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Mizuno M, Matsuda J, Watanabe K, Shimizu N, Sekiya I. Effect of disinfectants and manual wiping for processing the cell product changeover in a biosafety cabinet. Regen Ther 2023; 22:169-175. [PMID: 36843961 PMCID: PMC9945742 DOI: 10.1016/j.reth.2023.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/12/2023] [Accepted: 01/26/2023] [Indexed: 02/11/2023] Open
Abstract
Introduction The process of cell product changeover poses a high risk of cross-contamination. Hence, it is essential to minimize cross-contamination while processing cell products. Following its use, the surface of a biosafety cabinet is commonly disinfected by ethanol spray and manual wiping methods. However, the effectiveness of this protocol and the optimal disinfectant have not yet been evaluated. Here, we assessed the effect of various disinfectants and manual wiping methods on bacterial removal during cell processing. Methods The hard surface carrier test was performed to evaluate the disinfectant efficacy of benzalkonium chloride with a corrosion inhibitor (BKC + I), ethanol (ETH), peracetic acid (PAA), and wiping against Bacillus subtilis endospores. Distilled water (DW) was used as the control. A pressure sensor was employed to investigate the differences in loading under dry and wet conditions. The pre-spray for wiping was monitored by eight operators using a paper that turns black when wet. Chemical properties, including residual floating proteins, and mechanical properties, such as viscosity and coefficient of friction, were examined. Results In total, 2.02 ± 0.21-Log and 3.00 ± 0.46-Log reductions from 6-Log CFU of B. subtilis endospores were observed for BKC + I and PAA, respectively, following treatment for 5 min. Meanwhile, wiping resulted in a 0.70 ± 0.12-Log reduction under dry conditions. Under wet conditions, DW and BKC + I showed 3.20 ± 0.17-Log and 3.92 ± 0.46-Log reductions, whereas ETH caused a 1.59 ± 0.26-Log reduction. Analysis of the pressure sensor suggested that the force was not transmitted under dry conditions. Evaluation of the amount of spray by eight operators showed differences and bias in the spraying area. While ETH had the lowest ratio in the protein floating and collection assays, it exhibited the highest viscosity. BKC + I had the highest friction coefficient under 4.0-6.3 mm/s; however, that of BKC + I decreased and became similar to the friction coefficient of ETH under 39.8-63.1 mm/s. Conclusions DW and BKC + I are effective for inducing a 3-Log reduction in bacterial abundance. Moreover, the combination of optimal wet conditions and disinfectants is essential for effective wiping in specific environments containing high-protein human sera and tissues. Given that some raw materials processed in cell products contain high protein levels, our findings suggest that a complete changeover of biosafety cabinets is necessary in terms of both cleaning and disinfection.
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Mizuno M, Yori K, Takeuchi T, Yamaguchi T, Watanabe K, Tomaru Y, Shimizu N, Sekiya I. Cross-contamination risk and decontamination during changeover after cell-product processing. Regen Ther 2022; 22:30-38. [PMID: 36618490 PMCID: PMC9800260 DOI: 10.1016/j.reth.2022.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/24/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction During changeover in cell-product processing, it is essential to minimize cross-contamination risks. These risks differ depending on the patient from whom the cells were derived. Human error during manual cell-product processing increases the contamination risk in biosafety cabinets. Here, we evaluate the risk of cross-contamination during manual cell-processing to develop an evidence-based changeover method for biosafety cabinets. Methods Contaminant coverage was analyzed during simulated medium preparation, cell seeding, and waste liquid decanting by seven operators, classified by skill. Environmental bacteria were surveyed at four participating facilities. Finally, we assessed the effect of conventional UV irradiation in biosafety cabinets on bacteria and fungi that pose a cross-contamination risk. Results Under simulated conditions, scattered contamination occurred via droplets falling onto the surface from heights of 30 cm, and from bubbles rupturing at this height. Visible traces of contaminants were distributed up to 50 cm from the point of droplet impact, or from the location of the pipette tip when the bubble ruptured. In several facilities, we detected Bacillus subtilis, of which the associated endospores are highly resistant to disinfection. Irradiation at 50 mJ/cm2 effectively eliminated Bacillus subtilis vegetative cells and Aspergillus brasiliensis, which is highly resistant to UV. Bacillus subtilis endospores were eliminated at 100 mJ/cm2. Conclusions Under these simulated optimal conditions, UV irradiation successfully prevents cross-contamination. Therefore, following cell-product processing, monitoring the UV dose in the biosafety cabinet during cell changeover represents a promising method for reducing cross-contamination.
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Affiliation(s)
- Mitsuru Mizuno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45, Bunkyo-ku, Yushima, Tokyo 113-8519, Japan,Corresponding author. Fax: +81-3-5803-0192.
| | - Kouichirou Yori
- Department of HeartSheet Business, Terumo Corporation, 1500 Inokuchi, Nakaicho, Ashigarakamigun, Kanagawa 259-0151, Japan
| | - Toshikazu Takeuchi
- Department of HeartSheet Business, Terumo Corporation, 1500 Inokuchi, Nakaicho, Ashigarakamigun, Kanagawa 259-0151, Japan
| | - Tetsuya Yamaguchi
- Department of HeartSheet Business, Terumo Corporation, 1500 Inokuchi, Nakaicho, Ashigarakamigun, Kanagawa 259-0151, Japan
| | - Ken Watanabe
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45, Bunkyo-ku, Yushima, Tokyo 113-8519, Japan
| | - Yasuhiro Tomaru
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45, Bunkyo-ku, Yushima, Tokyo 113-8519, Japan
| | - Norio Shimizu
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45, Bunkyo-ku, Yushima, Tokyo 113-8519, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45, Bunkyo-ku, Yushima, Tokyo 113-8519, Japan
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Tyan K, Zuckerman JM, Cutler C, Modupe K, Ray D, Marmolejo L, Kang J. A multiphase intervention of novel color additive for bleach disinfectant wipes improves thoroughness of cleaning in an academic medical center. Am J Infect Control 2022; 50:469-472. [PMID: 34793887 DOI: 10.1016/j.ajic.2021.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/08/2021] [Accepted: 11/08/2021] [Indexed: 11/28/2022]
Abstract
Surface disinfection is critical for preventing health care-associated infections; however, sustaining high-quality cleaning technique is challenging without constant feedback and training of staff. A novel color additive to bleach wipes, Highlight, indicates where surfaces have been wiped and fades to colorless to provide real-time visual feedback of cleaning. In a multiphase interventional study, Highlight reduced failure rates of cleaning based on fluorescent marker removal (15.0%-4.5%) and adenosine triphosphate bioluminescence assay (3.6%-2.5%).
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Affiliation(s)
- Kevin Tyan
- Kinnos Inc., Brooklyn, NY; Harvard Medical School, Boston, MA.
| | | | | | - Kunle Modupe
- Hackensack University Medical Center, Hackensack, NJ
| | - Dennis Ray
- Hackensack University Medical Center, Hackensack, NJ
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Meyer J, Nippak P, Cumming A. An evaluation of cleaning practices at a teaching hospital. Am J Infect Control 2021; 49:40-43. [PMID: 32599097 PMCID: PMC7318966 DOI: 10.1016/j.ajic.2020.06.187] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 11/02/2022]
Abstract
BACKGROUND The COVID-19 outbreak has highlighted the role of hospital-acquired infections in spreading epidemics. Adequately cleaning surfaces in patient rooms is an essential part of this fight to reduce the spread. Traditional audits, however, are insufficient. This study assesses surface cleaning practices using ultravoilet (UV) marker technology and the extent to which this technology can help improve cleaning audits and practices. METHODS One hundred and forty-four audits (1,235 surfaces) were retrieved. UV-marker cleaning audits conducted at a major teaching hospital in 2018 after implementing a new cleaning protocol. In addition, semi-structured interviews were conducted with cleaning staff and supervisors. RESULTS On average, 63% of surfaces were appropriately cleaned. Toilet handles (80%) and toilet seats underside (83%) scored highest while main room sink fixtures (54%), light switch (55%), and bedrails (56%) scored lowest. Training, staffing and time constraints may play a role in low cleaning rates. DISCUSSION The high-touch patient surfaces in the bedroom remain neglected and a potential source of infections. UV marker audits provided an objective measure of cleaning practices that managers and staff were unaware of. CONCLUSIONS UV-markers audits can play a key role in revealing deficiencies in cleaning practices and help in raising awareness of these deficiencies and improving cleaning practices.
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Horn H, Niemeyer B. Aerosol disinfection of bacterial spores by peracetic acid on antibacterial surfaces and other technical materials. Am J Infect Control 2020; 48:1200-1203. [PMID: 32173125 DOI: 10.1016/j.ajic.2020.01.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The effectiveness of aerosol disinfection processes based on peracetic acid (PAA) might differ depending on the surface targeted. Especially antibacterial, oligodynamic materials have to be regarded as they could cause elevated decomposition of PAA. AIM This study aimed on the determination of differences in disinfection effectiveness using PAA caused by the treated material. METHODS Aerosol disinfection of Geobacillus stearothermophilus spores was performed on the antibacterial, oligodynamic materials copper and brass in comparison to stainless steel and aluminium as well as polyvinylchloride, wood, and ceramics. Additionally, the influence of the materials on the decomposition reaction of PAA was evaluated. RESULTS For aluminium and stainless steel as well as ceramics and polyvinylchloride, a disinfection of 106 spores of Geobacillus stearothermophilus on 40 cm² was obtained by the employment of 60 mL aerosolized disinfectant/m³ on laboratory scale (0.5 m³). For the application on the oligodynamic materials copper and brass an over 30% higher amount of disinfectant was necessary to achieve significant disinfection results, than for the other material surfaces. In contrast to aluminium and stainless steel, copper and brass caused elevated decomposition of PAA what seems to be the reason for the lowered disinfection effectiveness. CONCLUSIONS Applying aerosol disinfection processes, in addition to parameters such as room size and geometry, the treated materials have to be considered when determining the necessary amount of disinfectant.
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Oliveira BADS, Bernardes LDO, Ferreira AM, Pessalacia JDR, Furlan MCR, de Sousa ÁFL, de Andrade D, Barbosa DA, Lapão LV, dos Santos Junior AG. Impact of Educational Intervention on Cleaning and Disinfection of an Emergency Unit. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093313. [PMID: 32397527 PMCID: PMC7246614 DOI: 10.3390/ijerph17093313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/09/2020] [Accepted: 04/17/2020] [Indexed: 11/16/2022]
Abstract
We aimed to evaluate the impact of an educational intervention on the surface cleaning and disinfection of an emergency room. This is an interventional, prospective, longitudinal, analytical and comparative study. Data collection consisted of three stages (Stage 1-baseline, Stage 2-intervention and immediate assessment, Stage 3-long term assessment). For the statistical analysis, we used a significance level of α = 0.05. The Wilcoxon and the Mann-Whitney test tests were applied. We performed 192 assessments in each stage totaling 576 evaluations. Considering the ATP method, the percentage of approval increased after the educational intervention, as the approval rate for ATP was 25% (Stage 1), immediately after the intervention it went to 100% of the approval (Stage 2), and in the long run, 75% of the areas have been fully approved. Stage 1 showed the existence of significant differences between the relative light units (RLU) scores on only two surfaces assessed: dressing cart (p = 0.021) and women's toilet flush handle (p = 0.014); Stage 2 presented three results with significant differences for ATP: dressing cart (p = 0.014), women's restroom door handle (p = 0.014) and women's toilet flush handle (p = 0.014); in step III, there was no significant difference for the ATP method. Therefore, conclusively, the educational intervention had a positive result in the short term for ATP; however, the same rates are not observed with the colony-forming units (CFU), due to their high sensitivity and the visual inspection method since four surfaces had defects in their structure.
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Affiliation(s)
- Bruna Andrade dos Santos Oliveira
- Campus Três Lagoas, University of Mato Grosso do Sul, Três Lagoas 79600-080, Brazil; (B.A.d.S.O.); (L.d.O.B.); (A.M.F.); (J.D.R.P.); (M.C.R.F.); (A.G.d.S.J.)
| | - Lucas de Oliveira Bernardes
- Campus Três Lagoas, University of Mato Grosso do Sul, Três Lagoas 79600-080, Brazil; (B.A.d.S.O.); (L.d.O.B.); (A.M.F.); (J.D.R.P.); (M.C.R.F.); (A.G.d.S.J.)
| | - Adriano Menis Ferreira
- Campus Três Lagoas, University of Mato Grosso do Sul, Três Lagoas 79600-080, Brazil; (B.A.d.S.O.); (L.d.O.B.); (A.M.F.); (J.D.R.P.); (M.C.R.F.); (A.G.d.S.J.)
| | - Juliana Dias Reis Pessalacia
- Campus Três Lagoas, University of Mato Grosso do Sul, Três Lagoas 79600-080, Brazil; (B.A.d.S.O.); (L.d.O.B.); (A.M.F.); (J.D.R.P.); (M.C.R.F.); (A.G.d.S.J.)
| | - Mara Cristina Ribeiro Furlan
- Campus Três Lagoas, University of Mato Grosso do Sul, Três Lagoas 79600-080, Brazil; (B.A.d.S.O.); (L.d.O.B.); (A.M.F.); (J.D.R.P.); (M.C.R.F.); (A.G.d.S.J.)
| | - Álvaro Francisco Lopes de Sousa
- Network in Exposome Human and Infectious Diseases (NEHID), School of Nursing of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-902, Brazil;
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, 1349-008 Lisbon, Portugal;
- Correspondence:
| | - Denise de Andrade
- Network in Exposome Human and Infectious Diseases (NEHID), School of Nursing of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-902, Brazil;
| | | | - Luis Velez Lapão
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, 1349-008 Lisbon, Portugal;
| | - Aires Garcia dos Santos Junior
- Campus Três Lagoas, University of Mato Grosso do Sul, Três Lagoas 79600-080, Brazil; (B.A.d.S.O.); (L.d.O.B.); (A.M.F.); (J.D.R.P.); (M.C.R.F.); (A.G.d.S.J.)
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Frota OP, Ferreira AM, Rigotti MA, Andrade DD, Borges NMA, Ferreira Júnior MA. Effectiveness of clinical surface cleaning and disinfection: evaluation methods. Rev Bras Enferm 2020; 73:e20180623. [PMID: 32049250 DOI: 10.1590/0034-7167-2018-0623] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 06/25/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To discuss the methods employed to evaluate the effectiveness of clinical surface cleaning and disinfection (C&D). METHOD This is a theoretical reflection based on scientific studies and the experience of the authors. Knowledge and current gaps, the need for further studies, and practical application of the methods were approached. RESULTS There are four main methods used to evaluate the effectiveness of clinical surface C&D: visual inspection, fluorescent markers, microbiological cultures, and adenosine triphosphate (ATP) bioluminescence. The first two are used to evaluate the process and to predict adherence to protocols by the staff, and the last two are employed to evaluate the results, therefore being the most relevant to assess the risk of infection. FINAL CONSIDERATIONS The ideal method was not found, because all of them showed limitations. There is a need for strategies to optimize the precision of these methods.
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Affiliation(s)
- Oleci Pereira Frota
- Universidade Federal de Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
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Furlan MCR, Ferreira AM, Rigotti MA, Guerra OG, Frota OP, Sousa AFLD, Andrade DD. Correlação entre métodos de monitoramento de limpeza e desinfecção de superfícies ambulatoriais. ACTA PAUL ENFERM 2019. [DOI: 10.1590/1982-0194201900039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Avaliar a correlação entre cultura microbiológica, teste de ATP por bioluminescência e inspeção visual na monitorização da eficiência da limpeza e da desinfecção de superfícies de uma unidade ambulatorial e determinar o valor de corte de ATP-bioluminescência capaz de indicar superfície limpa em relação à avaliação microbiológica. Métodos Estudo exploratório, longitudinal e correlacional. Foram realizadas 720 avaliações em cinco superfícies antes e após a limpeza e a desinfecção. Nos resultados, foram realizadas análises de duas proporções, a correlação de Spearman e a curva ROC. Resultados Ocorreram proporções semelhantes (p≥0,05) entre as taxas de reprovação apenas entre ATP-bioluminescência e contagem de colônias aeróbias (CCA) quando somadas as avaliações de todas as superfícies antes e depois da limpeza e da desinfecção. Houve correlação significativa entre os métodos de quantificação de ATP e a contagem microbiana para o balcão da recepção e a maca. A análise ROC indicou que a quantificação de ATP apresentou resultado significativo na comparação com a CCA (p=0,044). Conclusão Embora discreta, houve correlação significativa entre os métodos de quantificação de ATP e contagem microbiana para duas superfícies. Sugere-se que superfícies que apresentam valores ≤49 unidades relativas de luz estão limpas.
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Implementation of cleaning and evaluation process for mobile patient equipment using adenosine triphosphate. Infect Control Hosp Epidemiol 2019; 40:798-800. [PMID: 31084662 DOI: 10.1017/ice.2019.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We implemented a cleaning process for mobile patient equipment (MPE) and determined its success using adenosine trisphosphate (ATP) monitoring and data feedback. Following education for staff and ATP data feedback, the data suggest that the MPE cleaning program we implemented was successful.
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Furlan MCR, Ferreira AM, da Silva Barcelos L, Rigotti MA, de Sousa AFL, Dos Santos Junior AG, de Andrade D, de Almeida MTG, da Silva Barreto M. Evaluation of disinfection of surfaces at an outpatient unit before and after an intervention program. BMC Infect Dis 2019; 19:355. [PMID: 31035961 PMCID: PMC6489196 DOI: 10.1186/s12879-019-3977-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 04/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cleaning and disinfection processes must be improved so that there is a reduction in environmental contamination of frequent-contact surfaces. The objective of this study was to evaluate cleaning and disinfection of surfaces at a specialized healthcare unit after an intervention program. METHODS Exploratory, longitudinal, and correlational study carried out in a medium-complexity clinic. Two hundred and forty samples from five surfaces were collected during three phases: diagnosis; implementation of an intervention program; and evaluation of immediate and long-term effects. In total, 720 evaluations were made, performed through three monitoring methods: visual inspection; adenosine triphosphate bioluminescence assay (ATP); and aerobic colony count (ACC). The Wilcoxon, Mann-Whitney, and Fisher's Exact tests were run to analyze data statistically. RESULTS Cleaning and disinfection of surfaces were not being performed properly in most cases. Failure rates of surfaces reached 37.5 and 100% when the ATP and ACC procedures were used, respectively. However, after an intervention program, an improvement occurred. Success rates increased by 43.96% (ATP) and 12.46% (ACC) in phase I, by 70.6% (ATP) and 82.3% (ACC) immediately after interventions, and by 76.52% (ATP) and 85.76% (ACC) two months after the changes, showing that the program was effective. CONCLUSION The present study reveals that implementing intervention actions with a cleaning and healthcare team brings benefits to prevent the spread of pathogenic agents through frequently touched hospital surfaces.
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Affiliation(s)
| | | | | | | | - Alvaro Francisco Lopes de Sousa
- Ribeirão Preto College of Nursing at University of São Paulo, Ribeirão Preto, São Paulo, Brazil. .,Global Health and Tropical Medicine, Instituto de Higiene e MedicinaTropical (IHMT), Universidade NOVA de Lisboa (UNL), Lisbon, Portugal. .,Campus Universitário - Bairro Monte Alegre, Avenida dos Bandeirantes, 3900, Ribeirão Preto, CEP: 14040-902, SP, Brasil.
| | | | - Denise de Andrade
- Ribeirão Preto College of Nursing at University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Frota OP, Ferreira AM, Guerra OG, Rigotti MA, Andrade DD, Borges NMA, Almeida MTGD. Efficiency of cleaning and disinfection of surfaces: correlation between assessment methods. Rev Bras Enferm 2018; 70:1176-1183. [PMID: 29160477 DOI: 10.1590/0034-7167-2016-0608] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 02/02/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to assess the correlation among the ATP-bioluminescence assay, visual inspection and microbiological culture in monitoring the efficiency of cleaning and disinfection (C&D) of high-touch clinical surfaces (HTCS) in a walk-in emergency care unit. METHOD a prospective and comparative study was carried out from March to June 2015, in which five HTCS were sampled before and after C&D by means of the three methods. The HTCS were considered dirty when dust, waste, humidity and stains were detected in visual inspection; when ≥2.5 colony forming units per cm2 were found in culture; when ≥5 relative light units per cm2 were found at the ATP-bioluminescence assay. RESULTS 720 analyses were performed, 240 per method. The overall rates of clean surfaces per visual inspection, culture and ATP-bioluminescence assay were 8.3%, 20.8% and 44.2% before C&D, and 92.5%, 50% and 84.2% after C&D, respectively (p<0.001). There were only occasional statistically significant relationships between methods. CONCLUSION the methods did not present a good correlation, neither quantitative nor qualitatively.
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Affiliation(s)
- Oleci Pereira Frota
- Universidade Federal de Mato Grosso do Sul, Postgraduate Program in Health and Development in the Midwest Region. Campo Grande, Mato Grosso do Sul, Brazil
| | - Adriano Menis Ferreira
- Universidade Federal de Mato Grosso do Sul, Postgraduate Program in Health and Development in the Midwest Region. Campo Grande, Mato Grosso do Sul, Brazil
| | - Odanir Garcia Guerra
- Universidade Federal de Mato Grosso do Sul, Nursing Course. Três Lagoas, Mato Grosso do Sul, Brazil
| | | | - Denise de Andrade
- Universidade de São Paulo, Ribeirão Preto College of Nursing, Department of General and Specialized Nursing. Ribeirão Preto, São Paulo, Brazil
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Liang SY, Riethman M, Fox J. Infection Prevention for the Emergency Department: Out of Reach or Standard of Care? Emerg Med Clin North Am 2018; 36:873-887. [PMID: 30297010 PMCID: PMC6203442 DOI: 10.1016/j.emc.2018.06.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Stephen Y Liang
- Division of Emergency Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8072, St Louis, MO 63110, USA; Division of Infectious Diseases, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8051, St Louis, MO 63110, USA.
| | - Madison Riethman
- Communicable Disease, Clark County Public Health, Center for Community Health, 1601 East Fourth Plain Boulevard, Building 17, PO Box 9825, Vancouver, WA 98666, USA
| | - Josephine Fox
- Infection Prevention, Barnes-Jewish Hospital, Mailstop 90-75-593, 4590 Children's Place, St Louis, MO 63108, USA
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Leone CM, Dharmasena M, Tang C, DiCAPRIO E, Ma Y, Araud E, Bolinger H, Rupprom K, Yeargin T, Li J, Schaffner D, Jiang X, Sharp J, Vinjé J, Fraser A. Prevalence of Human Noroviruses in Commercial Food Establishment Bathrooms. J Food Prot 2018; 81:719-728. [PMID: 29611730 PMCID: PMC6361381 DOI: 10.4315/0362-028x.jfp-17-419] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Although transmission of human norovirus in food establishments is commonly attributed to consumption of contaminated food, transmission via contaminated environmental surfaces, such as those in bathrooms, may also play a role. Our aim was to determine the prevalence of human norovirus on bathroom surfaces in commercial food establishments in New Jersey, Ohio, and South Carolina under nonoutbreak conditions and to determine characteristics associated with the presence of human norovirus. Food establishments (751) were randomly selected from nine counties in each state. Four surfaces (underside of toilet seat, flush handle of toilet, inner door handle of stall or outer door, and sink faucet handle) were swabbed in male and female bathrooms using premoistened macrofoam swabs. A checklist was used to collect information about the characteristics, materials, and mechanisms of objects in bathrooms. In total, 61 (1.5%) of 4,163 swabs tested were presumptively positive for human norovirus, 9 of which were confirmed by sequencing. Some factors associated with the presence of human norovirus included being from South Carolina (odd ratio [OR], 2.4; 95% confidence interval [CI], 1.2 to 4.9; P < 0.05) or New Jersey (OR, 1.7; 95% CI, 0.9 to 3.3; 0.05 < P < 0.10), being a chain establishment (OR, 1.9; 95% CI, 1.1 to 3.3; P < 0.05), being a unisex bathroom (versus male: OR, 2.0; 95% CI, 0.9 to 4.1; 0.05 < P < 0.10; versus female: OR, 2.6; 95% CI, 1.2 to 5.7; P < 0.05), having a touchless outer door handle (OR, 3.3; 95% CI, 0.79 to 13.63; 0.05 < P < 0.10), and having an automatic flush toilet (OR, 2.5, 95% CI, 1.1 to 5.3; 0.05 < P < 0.10). Our findings confirm that the presence of human norovirus on bathroom surfaces in commercial food establishments under nonoutbreak conditions is a rare event. Therefore, routine environmental monitoring for human norovirus contamination during nonoutbreak periods is not an efficient method of monitoring norovirus infection risk.
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Affiliation(s)
| | | | - Chaoyi Tang
- 1 Clemson University, Clemson, South Carolina 29634, USA
| | | | - Yuanmei Ma
- 2 Ohio State University, Columbus, Ohio 43210, USA
| | | | | | | | - Thomas Yeargin
- 5 Centers for Disease Control and Prevention Foundation, Atlanta, Georgia 30308, USA; and
| | - Jianrong Li
- 2 Ohio State University, Columbus, Ohio 43210, USA
| | | | - Xiuping Jiang
- 1 Clemson University, Clemson, South Carolina 29634, USA
| | - Julia Sharp
- 1 Clemson University, Clemson, South Carolina 29634, USA
| | - Jan Vinjé
- 6 Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
| | - Angela Fraser
- 1 Clemson University, Clemson, South Carolina 29634, USA
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Santos Junior AGD, Ferreira AM, Rigotti MA, Santos FRD, Furlan MCR, Andrade DD. AVALIAÇÃO DA EFICIÊNCIA DA LIMPEZA E DESINFECÇÃO DE SUPERFÍCIES EM UMA UNIDADE BÁSICA DE SAÚDE. TEXTO & CONTEXTO ENFERMAGEM 2018. [DOI: 10.1590/0104-07072018003720017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: avaliar o efeito de intervenções educativasna limpeza e desinfecção de superfícies em uma unidade básica de saúde. Métodos: trata-se de um estudo prospectivo, analítico com abordagem quantitativa. O estudo foi realizado em uma unidade básica de saúde, onde atuam duas equipes da Estratégia de Saúde da Família. Optou-se por avaliar a limpeza e desinfecção das superfícies: carrinho de curativo, balcão da recepção, mesa ginecológica, maca do paciente e mesa de consulta de enfermagem, utilizando-se dos métodos de monitoramento: avaliação visual, contagem de unidades formadoras de colônias e mensuração de adenosina trifosfato. Utilizaram-se, para a análise estatística, o teste de postos de Wilcoxon e o teste de Mann-Whitney, considerou-se nível de significância de 5% ou (p<0,05). Resultados: obteve-se um total de 720 avaliações realizadas ao término de todas as fases. Observou-se na fase I uma taxa de reprovação de 57,5%, 20,0% e 90,0%; após a intervenção educativa, os quantitativos de reprovação em curto prazo diminuíram para 0,0%, 2,5,0% e 50,0% (dados da fase III) e, em longo prazo, para 5,0%, 0,0% e 65% (dados da fase IV) para os métodos visual, adenosina trifosfato e cultura, respectivamente. A inspeção visual foi o método que apresentou maior frequência de superfícies reprovadas nas fases I e IV. Conclusão: houve redução da carga microbiana e valores das leituras de adenosina trifosfato; embora essa redução não tenha sido estatisticamente significativa em todas as superfícies. Constatou-se que a intervenção educativa foi eficiente.
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