calcium.

[DIFFERENTIAL SENSITIVITY OF MICROORGANISMS TO POLYHEXAMETHYLENEGUANIDINE]

Factors identified that affect the sensitivity of microorganisms to polyhexamethyleneguanidine (PHMG). Salts of PHMG chloride, valerate, maleate, succinate was to use. Test strains of Esherichia coli, Staphylococcus aureus, Bacillus cereus, Leptospira interrogans, Paenibacillus larvae, Mycobacterium bovis, M. avium, M. fortuitum, Aspergillus niger and some strains of viruses are taken as objects of research. We have determined that the cytoplasm membrane phospholipids is main "target" for the polycation molecules of PHMG. A differential sensitivity of the microorganisms to this drug is primarily determined by relative amount of lipids in membrane and their accessibility. Such trends exist: increase the relative contents of anionic lipids and more negative surface electric potential of membrane, and reduction of the sizes fat acid remainder of lipids bring to increase of microorganism sensitivity. Types of anion salt PHMG just have a certain value. Biocide activity of PHMG chloride is more, than its salts with organic acid. Feasibility of combining PHMG with other biocides in the multicomponent disinfectants studied and analyzed. This combination does not lead to a significant increase in the sensitivity of microorganisms tested in most cases. Most species of pathogenic bacteria can be quickly neutralized by aqueous solutions of PHMG in less than 1% concentrations.

Diversities in perceived knowledge and practice of preoperative skin preparation in Swedish orthopaedic surgery

Preoperative skin preparations may reduce the risk of hospital-acquired infections. This cross sectional questionnaire study aimed to identify the practice and knowledge of preoperative skin preparation in Swedish orthopaedic surgery departments. One hundred and six respondents (response rate 68%) from 13 Swedish orthopaedic departments reported a diversity of current recommendations and evidence, and good knowledge of skin preparations. This study found variations in practice and deviations from recommendations, despite high levels of knowledge.

Antibiotic therapy in the management of atopic dermatitis

Atopic dermatitis (AD), also known as atopic eczema, is a syndrome characterized by a chronic eczematous dermatitis, with associated pruritus, characteristic age-specific morphology and distribution of lesions and recurrent nature. Secondary infections in patients with AD are very common and difficult to treat. S. aureus colonizes almost all eczematous lesions in atopic patients and releases several super-antigens and exotoxins (i.e., toxic shock syndrome toxin-1, enterotoxins A-D, etc.), which sustain inflammatory reactions and promote tachyphylaxis. The topical antibiotics most commonly prescribed for mild/moderate secondary infections are gentamicin, fusidic acid and mupirocine. This article reviews existing therapeutic options and provides guidance for the management of secondary skin infection among patients with AD.

Silver biocide's real-world success

Although temperature control has been the UK's longest-serving means of controlling the growth and proliferation of Legionella in hot and cold water systems, there are other factors, including major rises in energy costs, that warrant the use of biocides--including in the healthcare sector. In 2000, the HSE's new 'L8' guidelines took this into account, giving equal weight to both temperature reg~mes and biocides, such as chlorine dioxide, as control methods. Susan Pearson BSc reports on one potentially effective biocide- silver hydrogen peroxide, explains how it 'works' in practice, and highlights the recent 'real-world' evidence of its effectiveness and advantages.