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Abdelkhalek MM, Mohamed AM, Abdallah RZ, Khedr GE, Siam R, Allam NK. Zeolitic imidazolate framework-8 encapsulated with Mo-based polyoxometalates as surfaces with antibacterial activity against Escherichia coli. NANOSCALE ADVANCES 2024; 6:3355-3366. [PMID: 38933851 PMCID: PMC11197405 DOI: 10.1039/d4na00142g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/01/2024] [Indexed: 06/28/2024]
Abstract
Bacterial infections represent a major global health concern, causing millions of deaths and a significant economic burden. The development of antibacterial nanoporous surfaces with potential mechano-bactericidal effects can revolutionize infection control practices. In this study, a hybrid material of zeolitic imidazolate framework-8 (ZIF-8) doped with phosphomolybdic acid (PMA) was synthesized and characterized by field emission scanning electron microscopy (FESEM), energy-dispersive X-ray spectroscopy (EDS), X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), and N2 sorption isotherms. PMA@ZIF-8 performance as an antibacterial agent against E. coli was superior to that of its individual constituents, suggesting a synergistic effect of PMA and ZIF-8. The incorporation of PMA into ZIF-8 significantly enhanced its antibacterial efficacy, as evidenced by a twofold reduction in MIC (375 μg mL-1 vs. 750 μg mL-1) and a 4.35 times increase in the bactericidal kinetics rate constant. The time-kill curve experiment revealed that PMA@ZIF-8 achieved a 3-log reduction within 7 hours, whereas ZIF-8 required 24 hours to reach the same level of reduction. The density functional theory (DFT) calculated bandgap of PMA@ZIF-8 was significantly less than that of ZIF-8. Also, PMA@ZIF-8 has caused the elimination of 56.72% of the thiol group as detected by Ellman's assay. Accordingly, PMA@ZIF-8 can be both computationally and experimentally demonstrated as an oxidative nanozyme. PMA@ZIF-8's surface topology revealed nanorod protrusions, suggesting a potential mechano-bactericidal effect, which was confirmed by live/dead assay on PMA@ZIF-8-coated glass. This study highlights the potential of the PMA@ZIF-8 hybrid as a highly effective antibacterial agent, holding promise for creating multifunctional antibacterial surfaces.
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Affiliation(s)
- Mariam M Abdelkhalek
- Energy Materials Laboratory, Physics Department, School of Sciences and Engineering, The American University in Cairo New Cairo 11835 Egypt
| | - Aya M Mohamed
- Department of Chemistry, Faculty of Science, Cairo University Cairo 12613 Egypt
| | - Rehab Z Abdallah
- Department of Biology, School of Sciences and Engineering, The American University in Cairo New Cairo 11835 Egypt
| | - Ghada E Khedr
- Department of Analysis and Evaluation, Egyptian Petroleum Research Institute Cairo 11727 Egypt
| | - Rania Siam
- Department of Biology, School of Sciences and Engineering, The American University in Cairo New Cairo 11835 Egypt
| | - Nageh K Allam
- Energy Materials Laboratory, Physics Department, School of Sciences and Engineering, The American University in Cairo New Cairo 11835 Egypt
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Wright D, Christie J, Lawrence J, Vaughn KL, Walsh TF. Effectiveness of dry hydrogen peroxide in reducing air and surface bioburden in a multicenter clinical setting. Infect Control Hosp Epidemiol 2024; 45:501-508. [PMID: 38017626 PMCID: PMC11007363 DOI: 10.1017/ice.2023.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/04/2023] [Accepted: 06/09/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE To determine the effectiveness of dry hydrogen peroxide (DHP) in reducing environmental bioburden in occupied areas. DESIGN Prospective environmental cohort study. SETTING The study was conducted in 2 tertiary-care hospitals and 1 free-standing emergency department. INTERVENTION Environmental air and surface sites were cultured before and after continuous deployment of DHP systems in targeted hospital areas. METHODS In total, 1,554 surface and 1,036 air samples were collected from 74 patient areas among the 3 facilities on 3 consecutive days before DHP deployment and on days 14, 30, 60, and 90 after deployment. At each sampling time, 2 air samples were collected at each facility from 1 room without DHP, along with 2 outdoor samples from each facility. The impact of negative-pressure usage on the efficacy of DHP was also evaluated, with 1 hospital continuously using negative pressure, another utilizing it only in patient isolation scenarios, and another without negative pressure. RESULTS In the 2 facilities without continuous negative pressure, exposure to DHP was associated with a significant reduction in surface bioburden, characterized as total colony-forming units (P = .019; P = .002). Significant associations between DHP exposure and reductions in airborne bacterial load at the 2 hospitals were observed (P ≤ .001; P = .041), and the free-standing emergency department experienced a reduction that did not achieve statistical significance (P = .073). CONCLUSIONS Our findings confirm that DHP has the potential to reduce microbial air and surface bioburden in occupied patient rooms with standard ventilation parameters.
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Affiliation(s)
- Don Wright
- Universal Health Services, King of Prussia, Pennsylvania
| | | | - Jordan Lawrence
- Department of Infection Prevention and Control, Aiken Regional Medical Centers, Aiken, South Carolina
| | - Kimberly L. Vaughn
- Department of Infection Prevention and Control, Henderson Hospital, Henderson, Nevada
| | - Timothy F. Walsh
- Department of Infection Prevention and Control, Valley Hospital Medical Center, Las Vegas, Nevada
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3
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Biazus-Dalcin C, Sincero T, Zamparette C, Tartari D, de Souza S, Silva T, Tomazoni A, Rocha P. Efficacy of disinfection procedures to reduce Acinetobacter baumanii blaOXA-23 contamination rate of needleless connectors: an in-vitro study. Infect Prev Pract 2024; 6:100328. [PMID: 38226398 PMCID: PMC10788527 DOI: 10.1016/j.infpip.2023.100328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 10/23/2023] [Accepted: 11/08/2023] [Indexed: 01/17/2024] Open
Abstract
Aim This study aimed to verify the efficacy of disinfection procedures to reduce Acinetobacter baumannii blaOXA-23 bacterial load in needleless connectors that had been experimentally contaminated. Methods Two-way intermediate extender's hub and needle-free valve were contaminated with Acinetobacter baumannii blaOXA-23. To disinfect them, the following procedures were carried out: sterile gauze with 70% ethanol, sterile gauze with Incidin®, and 70% isopropyl alcohol single-use cap, with eight times friction for 10 s, followed by 5 s drying time. The statistical tests Kruskal-Wallis and post-hoc Conover were performed using MedCalc®. Results A total of 82 experiments were conducted. All tested disinfection procedures were efficacious in reducing the A. baumannii blaOXA-23 load. The 70% IPA single-use cap was found to be the best method for disinfecting the two-way intermediate extender's hub (87.28%), while all the methods were efficacious for the disinfection of the needle-free valve (more than 90%). During the inoculation period, A. baumannii blaOXA-23 showed less adherence to the needle-free valve during the inoculation period, probably due to the device's design. Conclusion The three tested disinfection procedures using sterile gauze with 70% ethanol, sterile gauze with Incidin®, and 70% IPA single-use cap were found to be efficacious in reducing the bacterial load of A. baumanni blaOXA-23 in needleless connectors. Proper disinfection of needleless connectors is a crucial nursing practice to prevent bloodstream infections, as it significantly reduces the bacterial load present in the device.
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Affiliation(s)
| | - T.C.M. Sincero
- Department of Clinical Analyses, Health Sciences Centre, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - C.P. Zamparette
- Department of Clinical Analyses, Health Sciences Centre, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - D.C. Tartari
- The State of Santa Catarina, Florianópolis, Brazil
| | - S. de Souza
- Nursing Department, Health Sciences Centre, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - T.L. Silva
- Nursing Department, Health Sciences Centre, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - A. Tomazoni
- Hospital de Clínicas of the Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | - P.K. Rocha
- Nursing Department, Health Sciences Centre, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
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Jovanovic A, Paunovic K, Ercegovac M, Popovic D, Davidovic D. Personal stethoscope disinfection practices and bacterial contamination: A cross-sectional study at the University Hospital Emergency Department in Belgrade, Serbia. Am J Infect Control 2024; 52:176-182. [PMID: 37598902 DOI: 10.1016/j.ajic.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND A significant reduction in bacterial growth on stethoscope membranes has been noticed after performing daily disinfection. Nevertheless, disinfection is rarely performed. We aimed to assess self-reported stethoscope disinfection practices among medical doctors, detect bacterial contamination on personal stethoscopes, and estimate the effectiveness of 70% ethanol as a stethoscope disinfecting agent. METHODS To determine stethoscope disinfection practices, participants filled out a questionnaire (N = 47), followed by providing stethoscopes for bacterial analysis. Differences in bacterial contamination were observed through the self-reported frequency and method of stethoscope disinfection. The effect of disinfecting with 70% ethanol was evaluated by comparing the presence of bacterial growth before and after disinfection. RESULTS The presence of bacterial growth was found in 78.7% of the stethoscope samples, with the median (interquartile range) number of colony-forming units at 25 (10-105). The frequency of disinfection greatly impacted the number of colony-forming units, and the method affected the presence of bacterial growth. Disinfection of stethoscope membranes using 70% ethanol resulted in a compelling 97.3% reduction of bacterial growth. CONCLUSIONS Adequate stethoscope disinfection is highly efficient in reducing bacterial contamination and as such should be considered a critical step in hygienic practices.
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Affiliation(s)
- Ana Jovanovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Institute of Hygiene and Medical Ecology, Belgrade, Serbia
| | - Katarina Paunovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Institute of Hygiene and Medical Ecology, Belgrade, Serbia
| | - Marko Ercegovac
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic of Neurology, Clinical Center of Serbia, Belgrade, Serbia
| | - Dusan Popovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Department of Gastroenterology, Clinic for Internal Medicine, Clinical Hospital Center "Dr Dragisa Misovic-Dedinje", Belgrade, Serbia
| | - Dragana Davidovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Institute of Hygiene and Medical Ecology, Belgrade, Serbia.
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Omardien S, Pingulkar S, Thayagan M, Buniotto L, de Oliveira Negreiros M. The antibacterial performance of a residual disinfectant against Staphylococcus aureus on environmental surfaces. Front Microbiol 2024; 15:1338238. [PMID: 38351915 PMCID: PMC10861741 DOI: 10.3389/fmicb.2024.1338238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/10/2024] [Indexed: 02/16/2024] Open
Abstract
Environmental surfaces play a key role in transmitting pathogens that can survive on surfaces for long durations. The interest in long-lasting or residual disinfectants are, therefore, growing as it might protect surfaces for longer than traditional disinfectants. In this study, a quat-based product claiming residual disinfecting performance against bacteria, among other microorganisms, was tested using an approved standardized method, in a controlled laboratory study and on environmental surfaces in an office building. The results obtained showed that the residual disinfectant can reduce the bacterial counts significantly compared to a traditional quat-based disinfectant when used on horizontal surfaces, twenty-four hours after application. During the standardized test method, the residual disinfectant provided a 6-log reduction, whereas the traditional disinfectant provided only a 1.9-log reduction. Similarly, the residual disinfectant provided a 2.5 log reduction in the laboratory study, whereas the traditional disinfectant had too-numerous-to-count colonies. When tested on environmental surfaces, an ANOVA statistical analysis indicated that surfaces treated with the residual disinfectant had significantly less bacteria present twenty-four hours after application. The antibacterial performance of the residual disinfectant showed to be limited by the orientation of the treated surface, and the thickness of the product film dried on the surface. This study showed the potential of residual disinfectants that warrants further investigation and could potentially aid the further development of the technology.
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Tyan K, Kang J. Implementation of a novel color additive for bleach disinfectant wipes enhances cleaning performance in an academic medical center. Infect Control Hosp Epidemiol 2023; 44:2089-2091. [PMID: 37395615 PMCID: PMC10755152 DOI: 10.1017/ice.2023.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/26/2023] [Accepted: 03/07/2023] [Indexed: 07/04/2023]
Abstract
Effective hospital environmental cleaning requires proper technique and training. Highlight is a novel additive that colorizes bleach wipes to help visualize wiped surfaces and fades to colorless to confirm effective cleaning. In a 401-bed hospital study, Highlight reduced fluorescent marker removal failure rates from a baseline of 12.4% to 0.6%.
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Nadimpalli G, Johnson JK, Magder LS, Haririan A, Stevens D, Harris AD, O'Hara LM. Efficacy of a continuously active disinfectant wipe on the environmental bioburden in the intensive care unit: A randomized controlled study. Infect Control Hosp Epidemiol 2023; 44:2036-2043. [PMID: 37395041 DOI: 10.1017/ice.2023.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To evaluate the efficacy of a new continuously active disinfectant (CAD) to decrease bioburden on high-touch environmental surfaces compared to a standard disinfectant in the intensive care unit. DESIGN A single-blind randomized controlled trial with 1:1 allocation. SETTING Medical intensive care unit (MICU) at an urban tertiary-care hospital. PARTICIPANTS Adult patients admitted to the MICU and on contact precautions. INTERVENTION A new CAD wipe used for daily cleaning. METHODS Samples were collected from 5 high-touch environmental surfaces before cleaning and at 1, 4, and 24 hours after cleaning. The primary outcome was the mean bioburden 24 hours after cleaning. The secondary outcome was the detection of any epidemiologically important pathogen (EIP) 24 hours after cleaning. RESULTS In total, 843 environmental samples were collected from 43 unique patient rooms. At 24 hours, the mean bioburden recovered from the patient rooms cleaned with the new CAD wipe (intervention) was 52 CFU/mL, and the mean bioburden was 92 CFU/mL in the rooms cleaned the standard disinfectant (control). After log transformation for multivariable analysis, the mean difference in bioburden between the intervention and control arm was -0.59 (95% CI, -1.45 to 0.27). The odds of EIP detection were 14% lower in the rooms cleaned with the CAD wipe (OR, 0.86; 95% CI, 0.31-2.32). CONCLUSIONS The bacterial bioburden and odds of detection of EIPs were not statistically different in rooms cleaned with the CAD compared to the standard disinfectant after 24 hours. Although CAD technology appears promising in vitro, larger studies may be warranted to evaluate efficacy in clinical settings.
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Affiliation(s)
- Gita Nadimpalli
- Department of Epidemiology and Public Health, The University of Maryland School of Medicine, Baltimore, Maryland
| | - J Kristie Johnson
- Department of Pathology, The University of Maryland School of Medicine, Baltimore, Maryland
| | - Laurence S Magder
- Department of Epidemiology and Public Health, The University of Maryland School of Medicine, Baltimore, Maryland
| | - Abdolreza Haririan
- Division of Nephrology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Deborah Stevens
- Department of Epidemiology and Public Health, The University of Maryland School of Medicine, Baltimore, Maryland
| | - Anthony D Harris
- Department of Epidemiology and Public Health, The University of Maryland School of Medicine, Baltimore, Maryland
| | - Lyndsay M O'Hara
- Department of Epidemiology and Public Health, The University of Maryland School of Medicine, Baltimore, Maryland
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Rutala WA, Donskey CJ, Weber DJ. Disinfection and sterilization: New technologies. Am J Infect Control 2023; 51:A13-A21. [PMID: 37890943 DOI: 10.1016/j.ajic.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Adherence to professional guidelines and/or manufacturer's instructions for use regarding proper disinfection and sterilization of medical devices is crucial to preventing cross transmission of pathogens between patients. Emerging pathogens (e.g., Candida auris) and complex medical devices provide new challenges. METHODS A search for published English articles on new disinfection and sterilization technologies was conducted by Google, Google scholar and PubMed. RESULTS Several new disinfection methods or products (e.g., electrostatic spraying, new sporicides, colorized disinfectants, "no touch" room decontamination, continuous room decontamination) and sterilization technologies (e.g., new sterilization technology for endoscopes) were identified. CONCLUSIONS These technologies should reduce patient risk.
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Affiliation(s)
- William A Rutala
- Statewide Program for Infection Control and Epidemiology, University of North Carolina (UNC) School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC.
| | - Curtis J Donskey
- Geriatric Research, Education and Clinical Care, Louis Stokes Cleveland VA Medical Center, Cleveland, OH
| | - David J Weber
- Statewide Program for Infection Control and Epidemiology, University of North Carolina (UNC) School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC; Infection Prevention, University of North Carolina Medical Center, Chapel Hill, NC
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9
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Weber DJ, Rutala WA, Anderson DJ, Sickbert-Bennett EE. ..úNo touch..Ñ methods for health care room disinfection: Focus on clinical trials. Am J Infect Control 2023; 51:A134-A143. [PMID: 37890944 DOI: 10.1016/j.ajic.2023.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 04/03/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Hospital patient room surfaces are frequently contaminated with multidrug-resistant organisms. Since studies have demonstrated that inadequate terminal room disinfection commonly occurs, ..úno touch..Ñ methods of terminal room disinfection have been developed such as ultraviolet light (UV) devices and hydrogen peroxide (HP) systems. METHODS This paper reviews published clinical trials of ..úno touch..Ñ methods and ..úself-disinfecting..Ñ surfaces. RESULTS Multiple papers were identified including clinical trials of UV room disinfection devices (N.ß=.ß20), HP room disinfection systems (N.ß=.ß8), handheld UV devices (N.ß=.ß1), and copper-impregnated or coated surfaces (N.ß=.ß5). Most but not all clinical trials of UV devices and HP systems for terminal disinfection demonstrated a reduction of colonization/infection in patients subsequently housed in the room. Copper-coated surfaces were the only ..úself-disinfecting..Ñ technology evaluated by clinical trials. Results of these clinical trials were mixed. DISCUSSION Almost all clinical trials reviewed used a ..úweak..Ñ design (eg, before-after) and failed to assess potential confounders (eg, compliance with hand hygiene and environmental cleaning). CONCLUSIONS The evidence is strong enough to recommend the use of a ..úno-touch..Ñ method as an adjunct for outbreak control, mitigation strategy for high-consequence pathogens (eg, Candida auris or Ebola), or when there are an excessive endemic rates of multidrug-resistant organisms.
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Affiliation(s)
- David J Weber
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC; Department of Infection Prevention, UNC Medical Center, Chapel Hill, NC.
| | - William A Rutala
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Deverick J Anderson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University School of Medicine, Durham, NC
| | - Emily E Sickbert-Bennett
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC; Department of Infection Prevention, UNC Medical Center, Chapel Hill, NC
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Rutala WA, Boyce JM, Weber DJ. Disinfection, sterilization and antisepsis: An overview. Am J Infect Control 2023; 51:A3-A12. [PMID: 37890951 DOI: 10.1016/j.ajic.2023.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Each year in the United States there are approximately 100,000,000 outpatient/inpatient surgical procedures. Each of these procedures involves contact by a medical device or surgical instrument with a patient's sterile tissue and/or mucous membrane. A major risk of all such procedures is the introduction of infection. METHODS We searched published literature for articles on the use and effectiveness of disinfectants, sterilization methods and antiseptics. RESULTS The level of disinfection is dependent on the intended use of the object: critical (items that contact sterile tissue such as surgical instruments), semicritical (items that contact mucous membrane such as endoscopes), and noncritical (devices that contact only intact skin such as stethoscopes) items require sterilization, high-level disinfection and low-level disinfection, respectively. Cleaning must always precede high-level disinfection and sterilization. Antiseptics are essential to infection prevention as part of a hand hygiene program as well as other uses such as surgical hand antisepsis and pre-operative patient skin preparation. CONCLUSIONS When properly used, disinfection and sterilization can ensure the safe use of invasive and non-invasive medical devices. Cleaning should always precede high-level disinfection and sterilization. Strict adherence to current disinfection and sterilization guidelines is essential to prevent patient infections and exposures to infectious agents.
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Affiliation(s)
- William A Rutala
- Statewide Program for Infection Control and Epidemiology, UNC School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC.
| | - John M Boyce
- J.M. Boyce Consulting, Boyce Consulting, LLC, Middletown, CT
| | - David J Weber
- Statewide Program for Infection Control and Epidemiology, UNC School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC; Infection Prevention, University of North Carolina Medical Center, Chapel Hill, NC
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Haag CW, Holliday G, Archulet K, Tang W. Comparing UV-C dosages of emitter placement strategies in a community hospital setting. Infect Control Hosp Epidemiol 2023; 44:1505-1507. [PMID: 36524309 DOI: 10.1017/ice.2022.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
We measured the amount of UV-C light (254 nm) achieved on hospital surfaces using a modified emitter and competing placement strategies. An autonomous UV-C strategy improved exposure on surfaces that were distant, angled, or shadowed to the nonautonomous strategies, leading to significantly higher overall UV-C dosages.
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Affiliation(s)
- Cody W Haag
- Clean Sweep Group, Los Angeles, California, United States
| | | | - Kenneth Archulet
- Providence Holy Cross Medical Center, Mission Hills, California, United States
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Gillings Global School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
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12
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Thompson SC, Rutala WA, Sickbert-Bennett EE, DiBiase LM, Anderson DJ, Weber DJ. A comparison of methods for microbiologic environmental sampling. Infect Control Hosp Epidemiol 2023; 44:1502-1504. [PMID: 36453138 DOI: 10.1017/ice.2022.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
We compared the effectiveness of 4 sampling methods to recover Staphylococcus aureus, Klebsiella pneumoniae and Clostridioides difficile from contaminated environmental surfaces: cotton swabs, RODAC culture plates, sponge sticks with manual agitation, and sponge sticks with a stomacher. Organism type was the most important factor in bacterial recovery.
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Affiliation(s)
- Sharon C Thompson
- Infection Prevention, University of North Carolina Medical Center, Chapel Hill, North Carolina
| | - William A Rutala
- Infection Prevention, University of North Carolina Medical Center, Chapel Hill, North Carolina
| | - Emily E Sickbert-Bennett
- Infection Prevention, University of North Carolina Medical Center, Chapel Hill, North Carolina
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina
| | - Lauren M DiBiase
- Infection Prevention, University of North Carolina Medical Center, Chapel Hill, North Carolina
| | - Deverick J Anderson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University, Durham, North Carolina
| | - David J Weber
- Infection Prevention, University of North Carolina Medical Center, Chapel Hill, North Carolina
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina
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13
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Ohishi T, Ootsuki K, Kanno S, Ishiyama C, Kashima S, Maruyama K, Fushimi R. Adenosine phosphate-based detection of worker exposure to contaminated water during bathroom cleaning. Am J Infect Control 2023; 51:884-889. [PMID: 36417952 DOI: 10.1016/j.ajic.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Workers who clean bathrooms at medical facilities may be regularly exposed to contaminated water harboring pathogenic microbes and should wear personal protective equipment (PPE) to prevent such exposure at medical facilities, which has not been quantitatively assessed. This study quantified the exposure risk from contaminated water when cleaning restrooms at medical facilities and clarified the importance of wearing PPE. METHODS Existing urinals, toilets, and handwashing sinks (16 each) in a hospital environment were coated with a simulated contaminant containing adenosine phosphate and cleaned with a brush or sponge by workers in PPE. Adenosine phosphate on the PPE, shelf near the toilet, and toilet paper cover was tested before and after cleaning to compare exposure status. RESULTS Adenosine phosphate on the worker's PPE, shelf near the toilet, and toilet paper cover was significantly higher after cleaning the urinal, toilet, and handwashing sink. More adenosine phosphate was disseminated from urinals and toilets when cleaning with a brush compared with a sponge. DISCUSSION Workers and the surrounding environment are exposed to contaminated water during bathroom cleaning. Wearing PPE while cleaning and wiping down the toilet environment after cleaning deserves further consideration.
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Affiliation(s)
- Takayuki Ohishi
- Department of Infection Control and Prevention, Saiseikai Yokoyama Eastern Hospital, Yokohama, Kanagawa, Japan.
| | | | - Sayaka Kanno
- WATAKYU SEIMOA Corporation, Shimogyo-ku, Kyoto, Japan
| | | | | | | | - Ryo Fushimi
- WATAKYU SEIMOA Corporation, Shimogyo-ku, Kyoto, Japan
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Rowan NJ, Kremer T, McDonnell G. A review of Spaulding's classification system for effective cleaning, disinfection and sterilization of reusable medical devices: Viewed through a modern-day lens that will inform and enable future sustainability. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 878:162976. [PMID: 36963674 DOI: 10.1016/j.scitotenv.2023.162976] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/23/2023] [Accepted: 03/17/2023] [Indexed: 05/13/2023]
Abstract
Despite advances in medicine and innovations in many underpinning fields including disease prevention and control, the Spaulding classification system, originally proposed in 1957, remains widely used for defining the disinfection and sterilization of contaminated re-usable medical devices and surgical instruments. Screening PubMed and Scopus databases using a PRISMA guiding framework generated 272 relevant publications that were used in this review. Findings revealed that there is a need to evolve how medical devices are designed, and processed by cleaning, disinfection (and/or sterilization) to mitigate patient risks, including acquiring an infection. This Spaulding Classification remains in use as it is logical, easily applied and understood by users (microbiologists, epidemiologists, manufacturers, industry) and by regulators. However, substantial changes have occurred over the past 65 years that challenge interpretation and application of this system that includes inter alia emergence of new pathogens (viruses, mycobacteria, protozoa, fungi), a greater understanding of innate and adaptive microbial tolerance to disinfection, toxicity risks, increased number of vulnerable patients and associated patient procedures, and greater complexity in design and use of medical devices. Common cited examples include endoscopes that enable non- or minimal invasive procedures but are highly sophisticated with various types of materials (polymers, electronic components etc), long narrow channels, right angle and heat-sensitive components and various accessories (e.g., values) that can be contaminated with high levels of microbial bioburden and patient tissues after use. Contaminated flexible duodenoscopes have been a source of several significant infection outbreaks, where at least 9 reported cases were caused by multidrug resistant organisms [MDROs] with no obvious breach in processing detected. Despite this, there is evidence of the lack of attention to cleaning and maintenance of these devices and associated equipment. Over the last few decades there is increasing genomic evidence of innate and adaptive resistance to chemical disinfectant methods along with adaptive tolerance to environmental stresses. To reduce these risks, it has been proposed to elevate classification of higher-risk flexible endoscopes (such as duodenoscopes) from semi-critical [contact with mucous membrane and intact skin] to critical use [contact with sterile tissue and blood] that entails a transition to using low-temperature sterilization modalities instead of routinely using high-level disinfection; thus, increasing the margin of safety for endoscope processing. This timely review addresses important issues surrounding use of the Spaulding classification system to meet modern-day needs. It specifically addresses the need for automated, robust cleaning and drying methods combined with using real-time monitoring of device processing. There is a need to understand entire end-to-end processing of devices instead of adopting silo approaches that in the future will be informed by artificial intelligence and deep-learning/machine learning. For example, combinational solutions that address the formation of complex biofilms that harbour pathogenic and opportunistic microorganisms on the surfaces of processed devices. Emerging trends are addressed including future sustainability for the medical devices sector that can be enabled via a new Quintuple Helix Hub approach that combines academia, industry, healthcare, regulators, and society to unlock real world solutions.
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Affiliation(s)
- N J Rowan
- Centre for Sustainable Disinfection and Sterilization, Bioscience Research Institute, Technological University of the Shannon Midlands Midwest, Athlone Campus, Ireland; Department of Nursing and Healthcare, Technological University of the Shannon Midwest Mideast, Athlone Campus, Ireland; SFI-funded CURAM Centre for Medical Device Research, University of Galway, Ireland.
| | - T Kremer
- Centre for Sustainable Disinfection and Sterilization, Bioscience Research Institute, Technological University of the Shannon Midlands Midwest, Athlone Campus, Ireland; Microbiological Quality & Sterility Assurance, Johnson & Johnson, 1000 Route 202, South Raritan, NJ 08869, USA
| | - G McDonnell
- Microbiological Quality & Sterility Assurance, Johnson & Johnson, 1000 Route 202, South Raritan, NJ 08869, USA
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Boyce JM. Quaternary ammonium disinfectants and antiseptics: tolerance, resistance and potential impact on antibiotic resistance. Antimicrob Resist Infect Control 2023; 12:32. [PMID: 37055844 PMCID: PMC10099023 DOI: 10.1186/s13756-023-01241-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 04/07/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Due to the substantial increase in the use of disinfectants containing quaternary ammonion compounds (QACs) in healthcare and community settings during the COVID-19 pandemic, there is increased concern that heavy use might cause bacteria to develop resistance to QACs or contribute to antibiotic resistance. The purpose of this review is to briefly discuss the mechanisms of QAC tolerance and resistance, laboratory-based evidence of tolerance and resistance, their occurrence in healthcare and other real-world settings, and the possible impact of QAC use on antibiotic resistance. METHODS A literature search was conducted using the PubMed database. The search was limited to English language articles dealing with tolerance or resistance to QACs present in disinfectants or antiseptics, and potential impact on antibiotic resistance. The review covered the period from 2000 to mid-Jan 2023. RESULTS Mechanisms of QAC tolerance or resistance include innate bacterial cell wall structure, changes in cell membrane structure and function, efflux pumps, biofilm formation, and QAC degradation. In vitro studies have helped elucidate how bacteria can develop tolerance or resistance to QACs and antibiotics. While relatively uncommon, multiple episodes of contaminated in-use disinfectants and antiseptics, which are often due to inappropriate use of products, have caused outbreaks of healthcare-associated infections. Several studies have identified a correlation between benzalkonium chloride (BAC) tolerance and clinically-defined antibiotic resistance. The occurrence of mobile genetic determinants carrying multiple genes that encode for QAC or antibiotic tolerance raises the concern that widespread QAC use might facilitate the emergence of antibiotic resistance. Despite some evidence from laboratory-based studies, there is insufficient evidence in real-world settings to conclude that frequent use of QAC disinfectants and antiseptics has promoted widespread emergence of antibiotic resistance. CONCLUSIONS Laboratory studies have identified multiple mechanisms by which bacteria can develop tolerance or resistance to QACs and antibiotics. De novo development of tolerance or resistance in real-world settings is uncommon. Increased attention to proper use of disinfectants is needed to prevent contamination of QAC disinfectants. Additional research is needed to answer many questions and concerns related to use of QAC disinfectants and their potential impact on antibiotic resistance.
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Affiliation(s)
- John M Boyce
- J.M. Boyce Consulting, LLC, 5123 Town Place, Middletown, CT, Connecticut, USA.
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16
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Weber J, Henssler L, Zeman F, Pfeifer C, Alt V, Nerlich M, Huber M, Herbst T, Koller M, Schneider-Brachert W, Kerschbaum M, Holzmann T. Nanosilver/DCOIT-containing surface coating effectively and constantly reduces microbial load in emergency room surfaces. J Hosp Infect 2023; 135:90-97. [PMID: 36958698 DOI: 10.1016/j.jhin.2023.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/13/2023] [Accepted: 01/23/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Colonization of near-patient surfaces in hospitals plays an important role as a source of healthcare-associated infections. Routine disinfection methods only result in short-term elimination of pathogens. AIM To investigate the efficiency of a newly developed antimicrobial coating containing nanosilver in long-term reduction of bacterial burden in hospital surfaces to close the gap between routine disinfection cycles. METHODS In this prospective, double-blinded trial, frequently touched surfaces of a routinely used treatment room in an emergency unit of a level-I hospital were treated with a surface coating (nanosilver/DCOIT-coated surface, NCS) containing nanosilver particles and another organic biocidal agent (4,5-dichloro-2-octyl-4-isothiazolin-3-one, DCOIT), whereas surfaces of another room were treated with a coating missing both the nanosilver- and DCOIT-containing ingredient and served as control. Bacterial contamination of the surfaces was examined using contact plates and liquid-based swabs daily for a total trial duration of 90 days. After incubation, total microbial counts and species were assessed. FINDINGS In a total of 2880 antimicrobial samples, a significant reduction of the overall bacterial load was observed in the NCS room (median: 0.31 cfu/cm2; interquartile range: 0.00-1.13) compared with the control coated surfaces (0.69 cfu/cm2; 0.06-2.00; P < 0.001). The nanosilver- and DCOIT-containing surface coating reduced the relative risk of a critical bacterial load (defined as >5 cfu/cm2) by 60% (odds ratio 0.38, P < 0.001). No significant difference in species distribution was detected between NCS and control group. CONCLUSION Nanosilver-/DCOIT-containing surface coating has shown efficiency for sustainable reduction of bacterial load of frequently touched surfaces in a clinical setting.
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Affiliation(s)
- J Weber
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany
| | - L Henssler
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany.
| | - F Zeman
- Center of Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - C Pfeifer
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany; Department of Orthopedic Trauma and Hand Surgery, Innklinikum Altötting-Mühldorf, Altötting, Germany
| | - V Alt
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany
| | - M Nerlich
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany
| | - M Huber
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany
| | - T Herbst
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany
| | - M Koller
- Center of Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - W Schneider-Brachert
- Institute of Medical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - M Kerschbaum
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany
| | - T Holzmann
- Institute of Medical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
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Mogul R, Miller DR, Ramos B, Lalla SJ. Metabolomic and cultivation insights into the tolerance of the spacecraft-associated Acinetobacter toward Kleenol 30, a cleanroom floor detergent. Front Microbiol 2023; 14:1090740. [PMID: 36950167 PMCID: PMC10025500 DOI: 10.3389/fmicb.2023.1090740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/20/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction Stringent cleaning procedures during spacecraft assembly are critical to maintaining the integrity of life-detection missions. To ensure cleanliness, NASA spacecraft are assembled in cleanroom facilities, where floors are routinely cleansed with Kleenol 30 (K30), an alkaline detergent. Methods Through metabolomic and cultivation approaches, we show that cultures of spacecraft-associated Acinetobacter tolerate up to 1% v/v K30 and are fully inhibited at ≥2%; in comparison, NASA cleanrooms are cleansed with ~0.8-1.6% K30. Results For A. johnsonii 2P08AA (isolated from a cleanroom floor), cultivations with 0.1% v/v K30 yield (1) no changes in cell density at late-log phase, (2) modest decreases in growth rate (~17%), (3) negligible lag phase times, (4) limited changes in the intracellular metabolome, and (5) increases in extracellular sugar acids, monosaccharides, organic acids, and fatty acids. For A. radioresistens 50v1 (isolated from a spacecraft surface), cultivations yield (1) ~50% survivals, (2) no changes in growth rate, (3) ~70% decreases in the lag phase time, (4) differential changes in intracellular amino acids, compatible solutes, nucleotide-related metabolites, dicarboxylic acids, and saturated fatty acids, and (5) substantial yet differential impacts to extracellular sugar acids, monosaccharides, and organic acids. Discussion These combined results suggest that (1) K30 manifests strain-dependent impacts on the intracellular metabolomes, cultivation kinetics, and survivals, (2) K30 influences extracellular trace element acquisition in both strains, and (3) K30 is better tolerated by the floor-associated strain. Hence, this work lends support towards the hypothesis that repeated cleansing during spacecraft assembly serve as selective pressures that promote tolerances towards the cleaning conditions.
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Affiliation(s)
- Rakesh Mogul
- Chemistry and Biochemistry Department, California State Polytechnic University, Pomona, CA, United States
- Blue Marble Institute of Science, Seattle, WA, United States
| | - Daniel R. Miller
- Chemistry and Biochemistry Department, California State Polytechnic University, Pomona, CA, United States
| | - Brian Ramos
- Chemistry and Biochemistry Department, California State Polytechnic University, Pomona, CA, United States
| | - Sidharth J. Lalla
- Chemistry and Biochemistry Department, California State Polytechnic University, Pomona, CA, United States
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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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McKinley L, Goedken CC, Balkenende E, Clore G, Hockett SS, Bartel R, Bradley S, Judd J, Lyons G, Rock C, Rubin M, Shaughnessy C, Reisinger HS, Perencevich E, Safdar N. Evaluation of daily environmental cleaning and disinfection practices in veterans affairs acute and long-term care facilities: A mixed methods study. Am J Infect Control 2023; 51:205-213. [PMID: 35644297 DOI: 10.1016/j.ajic.2022.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To describe daily environmental cleaning and disinfection practices and their associations with cleaning rates while exploring contextual factors experienced by healthcare workers involved in the cleaning process. METHODS A convergent mixed methods approach using quantitative observations (ie, direct observation of environmental service staff performing environmental cleaning using a standardized observation form) and qualitative interviews (ie, semistructured interviews of key healthcare workers) across 3 Veterans Affairs acute and long-term care facilities. RESULTS Between December 2018 and May 2019 a total of sixty-two room observations (N = 3602 surfaces) were conducted. The average observed surface cleaning rate during daily cleaning in patient rooms was 33.6% for all environmental surfaces and 60.0% for high-touch surfaces (HTS). Higher cleaning rates were observed with bathroom surfaces (Odds Ratio OR = 3.23), HTSs (OR = 1.57), and reusable medical equipment (RME) (OR = 1.40). Lower cleaning rates were observed when cleaning semiprivate rooms (OR = 0.71) and rooms in AC (OR = 0.56). In analysis stratified by patient presence (ie, present, or absent) in the room during cleaning, patient absence was associated with higher cleaning rates for HTSs (OR = 1.71). In addition, the odds that bathroom surfaces being cleaned more frequently than bedroom surfaces decreased (OR = 1.97) as well as the odds that private rooms being cleaned more frequently than semi-private rooms also decreased (OR = 0.26; 0.07-0.93). Between January and June 2019 eighteen qualitative interviews were conducted and found key themes (ie, patient presence and semiprivate rooms) as potential barriers to cleaning; this supports findings from the quantitative analysis. CONCLUSION Overall observed rates of daily cleaning of environmental surfaces in both acute and long-term care was low. Standardized environmental cleaning practices to address known barriers, specifically cleaning practices when patients are present in rooms and semi-private rooms are needed to achieve improvements in cleaning rates.
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Affiliation(s)
| | - C C Goedken
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA, Iowa City, IA
| | - E Balkenende
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA, Iowa City, IA; University of Iowa, Iowa City, IA
| | - G Clore
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA, Iowa City, IA; University of Iowa, Iowa City, IA
| | - Sherlock S Hockett
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA, Iowa City, IA; University of Iowa, Iowa City, IA
| | - R Bartel
- Patient-Centered Outcomes Research Institute (PCORI), Washington DC
| | - S Bradley
- Ann Arbor VA, Ann Arbor, MI; University of Michigan, Ann Arbor, MI
| | - J Judd
- Salt Lake City VA, Salt Lake City, UT; University of Utah, Salt Lake City, UT
| | - Goedken Lyons
- Ann Arbor VA, Ann Arbor, MI; University of Michigan, Ann Arbor, MI
| | - C Rock
- Johns Hopkins University, Baltimore, MD
| | - M Rubin
- Salt Lake City VA, Salt Lake City, UT; University of Utah, Salt Lake City, UT
| | | | - H S Reisinger
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA, Iowa City, IA; University of Iowa, Iowa City, IA
| | - E Perencevich
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA, Iowa City, IA; University of Iowa, Iowa City, IA
| | - N Safdar
- Madison VA, Madison, WI; University of Wisconsin - Madison, Madison, WI
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20
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Michalski J, Sommer J, Rossmanith P, Syguda A, Clapa T, Mester P. Antimicrobial and Virucidal Potential of Morpholinium-Based Ionic Liquids. Int J Mol Sci 2023; 24:ijms24021686. [PMID: 36675201 PMCID: PMC9863300 DOI: 10.3390/ijms24021686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/08/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Witnessed by the ongoing spread of antimicrobial resistant bacteria as well as the recent global pandemic of the SARS-CoV-2 virus, the development of new disinfection strategies is of great importance, and novel substance classes as effective antimicrobials and virucides are urgently needed. Ionic liquids (ILs), low-melting salts, have been already recognized as efficient antimicrobial agents with prospects for antiviral potential. In this study, we examined the antiviral activity of 12 morpholinium based herbicidal ionic liquids with a tripartite test system, including enzyme inhibition tests, virucidal activity determination against five model viruses and activity against five bacterial species. The antimicrobial and enzymatic tests confirmed that the inhibiting activity of ILs corresponds with the number of long alkyl side chains and that [Dec2Mor]+ based ILs are promising candidates as novel antimicrobials. The virucidal tests showed that ILs antiviral activity depends on the type and structure of the virus, revealing enveloped Phi6 phage as highly susceptible to the ILs action, while the non-enveloped phages PRD1 and MS2 proved completely resistant to ionic liquids. Furthermore, a comparison of results obtained for P100 and P001 phages demonstrated for the first time that the susceptibility of viruses to ionic liquids can be dependent on differences in the phage tail structure.
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Affiliation(s)
- Jakub Michalski
- Department of Biochemistry and Biotechnology, Poznań University of Life Sciences, Dojazd 11, 60-632 Poznan, Poland
| | - Julia Sommer
- Christian Doppler Laboratory for Monitoring of Microbial Contaminants, Unit for Food Microbiology, Department of Veterinary Public Health and Food Science, University of Veterinary Medicine, 1210 Vienna, Austria
- Epitome GmbH, The ICON Vienna, Tower 17, Gertrude-Fröhlich-Sandner-Str. 2–4, 1100 Vienna, Austria
| | - Peter Rossmanith
- Christian Doppler Laboratory for Monitoring of Microbial Contaminants, Unit for Food Microbiology, Department of Veterinary Public Health and Food Science, University of Veterinary Medicine, 1210 Vienna, Austria
- Unit of Food Microbiology, Institute of Food Safety, Food Technology and Veterinary Public Health, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210 Vienna, Austria
| | - Anna Syguda
- Department of Chemical Technology, Poznan University of Technology, Berdychowo 4, 60-965 Poznan, Poland
| | - Tomasz Clapa
- Department of Biochemistry and Biotechnology, Poznań University of Life Sciences, Dojazd 11, 60-632 Poznan, Poland
| | - Patrick Mester
- Christian Doppler Laboratory for Monitoring of Microbial Contaminants, Unit for Food Microbiology, Department of Veterinary Public Health and Food Science, University of Veterinary Medicine, 1210 Vienna, Austria
- Unit of Food Microbiology, Institute of Food Safety, Food Technology and Veterinary Public Health, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210 Vienna, Austria
- Correspondence:
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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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Desai SR, Tang L, Hwang NC. Infection Control for Perioperative Ultrasonography and Echocardiography. J Cardiothorac Vasc Anesth 2022; 36:4440-4448. [PMID: 36123263 DOI: 10.1053/j.jvca.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/04/2022] [Accepted: 08/12/2022] [Indexed: 11/11/2022]
Abstract
Ultrasound technology has revolutionized point-of-care diagnostics, decision-making, and the guidance of interventional procedures in Anesthesiology and Perioperative Medicine. Recent literature has highlighted important infection control considerations when performing transesophageal or transthoracic echocardiography, point-of-care ultrasound, and ultrasound-guided procedures. This narrative review focuses on operator precautions and disinfection methods and summarizes key recommendations from the international Echocardiography and Radiology Societies.
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Affiliation(s)
- Suneel Ramesh Desai
- Department of Anaesthesiology, Singapore General Hospital, Singapore; Department of Cardiothoracic Anaesthesia, National Heart Centre, Singapore; Department of Surgical Intensive Care, Singapore General Hospital, Singapore
| | - Leonard Tang
- Department of Anaesthesiology, Singapore General Hospital, Singapore
| | - Nian Chih Hwang
- Department of Anaesthesiology, Singapore General Hospital, Singapore; Department of Cardiothoracic Anaesthesia, National Heart Centre, Singapore.
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Wu H, Liao K, Yang C, Zhou N, Dou H, Xu Z, Chu L, Song C, Luo C. Psychological experience of Juvenile patients’ parents in Fangcang shelter hospital during the Omicron wave of COVID-19 pandemic in Shanghai, China: a qualitative study. BMC Public Health 2022; 22:2203. [PMCID: PMC9703436 DOI: 10.1186/s12889-022-14689-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Objective
To explore the psychological experience of Juvenile patient’s parents in Fangcang shelter hospital during the Omicron wave of COVID-19 pandemic.
Methods
A qualitative study was conducted by using a phenomenological research method. Sixteen parents of juvenile patients with COVID-19 were recruited from National Exhibition and Convention Center (Shanghai, China) Fangcang shelter hospital (FSH) using purposive sampling. Data were collected by face-to-face in-depth interviews over 27 days, from April 9 to May 6, 2022. The interview data were analyzed using Colaizzi seven-step analysis method.
Results
The psychological experiences of the parents of juvenile patients in the Fangcang shelter hospital were summarized into three themes: "perception regarding the FSH", "worried about the unmet needs of juvenile patients ", and "the psychological burden after discharge". These themes were classified into 9 sub-themes, including the acceptance of FSH, adaptability to FSH, concerns about cross-infection in the FSH, special needs of infants and young children, psychological needs of preschool children, the learning demands of school-age children, concern about re-positive, fear of sequelae, worry about social acceptance.
Conclusion
Juvenile patients and their parents in the Fangcang shelter hospitals have both positive and negative experiences. It is suggested that facilities for minors should be planned in advance. Humanistic care for adolescent patients and health education for the public are also critical.
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Abd-ElShafy DN, Nadeem R, Bahgat MM. Addition of Camellia sinensis extract to water to disinfect respiratory viruses accumulated over different surfaces. JOURNAL OF WATER AND HEALTH 2022; 20:1102-1111. [PMID: 35902992 DOI: 10.2166/wh.2022.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
New precautions have become part of our daily life since COVID-19 pandemic such as wearing masks, maintaining distance and disinfecting products bought from markets before using them which is exhausting. We aimed to test the inhibitory effect of Camellia sinensis (black tea) water extracts on respiratory viruses and the inhibition of viruses accumulated over different surface types after being soaked in water supplemented with the extracts. Two water extraction methods (extract A: maceration at 80 °C for 30 min and extract B: boiling for 40 min) were applied; extracts were analyzed by high-performance liquid chromatography to detect polyphenolic compounds. Results showed that 200 μg/ml of extract A and 50 μg/ml of extract B in water caused 100% inhibition of influenza A (enveloped virus) virus after 1.5 h and similar results were obtained for adenovirus (non-enveloped virus) but at the same concentration of extract A and at 100 μg/ml of extract B. Different surfaces (aluminum, glass, plastic or carton, vegetables of smooth (tomato) or rough (lemon) surfaces and green leaves) were inoculated with both viruses for 20 min and then soaked in the water supplemented with 200 μg/ml of extract A or 100 μg/ml of extract B for 1.5 h, and this resulted in complete inhibition of both viruses.
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Affiliation(s)
- Dina Nadeem Abd-ElShafy
- Environmental Virology Laboratory, Department of Water Pollution Research, Institute of Environmental Research and Climate Changes, the National Research Centre, Giza 12311, Egypt E-mail: ; Research Group Immune- and Bio-markers for Infection, the Centre of Excellence for Advanced Science, the National Research Centre, Giza 12311, Egypt
| | - Rola Nadeem
- Research Group Immune- and Bio-markers for Infection, the Centre of Excellence for Advanced Science, the National Research Centre, Giza 12311, Egypt; Department of Therapeutic chemistry, Institute of Pharmaceutical and Drug Industries Research, the National Research Centre, Dokki, Giza 12311, Egypt
| | - Mahmoud Mohamed Bahgat
- Research Group Immune- and Bio-markers for Infection, the Centre of Excellence for Advanced Science, the National Research Centre, Giza 12311, Egypt; Department of Therapeutic chemistry, Institute of Pharmaceutical and Drug Industries Research, the National Research Centre, Dokki, Giza 12311, Egypt
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Chen Y, Luo Y, Hu B. Towards Next Generation Cleaning Tools: Factors Affecting Cleaning Robot Usage and Proxemic Behaviors Design. FRONTIERS IN ELECTRONICS 2022. [DOI: 10.3389/felec.2022.895001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Among all healthcare sectors and working processes, the janitorial section is a prominent source of work-related injuries due to its labor-intensive nature and rising need for a hygienic environment, thus requiring extra attention for prevention strategies. Advancement in robotic technology has allowed autonomous cleaning robots to be a viable solution to ease the burden of janitors. To evaluate the application of commercial-grade cleaning robots, a video-based survey was developed and distributed to participants. Results from 117 participants revealed that: 1) participants were less tolerant when their personal space was invaded by humans compared with the cleaning robot, 2) it is better to inform the surrounding humans that the cleaning robot has been sanitized to make them feel safe and comfortable during the pandemic, and 3) to make the interaction more socially acceptable, the cleaning robot should respect human personal space, especially when there is ample space to maneuver. The findings of the present study provide insight into the usage and Proxemic behaviors design of future cleaning robots.
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McMillan S. Preventing healthcare-associated infections by decontaminating the clinical environment. Nurs Stand 2022; 37:e11935. [PMID: 35477994 DOI: 10.7748/ns.2022.e11935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 11/09/2022]
Abstract
Healthcare-associated infections (HAIs) continue to cause patient harm and at increasing rates. Factors contributing to this increase include suboptimal hand hygiene, antimicrobial resistance, and inadequate decontamination of the patient environment and shared patient equipment. To reduce the risk of HAIs and enhance patient safety, it is important that nurses and other healthcare professionals adhere to infection prevention and control guidance, including decontamination procedures. It is also important to identify and address the barriers that can affect adherence to this guidance. This article discusses effective decontamination of the patient environment and non-critical shared patient equipment, the barriers to adhering to guidance and strategies for improving decontamination procedures.
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Affiliation(s)
- Sacha McMillan
- Christchurch Hospital Campus, Canterbury District Health Board, Christchurch, Canterbury, New Zealand
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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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Cannon JL, Park GW, Anderson B, Leone C, Chao M, Vinjé J, Fraser AM. Hygienic monitoring in long-term care facilities using ATP, crAssphage, and human noroviruses to direct environmental surface cleaning. Am J Infect Control 2022; 50:289-294. [PMID: 35184878 PMCID: PMC8903150 DOI: 10.1016/j.ajic.2021.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Norovirus and C. difficile are associated with diarrheal illnesses and deaths in long-term care (LTC) facilities and can be transmitted by contaminated environmental surfaces. Hygienic monitoring tools such as adenosine triphosphate (ATP) bioluminescence and indicators of fecal contamination can help to identify LTC facility surfaces with cleaning deficiencies. METHODS High-touch surfaces in 11 LTC facilities were swabbed and tested for contamination by norovirus, a fecal indicator virus, crAssphage, and ATP which detects organic debris. High levels of contamination were defined as log ATP relative light unit values or crAssphage log genomic copy values in the 75th percentile of values obtained from each facility. RESULTS Over 90% of surfaces tested positive for crAssphage or gave failing ATP scores. Norovirus contamination was not detected. Handrails, equipment controls, and patient beds were 4 times more likely than other surfaces or locations to have high levels of crAssphage. Patient bed handrails and tables and chairs in patient lounges had high levels of both ATP and crAssphage. CONCLUSIONS Surfaces with high levels of ATP and crAssphage were identified. Quantifying levels of contamination longitudinally and before and after cleaning might enhance infection prevention and control procedures for reducing diarrheal illnesses in LTC facilities.
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Affiliation(s)
- Jennifer L. Cannon
- National Foundation for the Centers for Disease Control and Prevention Inc., 600 Peachtree St. NE #1000, Atlanta, GA, 30308, USA,Center for Food Safety, University of Georgia, 1109 Experiment St, Griffin, GA, 30223, USA,Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA,Correspondence: Jennifer Cannon, 1600 Clifton Rd. NE, H18-7, Atlanta, GA, 30333, USA,
| | - Geun Woo Park
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA
| | - Benjamin Anderson
- Center for Food Safety, University of Georgia, 1109 Experiment St, Griffin, GA, 30223, USA
| | - Cortney Leone
- Food, Nutrition, and Packaging Sciences Department, Clemson University, 206 Poole Agricultural Center, Clemson, SC, 29334, USA
| | - Morgan Chao
- Food, Nutrition, and Packaging Sciences Department, Clemson University, 206 Poole Agricultural Center, Clemson, SC, 29334, USA
| | - Jan Vinjé
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA
| | - Angela M. Fraser
- Food, Nutrition, and Packaging Sciences Department, Clemson University, 206 Poole Agricultural Center, Clemson, SC, 29334, USA
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Engaging veterans in identifying key elements of environmental cleaning and disinfection for preventing healthcare-associated infections: A qualitative study. Am J Infect Control 2022; 50:148-154. [PMID: 35101177 DOI: 10.1016/j.ajic.2021.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/15/2021] [Accepted: 10/16/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Environmental cleaning and disinfection are important for preventing healthcare-associated infections (HAIs) via contaminated surfaces. Hospital cleanliness plays a large role in patient perception and satisfaction regarding their healthcare. However, patient perceptions of environmental cleaning procedures remain unclear. The objective of the study was to engage patients in achieving patient-centered care and examine patient perspectives on environmental cleaning work systems in healthcare. METHODS A qualitative descriptive study was conducted using semi-structured interviews with hospitalized patients at a Midwestern Veterans Administration Hospital. Interviews were audio recorded, transcribed, then coded to identify recurring themes. RESULTS Fifteen patient interview were conducted. Patients reported expecting a clean hospital room. Some patients expressed feeling "in the way" during cleaning, possibly rushing cleaning procedures. Patients expressed confidence in Environmental Management Service (EMS) staff's skilled work and noted "soft skills" as desirable attributes, including camaraderie which can develop between Veteran patients and Veteran staff during room cleaning. CONCLUSIONS Patients identified environmental cleaning as a priority for HAI patient-centered infection prevention practices. Cleaning occupied rooms may be an important entry point for intervention to address actual or perceived disruption to patients or build upon Veteran peer relationships. Cleaning procedures may become more patient-centric if cleaning procedures were explained and based on patient preferences.
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Fernández-Martínez NF, Cárcel-Fernández S, De la Fuente-Martos C, Ruiz-Montero R, Guzmán-Herrador BR, León-López R, Gómez FJ, Guzmán-Puche J, Martínez-Martínez L, Salcedo-Leal I. Risk Factors for Multidrug-Resistant Gram-Negative Bacteria Carriage upon Admission to the Intensive Care Unit. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1039. [PMID: 35162062 PMCID: PMC8834020 DOI: 10.3390/ijerph19031039] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/13/2022] [Accepted: 01/15/2022] [Indexed: 01/27/2023]
Abstract
Multidrug-resistant Gram-negative bacteria (MDR-GNB) are microorganisms that have acquired resistance to extended-spectrum antibacterials and constitute an emerging threat to public health. Although carriers are an important source of transmission in healthcare settings, data about risk factors for MDR-GNB carriage are limited. Therefore, we aimed to identify risk factors for MDR-GNB carriage upon intensive care unit (ICU) admission and to optimise screening strategies. We conducted a case-control study. Admissions of adult patients to the ICU of a 1000-bed hospital during a year were included. We collected sociodemographic, clinical and microbiological data and performed a multivariate logistic regression model. A total of 1342 patients resulted in 1476 episodes of ICU admission, 91 (6.2%) of whom harboured MDR-GNB (38.5% women; median age 63.9 years). The most frequently isolated pathogens were Escherichia coli (57%) and Klebsiella pneumoniae (16%). The most frequent resistance mechanism was production of extended-spectrum beta lactamases. MDR-GNB carriage was associated to liver cirrhosis (OR 6.54, 95% CI 2.17-19.17), previous MDR-GNB carriage (OR 5.34, 1.55-16.60), digestive surgery (OR 2.83, 1.29-5.89) and length of hospital stay (OR 1.01 per day, 1.00-1.03). Several risk factors for MDR-GNB carriage upon admission to a high-risk setting were identified; the main comorbidity was liver cirrhosis.
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Affiliation(s)
- Nicolás Francisco Fernández-Martínez
- Preventive Medicine and Public Health Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain; (N.F.F.-M.); (B.R.G.-H.); (I.S.-L.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain; (S.C.-F.); (C.D.l.F.-M.); (R.L.-L.); (J.G.-P.); (L.M.-M.)
| | - Sheila Cárcel-Fernández
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain; (S.C.-F.); (C.D.l.F.-M.); (R.L.-L.); (J.G.-P.); (L.M.-M.)
- Intensive Care Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain
- Department of Medicine, University of Granada, 18011 Granada, Spain;
| | - Carmen De la Fuente-Martos
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain; (S.C.-F.); (C.D.l.F.-M.); (R.L.-L.); (J.G.-P.); (L.M.-M.)
- Intensive Care Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain
| | - Rafael Ruiz-Montero
- Preventive Medicine and Public Health Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain; (N.F.F.-M.); (B.R.G.-H.); (I.S.-L.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain; (S.C.-F.); (C.D.l.F.-M.); (R.L.-L.); (J.G.-P.); (L.M.-M.)
- Department of Medical and Surgical Sciences, University of Córdoba, 14004 Córdoba, Spain
| | - Bernardo R. Guzmán-Herrador
- Preventive Medicine and Public Health Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain; (N.F.F.-M.); (B.R.G.-H.); (I.S.-L.)
| | - Rafael León-López
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain; (S.C.-F.); (C.D.l.F.-M.); (R.L.-L.); (J.G.-P.); (L.M.-M.)
- Intensive Care Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain
| | | | - Julia Guzmán-Puche
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain; (S.C.-F.); (C.D.l.F.-M.); (R.L.-L.); (J.G.-P.); (L.M.-M.)
- Microbiology Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Carlos III Research Institute, 28029 Majadahonda, Spain
| | - Luis Martínez-Martínez
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain; (S.C.-F.); (C.D.l.F.-M.); (R.L.-L.); (J.G.-P.); (L.M.-M.)
- Microbiology Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Carlos III Research Institute, 28029 Majadahonda, Spain
- Department of Agricultural Chemistry, Soil Science and Microbiology, University of Córdoba, 14004 Córdoba, Spain
| | - Inmaculada Salcedo-Leal
- Preventive Medicine and Public Health Unit, Reina Sofía University Hospital, 14004 Córdoba, Spain; (N.F.F.-M.); (B.R.G.-H.); (I.S.-L.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain; (S.C.-F.); (C.D.l.F.-M.); (R.L.-L.); (J.G.-P.); (L.M.-M.)
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Carlos III Research Institute, 28029 Majadahonda, Spain
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Impact of dry hydrogen peroxide on hospital-acquired infection at a pediatric oncology hospital. Am J Infect Control 2021; 50:909-915. [PMID: 34973358 DOI: 10.1016/j.ajic.2021.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND This study aims to describe the effect of Dry Hydrogen Peroxide (DHP), as an adjunct to environmental cleaning and disinfection, on the incidence of hospital-acquired infections (HAIs) at Unidad Nacional de Oncologia Pediatrica (UNOP) in Guatemala City, Guatemala. METHODS A retrospective study of all HAI data from the hospital's surveillance system, which follows Centers for Disease Control and Prevention (CDC) protocols, was conducted from January 2019 to November 2020. DHP was installed in all Pediatric Intensive Care Unit (PICU) rooms in January 2020, but nowhere else in the hospital, including the Intermediate Care Unit (IMCU). RESULTS There were 189 HAI cases during the study period, with 173 occurring in either the PICU or IMCU. A statistically significant decrease in HAI incidence rates occurred in the PICU in 2020 compared to 2019 (P = .028), including Clostridiodes-associated gastroenteritis (P = .048). Logistic multivariate regression yielded a significant association between DHP exposure and reduced odds of developing an HAI during the study (OR = 0.3857, P = .029). CONCLUSION The use of DHP as an adjunct technology for environmental cleaning and disinfection contributed to the reduction in HAIs in the PICU. Our study highlights the value of such an approach as an addition to manual cleaning to decrease the risk of infection from environmental contamination.
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Bäumler W, Eckl D, Holzmann T, Schneider-Brachert W. Antimicrobial coatings for environmental surfaces in hospitals: a potential new pillar for prevention strategies in hygiene. Crit Rev Microbiol 2021; 48:531-564. [PMID: 34699296 DOI: 10.1080/1040841x.2021.1991271] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Recent reports provide evidence that contaminated healthcare environments represent major sources for the acquisition and transmission of pathogens. Antimicrobial coatings (AMC) may permanently and autonomously reduce the contamination of such environmental surfaces complementing standard hygiene procedures. This review provides an overview of the current status of AMC and the demands to enable a rational application of AMC in health care settings. Firstly, a suitable laboratory test norm is required that adequately quantifies the efficacy of AMC. In particular, the frequently used wet testing (e.g. ISO 22196) must be replaced by testing under realistic, dry surface conditions. Secondly, field studies should be mandatory to provide evidence for antimicrobial efficacy under real-life conditions. The antimicrobial efficacy should be correlated to the rate of nosocomial transmission at least. Thirdly, the respective AMC technology should not add additional bacterial resistance development induced by the biocidal agents and co- or cross-resistance with antibiotic substances. Lastly, the biocidal substances used in AMC should be safe for humans and the environment. These measures should help to achieve a broader acceptance for AMC in healthcare settings and beyond. Technologies like the photodynamic approach already fulfil most of these AMC requirements.
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Affiliation(s)
- Wolfgang Bäumler
- Department of Dermatology, University Hospital, Regensburg, Germany
| | - Daniel Eckl
- Department of Microbiology, University of Regensburg, Regensburg, Germany
| | - Thomas Holzmann
- Department of Infection Control and Infectious Diseases, University Hospital, Regensburg, Germany
| | - Wulf Schneider-Brachert
- Department of Infection Control and Infectious Diseases, University Hospital, Regensburg, Germany
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Hunter ND, Hoet AE, van Balen J, Stull JW. Longitudinal environmental Staphylococcus contamination in a new small animal veterinary hospital and utility of cleaning checklists. Zoonoses Public Health 2021; 68:947-954. [PMID: 34379895 DOI: 10.1111/zph.12887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/06/2020] [Accepted: 07/31/2021] [Indexed: 01/06/2023]
Abstract
Staphylococci are inhabitants of skin and mucous membranes with Staphylococcus pseudintermedius (SP) and Staphylococcus aureus (SA) serving as important pathogens for animals and people, respectively. Previous research has identified the environment as potentially important in hospital-associated infections and zoonotic transmission in veterinary settings. The objective of this pilot study was to determine the longitudinal prevalence over repeated samplings of environmental coagulase-positive Staphylococcus (CPS) in a new veterinary hospital and evaluate associations between contamination and environmental and clinical (caseload, cleaning checklists and staff numbers) factors. Cleaning and disinfection compliance, based on staff-completed checklists, were reviewed for the three shifts immediately prior to sampling. We hypothesized that over time, environmental contamination would increase as the clinic developed and caseload increased and compliance to cleaning checklists would decrease with increasing caseload. Over 18 months, 351 environmental samples were collected at five sampling times (sampling occurred before opening the hospital and every 3 to 6 months thereafter). Overall contamination with CPS was 30.8% (108/351), with SA (16.8%) and SP (13.1%) identified from the contaminated surfaces. Overall, methicillin-resistant strains (MRSA and MRSP) were infrequently recovered (combined n = 3; <1%). Point prevalence of CPS contamination was relatively stable over the study period (22.5%-28.4%), with the exception of an increase at the fourth sampling (52.9%). Cleaning compliance varied over the study period (57.9%-100%); the lowest reported cleaning coincided with the highest proportion of CPS contamination. The most commonly contaminated surfaces were chairs (7/15; 46.7%), examination tables (19/47; 40.4%) and computers (12/35; 34.3%); these items were infrequently included on cleaning lists. Surfaces not included in the checklist were 2.3 times more likely to be contaminated by CPS than those that were included (OR: 2.3, CI 95%: 1.02 -5.35, p-value=.04). MRSA and MRSP were rarely isolated from the environment in the newly opened hospital, indicating it may take time for resistant strains to enter the environment and persist on surfaces. This study identified the possible utility of cleaning checklists for directing cleaning practices and reducing the environmental contamination.
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Affiliation(s)
- Noelle D Hunter
- The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Armando E Hoet
- The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Joany van Balen
- The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Jason W Stull
- The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
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Sanguinet J, Edmiston C. Evaluation of dry hydrogen peroxide in reducing microbial bioburden in a healthcare facility. Am J Infect Control 2021; 49:985-990. [PMID: 33737038 DOI: 10.1016/j.ajic.2021.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Standard manual cleaning and disinfection practices are often inadequate. Persistent contamination in the environment poses an infection risk that may be mitigated by no-touch disinfection systems. This study evaluates the efficacy of dry hydrogen peroxide (DHP) on microbial air and surface contamination as an adjunct to routine cleaning and disinfection in a large urban hospital. METHODS Surface samples were collected in five different hospital units, two pediatric and three adult, after manual cleaning on multiple days before and after DHP implementation. Air samples were also collected in each unit pre- and post-DHP use. Data outcomes were reported as colony forming units (CFU) with species identification. RESULTS The overall mean surface microbial burden was reduced by 96.5 percent for all units post-DHP compared to baseline (P < 0.001), with the greatest reductions achieved on privacy curtains (99.5 %). Mean microbial air sample counts were also reduced post-DHP compared to pre-DHP. CONCLUSIONS This study demonstrates that DHP was effective in reducing both air and surface microbial contamination in a variety of settings within a large, tertiary care hospital.
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Hill SC, Mackowski DW, Doughty DC. Shielding of viruses such as SARS-Cov-2 from ultraviolet radiation in particles generated by sneezing or coughing: Numerical simulations of survival fractions. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2021; 18:394-408. [PMID: 34161194 DOI: 10.1080/15459624.2021.1939877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
SARS-CoV-2 and other microbes within aerosol particles can be partially shielded from UV radiation. The particles refract and absorb light, and thereby reduce the UV intensity at various locations within the particle. Previously, we demonstrated shielding in calculations of UV intensities within spherical approximations of SARS-CoV-2 virions within spherical particles approximating dried-to-equilibrium respiratory fluids. The purpose of this paper is to extend that work to survival fractions of virions (i.e., fractions of virions that can infect cells) within spherical particles approximating dried respiratory fluids, and to investigate the implications of these calculations for using UV light for disinfection. The particles may be on a surface or in air. Here, the survival fraction (S) of a set of individual virions illuminated with a UV fluence (F, in J/m2) is assumed described by S(kF) = exp(-kF), where k is the UV inactivation rate constant (m2/J). The average survival fraction (Sp) of the simulated virions in a group of particles is calculated using the energy absorbed by each virion in the particles. The results show that virions within particles of dried respiratory fluids can have larger Sp than do individual virions. For individual virions, and virions within 1-, 5-, and 9-µm particles illuminated (normal incidence) on a surface with 260-nm UV light, the Sp = 0.00005, 0.0155, 0.22, and 0.28, respectively, when kF = 10. The Sp decrease to <10-7, <10-7, 0.077, and 0.15, respectively, for kF = 100. Results also show that illuminating particles with UV beams from widely separated directions can strongly reduce the Sp. These results suggest that the size distributions and optical properties of the dried particles of virion-containing respiratory fluids are likely important to effectively designing and using UV germicidal irradiation systems for microbes in particles. The results suggest the use of reflective surfaces to increase the angles of illumination and decrease the Sp. The results suggest the need for measurements of the Sp of SARS-CoV-2 in particles having compositions and sizes relevant to the modes of disease transmission.
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Tarik A, Soukaina R, Samir M, Asmae S, Ahlame B, Rida B, Yasser A, Ilham E, Noureddine E, Hassan S, Ahmed B. Gastrointestinal manifestations during COVID-19 virus infection: A Moroccan prospective study. Arab J Gastroenterol 2021; 22:305-309. [PMID: 34509387 PMCID: PMC8321706 DOI: 10.1016/j.ajg.2021.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 06/12/2021] [Accepted: 07/27/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND STUDY AIMS Gastrointestinal manifestations are common during coronavirus disease (COVID-19) infection. They can occur before respiratory symptoms, resulting in a diagnostic delay and an increased risk of disease transmission. The current study reports major gastrointestinal manifestations as initial symptoms of COVID-19. PATIENTS AND METHODS This prospective, descriptive, cross-sectional, and single-center study of 713 cases was conducted in a field hospital in Morocco over a 5-week period from June 21 to July 25, 2020. RESULTS The average age of our patients was 31.95 years. Clinically, on admission, anorexia was the main symptom, present in 32.3% of patients. Gastrointestinal manifestations were present in 14.9% of patients, including watery diarrhea in 8.6% of cases, nausea and/or vomiting in 4.6% of cases, and abdominal pain in 1.6% of cases. Six hundred thirty-two patients were treated in accordance with one of the two therapeutic protocols recommended by the National Ministry of Health. The treatment-related effects that occurred in 61.4% of patients were primarily digestive in 55.3% of cases. In multivariate analysis, following adjustment of the studied parameters, only the presence of gastrointestinal manifestations (odds ratio [OR]: 1.478 confidence interval [CI]: 1.286-1.698; p < 0.001) and treatment side effects (OR = 1.069, CI: 1.020-1.119, p = 0.005) altered the rate of negative polymerase chain reaction (PCR) tests on day 10. CONCLUSION Gastrointestinal manifestations are common during COVID-19 and seem to be linked to a longer duration of disease. SARS-CoV-2 (the causative virus of COVID-19) can persist in the digestive tract, with the possibility of fecal-oral transmission. Therefore, hygiene is extremely important, especially handwashing and strict precautions when performing gastrointestinal endoscopy and handling stools from infected patients.
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Affiliation(s)
- Addajou Tarik
- Department of Gastroenterology, Military Hospital Mohammed V, Rabat, Morocco.
| | - Rokhsi Soukaina
- Department of Gastroenterology, Military Hospital Mohammed V, Rabat, Morocco
| | - Mrabti Samir
- Department of Gastroenterology, Military Hospital Mohammed V, Rabat, Morocco
| | - Sair Asmae
- Department of Gastroenterology, Military Hospital Mohammed V, Rabat, Morocco
| | - Benhamdane Ahlame
- Department of Gastroenterology, Military Hospital Mohammed V, Rabat, Morocco
| | - Berraida Rida
- Department of Gastroenterology, Military Hospital Mohammed V, Rabat, Morocco
| | - Azali Yasser
- Department of Gastroenterology, Military Hospital Mohammed V, Rabat, Morocco
| | - Elkoti Ilham
- Department of Gastroenterology, Military Hospital Mohammed V, Rabat, Morocco
| | - Errami Noureddine
- Department of Otorhinolaryngology, Military Hospital Mohammed V, Rabat, Morocco
| | - Seddik Hassan
- Department of Gastroenterology, Military Hospital Mohammed V, Rabat, Morocco
| | - Benkirane Ahmed
- Department of Gastroenterology, Military Hospital Mohammed V, Rabat, Morocco
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Does enhanced environmental cleaning reduce carbapenem-resistant Acinetobacter baumannii colonization in the intensive care unit? Int J Infect Dis 2021; 109:72-76. [PMID: 34229090 DOI: 10.1016/j.ijid.2021.06.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/15/2021] [Accepted: 06/30/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the impact of enhanced environmental cleaning (two times per day) compared with conventional cleaning on the acquisition of carbapenem-resistant Acinetobacter baumannii (CRAB) in a highly endemic intensive care unit (ICU). METHODS The intervention consisted of alternating environmental cleaning and conventional cleaning every 3 months during the study period from July 2018 to June 2019. CRAB acquisition was assessed using incidence and prevalence rates, and colonization pressure. RESULTS The incidence rates of CRAB with and without enhanced cleaning were 16.3 and 13.9 cases per 1000 population, respectively; and the prevalence rates were 66.9 and 61.7 cases per 1000 population, respectively. Colonization pressure was 53.3% with enhanced cleaning and 51.3% without enhanced cleaning. No association was found between enhanced environmental cleaning and the incidence (P=0.156), prevalence (P=0.888) and colonization pressure (P=0.825) of CRAB acquisition. The ventilator utilization ratio increased the colonization pressure of CRAB acquisition (P=0.010, β coefficient=0.37). The proportion of new nurses with <3 years of clinical practice experience was positively correlated with the incidence and prevalence of CRAB acquisition. CONCLUSION Enhanced environmental cleaning alone failed to reduce CRAB acquisition in a highly endemic ICU. The ventilator utilization ratio may be of more importance than environmental cleaning. Inexperienced nurses may need to be monitored regarding infection control activities in addition to hand hygiene adherence.
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Dhama K, Patel SK, Kumar R, Masand R, Rana J, Yatoo MI, Tiwari R, Sharun K, Mohapatra RK, Natesan S, Dhawan M, Ahmad T, Emran TB, Malik YS, Harapan H. The role of disinfectants and sanitizers during COVID-19 pandemic: advantages and deleterious effects on humans and the environment. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:34211-34228. [PMID: 33991301 PMCID: PMC8122186 DOI: 10.1007/s11356-021-14429-w] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/11/2021] [Indexed: 04/16/2023]
Abstract
Disinfectants and sanitizers are essential preventive agents against the coronavirus disease 2019 (COVID-19) pandemic; however, the pandemic crisis was marred by undue hype, which led to the indiscriminate use of disinfectants and sanitizers. Despite demonstrating a beneficial role in the control and prevention of COVID-19, there are crucial concerns regarding the large-scale use of disinfectants and sanitizers, including the side effects on human and animal health along with harmful impacts exerted on the environment and ecological balance. This article discusses the roles of disinfectants and sanitizers in the control and prevention of the current pandemic and highlights updated disinfection techniques against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This article provides evidence of the deleterious effects of disinfectants and sanitizers exerted on humans, animals, and the environment as well as suggests mitigation strategies to reduce these effects. Additionally, potential technologies and approaches for the reduction of these effects and the development of safe, affordable, and effective disinfectants are discussed, particularly, eco-friendly technologies using nanotechnology and nanomedicine.
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Affiliation(s)
- Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India.
| | - Shailesh Kumar Patel
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - Rakesh Kumar
- Department of Veterinary Pathology, Dr. G.C Negi College of Veterinary and Animal Sciences, CSK Himachal Pradesh Agricultural University, Palampur, Himachal Pradesh, 176062, India
| | - Rupali Masand
- Department of Veterinary Pathology, Dr. G.C Negi College of Veterinary and Animal Sciences, CSK Himachal Pradesh Agricultural University, Palampur, Himachal Pradesh, 176062, India
| | - Jigyasa Rana
- Department of Veterinary Anatomy, Faculty of Veterinary and Animal Sciences, Rajeev Gandhi South Campus, Banaras Hindu University, Barkachha, Mirzapur, Uttar Pradesh, 231001, India
| | - Mohd Iqbal Yatoo
- Division of Veterinary Clinical Complex, Faculty of Veterinary Sciences and Animal Husbandry, Shuhama, Alusteng Srinagar, Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Shalimar, Srinagar, Jammu and Kashmir, 190006, India
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, Uttar Pradesh Pandit Deen Dayal Upadhyaya Pashu Chikitsa Vigyan Vishwavidyalaya Evam Go Anusandhan Sansthan (DUVASU), Mathura, 281001, India
| | - Khan Sharun
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - Ranjan K Mohapatra
- Department of Chemistry, Government College of Engineering, Keonjhar, Odisha, 758002, India
| | - Senthilkumar Natesan
- Indian Institute of Public Health Gandhinagar, Lekawada, Gandhinagar, Gujarat, 382042, India
| | - Manish Dhawan
- Department of Microbiology, Punjab Agricultural University, Ludhiana, 141004, India
- The Trafford Group of Colleges, Manchester, WA14 5PQ, UK
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, 4381, Bangladesh
| | - Yashpal Singh Malik
- Division of Biological Standardization, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia.
- Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia.
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia.
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Jara BJ. Infection Prevention in the Era of COVID-19: 2021 Basic Procedure Review. J Nucl Med Technol 2021; 49:126-131. [PMID: 34083454 PMCID: PMC8712632 DOI: 10.2967/jnmt.121.262281] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
Infection prevention and control practices represent a vital behavioral skill set, especially in the era of COVID-19. Standard precautions, correct use of personal protective equipment, proper hand hygiene, and appropriate cleaning and disinfecting are necessary to prevent health-care-acquired infections in care facilities.
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Affiliation(s)
- Barbara J Jara
- Nuclear Diagnostic Products, Pharmalogic, Lansdowne, Pennsylvania
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Antibacterial Treatment of Selected High-Touch Objects and Surfaces within Provision of Nursing Care in Terms of Prevention of Healthcare-Associated Infections. Healthcare (Basel) 2021; 9:healthcare9060675. [PMID: 34199992 PMCID: PMC8228692 DOI: 10.3390/healthcare9060675] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 11/20/2022] Open
Abstract
Prevention of healthcare-associated infections is an important part of providing nursing care. High-touch objects and surfaces that can be contaminated with various bacteria are matters of concern. The possibility of reducing contamination is the use of antibacterial and hydrophobic nanolayers. The aim of this study was to determine, by means of an experimental method, the microbial efficacy of applied antibacterial and hydrophobic nanolayers on high-touch objects and surfaces used in nursing practice in a regional hospital in the Czech Republic. The results show that the antibacterial efficacy of the applied nanolayer was not demonstrated. Furthermore, the results show that selected objects and surfaces can always be contaminated by bacterial agents in about 1/3 of cases. It is mainly contamination with nonpathogenic bacteria; however, the presence of pathogenic bacteria, such as Staphylococcus aureus, has also been detected. The results of this study pinpoint the importance of following the basic rules for the use of decontaminated objects and surfaces used to provide healthcare.
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Kanamori H, Weber DJ, Rutala WA. Role of the Healthcare Surface Environment in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission and Potential Control Measures. Clin Infect Dis 2021; 72:2052-2061. [PMID: 32985671 PMCID: PMC7543309 DOI: 10.1093/cid/ciaa1467] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 09/24/2020] [Indexed: 01/08/2023] Open
Abstract
The healthcare environment serves as one of the possible routes of transmission of epidemiologically important pathogens, but the role of the contaminated environment on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission remains unclear. We reviewed survival, contamination, and transmission of SARS-CoV-2 via environmental surfaces and shared medical devices as well as environmental disinfection of SARS-CoV-2 in healthcare settings. Coronaviruses, including SARS-CoV-2, have been demonstrated to survive for hours to days on environmental surfaces depending on experimental conditions. The healthcare environment is frequently contaminated with SARS-CoV-2 RNA in most studies but without evidence of viable virus. Although direct exposure to respiratory droplets is the main transmission route of SARS-CoV-2, the contaminated healthcare environment can potentially result in transmission of SARS-CoV-2 as described with other coronaviruses such as SARS and Middle East respiratory syndrome coronaviruses. It is important to improve thoroughness of cleaning/disinfection practices in healthcare facilities and select effective disinfectants to decontaminate inanimate surfaces and shared patient care items.
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Affiliation(s)
- Hajime Kanamori
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.,Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - David J Weber
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - William A Rutala
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
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Brêda Mascarenhas LA, Machado BAS, Rodrigues LDAP, Saraiva Hodel KV, Bandeira Santos AÁ, Freitas Neves PR, da Silva Andrade LPC, Soares MB, de Andrade JB, Badaró R. Potential application of novel technology developed for instant decontamination of personal protective equipment before the doffing step. PLoS One 2021; 16:e0250854. [PMID: 34086691 PMCID: PMC8177472 DOI: 10.1371/journal.pone.0250854] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 02/02/2021] [Indexed: 12/14/2022] Open
Abstract
The use of personal protective equipment (PPE) has been considered the most effective way to avoid the contamination of healthcare workers by different microorganisms, including SARS-CoV-2. A spray disinfection technology (chamber) was developed, and its efficacy in instant decontamination of previously contaminated surfaces was evaluated in two exposure times. Seven test microorganisms were prepared and inoculated on the surface of seven types of PPE (respirator mask, face shield, shoe, glove, cap, safety glasses and lab coat). The tests were performed on previously contaminated PPE using a manikin with a motion device for exposure to the chamber with biocidal agent (sodium hypochlorite) for 10 and 30s. In 96.93% of the experimental conditions analyzed, the percentage reduction was >99% (the number of viable cells found on the surface ranged from 4.3x106 to <10 CFU/mL). The samples of E. faecalis collected from the glove showed the lowest percentages reduction, with 86.000 and 86.500% for exposure times of 10 and 30 s, respectively. The log10 reduction values varied between 0.85 log10 (E. faecalis at 30 s in glove surface) and 9.69 log10 (E. coli at 10 and 30 s in lab coat surface). In general, E. coli, S. aureus, C. freundii, P. mirabilis, C. albicans and C. parapsilosis showed susceptibility to the biocidal agent under the tested conditions, with >99% reduction after 10 and 30s, while E. faecalis and P. aeruginosa showed a lower susceptibility. The 30s exposure time was more effective for the inactivation of the tested microorganisms. The results show that the spray disinfection technology has the potential for instant decontamination of PPE, which can contribute to an additional barrier for infection control of healthcare workers in the hospital environment.
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Affiliation(s)
- Luís Alberto Brêda Mascarenhas
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Bruna Aparecida Souza Machado
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
- SENAI CIMATEC, National Service of Industrial Learning–SENAI, Computational Modeling and Industrial Technology, University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Leticia de Alencar Pereira Rodrigues
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Katharine Valéria Saraiva Hodel
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Alex Álisson Bandeira Santos
- SENAI CIMATEC, National Service of Industrial Learning–SENAI, Computational Modeling and Industrial Technology, University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Paulo Roberto Freitas Neves
- SENAI CIMATEC, National Service of Industrial Learning–SENAI, Computational Modeling and Industrial Technology, University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Leone Peter Correia da Silva Andrade
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Milena Botelho Soares
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (IGM-FIOCRUZ/BA), Salvador, Bahia, Brazil
| | - Jailson Bittencourt de Andrade
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Roberto Badaró
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
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Bacterial Pathogens and Their Antimicrobial Resistance Patterns of Inanimate Surfaces and Equipment in Ethiopia: A Systematic Review and Meta-analysis. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5519847. [PMID: 34095296 PMCID: PMC8137297 DOI: 10.1155/2021/5519847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/01/2021] [Indexed: 11/29/2022]
Abstract
Background Hospital-acquired infections have remained a serious cause of mortality, morbidity, and extended hospitalization. Bacterial contamination of inanimate surfaces of the hospital environment and equipment is considered a major contributing factor to the development of several nosocomial infections worldwide. The hospital environment and many devices are an important reservoir of many clinically important bacterial agents including multidrug-resistant pathogens. Therefore, this systematic review and meta-analysis are aimed at investigating bacterial pathogens and their antimicrobial resistance patterns of inanimate surfaces and equipment in Ethiopia. Methods An exhaustive literature search was carried out using the major electronic databases including PubMed, Web of Science, MEDLINE, EMBASE, CINAHL, Google Scholar, Cochrane Library, Scopus, and Wiley online library to identify potentially relevant studies without date restriction. Original articles which address the research question were identified, screened, and included using the PRISMA flow diagram. Data extraction was prepared in Microsoft Excel, and data quality was assessed by using 9-point Joanna Briggs Institute critical appraisal tools. Then, data were exported to STATA 16.0 software for analyses of pooled estimation of outcome measures. Estimation of outcome measures at a 95% confidence interval was performed using DerSimonian-Laird's random-effects model. Finally, results were presented via text, figures, and tables. Results A total of 18 studies with 3058 bacterial isolates recovered from 3423 swab specimens were included for systematic review and meta-analysis. The pooled prevalence of bacterial contamination of inanimate surfaces and equipment was found 70% (95% CI: 59, 82). Among the Gram-negative bacterial species, the prevalence of ampicillin-resistant K. pneumoniae was the highest 80% (95% CI: 78, 92) followed by Citrobacter species 78% (95% CI: 57, 83). Conclusion This study has shown a high prevalence of bacterial contamination of inanimate surfaces and equipment in Ethiopia.
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Ramirez M, Matheu L, Gomez M, Chang A, Ferrolino J, Mack R, Antillon-Klussmann F, Melgar M. Effectiveness of dry hydrogen peroxide on reducing environmental microbial bioburden risk in a pediatric oncology intensive care unit. Am J Infect Control 2021; 49:608-613. [PMID: 32828799 DOI: 10.1016/j.ajic.2020.08.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/16/2020] [Accepted: 08/17/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Routine manual cleaning and disinfection of the health care environment is often suboptimal. Residual contamination poses an infection risk, particularly for immunocompromised patients. This study evaluates the efficacy of dry hydrogen peroxide (DHP) on microbial surface contamination in a pediatric oncology intensive care unit. METHODS Surface samples from 5 high-touch and 2 low-touch surfaces were obtained for culture and adenosine triphosphate readings after manual cleaning on multiple days in 4 intensive care unit rooms, before and after DHP was deployed. Air samples were collected as well at the study site. Data outcomes were measured in terms of total colony-forming units for the cultures and relative light units for adenosine triphosphate. RESULTS The overall mean surface microbial burden was significantly reduced in the intervention group compared to the control group (mean 5.50 vs 11.77, P<.001). These reductions in colony-forming units were seen across all sampling sites in the intervention group. A reduction in the mean relative light units levels was also noted in the intervention group when compared to the control group (172.08 vs 225.83, P <.006). Reductions with the air samples were also noted (P = .139). CONCLUSIONS Study demonstrates that DHP was effective in reducing microbial surface contamination and improves quality of environmental cleaning.
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Affiliation(s)
- Marilyn Ramirez
- Department of Infection Prevention and Control, Unidad Nacional de Oncologia Pediatrica, Guatemala
| | - Laura Matheu
- Department of Infection Prevention and Control, Unidad Nacional de Oncologia Pediatrica, Guatemala
| | - Miguel Gomez
- Department of Infection Prevention and Control, Unidad Nacional de Oncologia Pediatrica, Guatemala
| | - Alicia Chang
- Department of Infection Prevention and Control, Unidad Nacional de Oncologia Pediatrica, Guatemala; Department of Pediatrics, Infectious Disease Division, Hospital Roosevelt, Guatemala
| | | | - Ricardo Mack
- Unidad Nacional de Oncologia Pediatrica, Guatemala
| | | | - Mario Melgar
- Department of Infection Prevention and Control, Unidad Nacional de Oncologia Pediatrica, Guatemala; Department of Pediatrics, Infectious Disease Division, Hospital Roosevelt, Guatemala.
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Assadian O, Harbarth S, Vos M, Knobloch JK, Asensio A, Widmer AF. Practical recommendations for routine cleaning and disinfection procedures in healthcare institutions: a narrative review. J Hosp Infect 2021; 113:104-114. [PMID: 33744383 DOI: 10.1016/j.jhin.2021.03.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 12/12/2022]
Abstract
Healthcare-associated infections (HAIs) are the most common adverse outcomes due to delivery of medical care. HAIs increase morbidity and mortality, prolong hospital stay, and are associated with additional healthcare costs. Contaminated surfaces, particularly those that are touched frequently, act as reservoirs for pathogens and contribute towards pathogen transmission. Therefore, healthcare hygiene requires a comprehensive approach whereby different strategies may be implemented together, next to targeted, risk-based approaches, in order to reduce the risk of HAIs for patients. This approach includes hand hygiene in conjunction with environmental cleaning and disinfection of surfaces and clinical equipment. This review focuses on routine environmental cleaning and disinfection including areas with a moderate risk of contamination, such as general wards. As scientific evidence has not yet resulted in universally accepted guidelines nor led to universally accepted practical recommendations pertaining to surface cleaning and disinfection, this review provides expert guidance for healthcare workers in their daily practice. It also covers outbreak situations and suggests practical guidance for clinically relevant pathogens. Key elements of environmental cleaning and disinfection, including a fundamental clinical risk assessment, choice of appropriate disinfectants and cleaning equipment, definitions for standardized cleaning processes and the relevance of structured training, are reviewed in detail with a focus on practical topics and implementation.
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Affiliation(s)
- O Assadian
- Regional Hospital Wiener Neustadt, Wiener Neustadt, Austria; Institute for Skin Integrity and Infection Prevention, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK.
| | - S Harbarth
- Infection Control Programme and Division of Infectious Diseases, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - M Vos
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - J K Knobloch
- Institute for Medical Microbiology, Virology and Hygiene, Department for Infection Prevention and Control, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - A Asensio
- Preventive Medicine Department, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - A F Widmer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
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Soltani M, Ravine TJ, Davis JH. Novel boronium salt exhibits substantial antibacterial activity when compared to a commercial quaternary ammonium disinfectant. Bioorg Med Chem Lett 2021; 36:127808. [DOI: 10.1016/j.bmcl.2021.127808] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/17/2020] [Accepted: 01/15/2021] [Indexed: 12/01/2022]
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Impact of a Whole-Room Atomizing Disinfection System on Healthcare Surface Contamination, Pathogen Transfer, and Labor Efficiency. Crit Care Explor 2021; 3:e0340. [PMID: 33623925 PMCID: PMC7892299 DOI: 10.1097/cce.0000000000000340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Supplemental Digital Content is available in the text. Healthcare surfaces contribute to nosocomial disease transmission. Studies show that despite standard guidelines and practices for cleaning and disinfection, secondary infection spread among healthcare workers and patients is common in ICUs. Manual terminal cleaning practices in healthcare are subject to highly variable results due to differences in training, compliance, and other inherent complexities. Standard cleaning practices combined with no-touch disinfecting technologies, however, may significantly lower nosocomial infection rates. The objective of this study was to evaluate the efficacy of a whole-room, no-touch disinfection intervention to reduce the concentration and cross-contamination of surface bacteria when used in tandem with manual cleaning protocols.
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NeoCLEAN: a multimodal strategy to enhance environmental cleaning in a resource-limited neonatal unit. Antimicrob Resist Infect Control 2021; 10:35. [PMID: 33579364 PMCID: PMC7881651 DOI: 10.1186/s13756-021-00905-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/03/2021] [Indexed: 11/26/2022] Open
Abstract
Background Contamination of the hospital environment contributes to neonatal bacterial colonization and infection. Cleaning of hospital surfaces and equipment is seldom audited in resource-limited settings. Methods A quasi-experimental study was conducted to assess the impact of a multimodal cleaning intervention for surfaces and equipment in a 30-bed neonatal ward. The intervention included cleaning audits with feedback, cleaning checklists, in-room cleaning wipes and training of staff and mothers in cleaning methods. Cleaning adequacy was evaluated for 100 items (58 surfaces, 42 equipment) using quantitative bacterial surface cultures, adenosine triphosphate bioluminescence assays and fluorescent ultraviolet markers, performed at baseline (P1, October 2019), early intervention (P2, November 2019) and late intervention (P3, February 2020). Results Environmental swabs (55/300; 18.3%) yielded growth of 78 potential neonatal pathogens with Enterococci, S. marcescens, K. pneumoniae, S. aureus and A. baumannii predominating. Highest aerobic colony counts were noted from moist surfaces such as sinks, milk kitchen surfaces, humidifiers and suction tubing. The proportion of surfaces and equipment exhibiting no bacterial growth increased between phases (P1 = 49%, P2 = 66%, P3 = 69%; p = 0.007). The proportion of surfaces and equipment meeting the ATP “cleanliness” threshold (< 200 relative light units) increased over time (P1 = 40%, P2 = 54%, P3 = 65%; p = 0.002), as did the UV marker removal rate (P1 = 23%, P2 = 71%, P3 = 74%; p < 0.001). Conclusion Routine environmental cleaning of this neonatal ward was sub-optimal at baseline but improved significantly following a multimodal cleaning intervention. Involving mothers and nursing staff was key to achieving improved environmental and equipment cleaning in this resource-limited neonatal unit. Supplementary information The online version contains supplementary material available at 10.1186/s13756-021-00905-y.
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Chen M, Qi J, Du Y, Cheng Z, Cai T, Li C. Rapid and accurate evaluation of vaporized hydrogen peroxide on the efficiency of disinfection, using a sensitive dual-channel laser scanning cytometer. BIOSAFETY AND HEALTH 2021. [DOI: 10.1016/j.bsheal.2020.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kinetics of Bacterial Inactivation by Peroxynitric Acid in the Presence of Organic Contaminants. Appl Environ Microbiol 2021; 87:AEM.01860-20. [PMID: 33127816 DOI: 10.1128/aem.01860-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/26/2020] [Indexed: 11/20/2022] Open
Abstract
Low-temperature atmospheric-pressure plasma has been studied for disinfection purposes. When plasma is exposed to water, reactive oxygen and nitrogen species are generated and preserved in the water fraction (plasma-treated water [PTW]), which consequently exhibits bactericidal activity. At low temperatures, one of the bactericidal components of PTW is peroxynitric acid (PNA). Importantly, PNA can also be synthesized by chemical reaction, without exposure to plasma. In this study, we evaluated the bactericidal properties of PNA based on reaction kinetics in comparison with other disinfectants. The analysis, based on dose-dependent effects, showed that PNA exhibited about 1 and 10 times the bactericidal activity of hypochlorous acid (HOCl) and peracetic acid, respectively. In addition, we evaluated the influence of organic contaminants on the bactericidal effects of PNA and HOCl. The bactericidal potential of both disinfectants was reduced by bovine serum albumin (BSA); however, PNA showed about 30-times-higher resistance against BSA inhibition than HOCl. Analysis of the dose-dependent effects of PNA revealed that the inhibition of bactericidal effect was caused by its consumption. Further experiments using model substrates containing particular amino acid residues (Met, Cys, Lys, and Leu) suggested that the bacterial inactivation by PNA is less affected by BSA due to the low reactivity and narrow reactivity spectrum of PNA for amino acid residues. Overall, our results suggest that PNA has a great disinfection potential, especially in the presence of organic contaminants (e.g., on the surface of the human body and on medical instruments contaminated with biological fluids).IMPORTANCE A good disinfectant for the human body should have various properties, such as strong bactericidal activity, harmlessness to living tissues, and resistance against biological fluids (or other organic contaminants). Peroxynitric acid (PNA) showed a bactericidal effect that was several tens up to several hundred times higher per unit of molarity than that of sodium hypochlorite and peracetic acid, which are used as general disinfectants for medical equipment. Moreover, the high resistance of PNA to organic load was confirmed, indicating that PNA will inactivate bacteria effectively even on contaminated surfaces, such as used medical devices or the human body surface. Therefore, we propose that PNA can be used as a strong disinfectant for the human body.
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