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Basiry D, Entezari Heravi N, Uluseker C, Kaster KM, Kommedal R, Pala-Ozkok I. The effect of disinfectants and antiseptics on co- and cross-selection of resistance to antibiotics in aquatic environments and wastewater treatment plants. Front Microbiol 2022; 13:1050558. [PMID: 36583052 PMCID: PMC9793094 DOI: 10.3389/fmicb.2022.1050558] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
The outbreak of the SARS-CoV-2 pandemic led to increased use of disinfectants and antiseptics (DAs), resulting in higher concentrations of these compounds in wastewaters, wastewater treatment plant (WWTP) effluents and receiving water bodies. Their constant presence in water bodies may lead to development and acquisition of resistance against the DAs. In addition, they may also promote antibiotic resistance (AR) due to cross- and co-selection of AR among bacteria that are exposed to the DAs, which is a highly important issue with regards to human and environmental health. This review addresses this issue and provides an overview of DAs structure together with their modes of action against microorganisms. Relevant examples of the most effective treatment techniques to increase the DAs removal efficiency from wastewater are discussed. Moreover, insight on the resistance mechanisms to DAs and the mechanism of DAs enhancement of cross- and co-selection of ARs are presented. Furthermore, this review discusses the impact of DAs on resistance against antibiotics, the occurrence of DAs in aquatic systems, and DA removal mechanisms in WWTPs, which in principle serve as the final barrier before releasing these compounds into the receiving environment. By recognition of important research gaps, research needs to determine the impact of the majority of DAs in WWTPs and the consequences of their presence and spread of antibiotic resistance were identified.
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Affiliation(s)
- Daniel Basiry
- Department of Chemistry, Bioscience and Environmental Engineering, Faculty of Science and Technology, University of Stavanger, Stavanger, Norway
| | - Nooshin Entezari Heravi
- Department of Chemistry, Bioscience and Environmental Engineering, Faculty of Science and Technology, University of Stavanger, Stavanger, Norway
| | - Cansu Uluseker
- School of Biosciences, University of Birmingham, Birmingham, United Kingdom
| | - Krista Michelle Kaster
- Department of Chemistry, Bioscience and Environmental Engineering, Faculty of Science and Technology, University of Stavanger, Stavanger, Norway
| | - Roald Kommedal
- Department of Chemistry, Bioscience and Environmental Engineering, Faculty of Science and Technology, University of Stavanger, Stavanger, Norway
| | - Ilke Pala-Ozkok
- Department of Chemistry, Bioscience and Environmental Engineering, Faculty of Science and Technology, University of Stavanger, Stavanger, Norway
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Efficacy of Three Commercial Disinfectants in Reducing Microbial Surfaces' Contaminations of Pharmaceuticals Hospital Facilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020779. [PMID: 33477614 PMCID: PMC7831293 DOI: 10.3390/ijerph18020779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 11/17/2022]
Abstract
To evaluate and validate the efficacy of disinfectants used in our cleaning procedure, in order to reduce pharmaceutical hospital surfaces' contaminations, we tested the action of three commercial disinfectants on small representative samples of the surfaces present in our hospital cleanrooms. These samples (or coupons) were contaminated with selected microorganisms for the validation of the disinfectants. The coupons were sampled before and after disinfection and the microbial load was assessed to calculate the Log10 reduction index. Subsequently, we developed and validated a disinfection procedure on real surfaces inside the cleanrooms intentionally contaminated with microorganisms, using approximately 107-108 total colony forming units per coupon. Our results showed a bactericidal, fungicidal, and sporicidal efficacy coherent to the acceptance criteria suggested by United States Pharmacopeia 35 <1072>. The correct implementation of our cleaning and disinfection procedure, respecting stipulated concentrations and contact times, led to a reduction of at least 6 Log10 for all microorganisms used. The proposed disinfection procedure reduced the pharmaceutical hospital surfaces' contaminations, limited the propagation of microorganisms in points adjacent to the disinfected area, and ensured high disinfection and safety levels for operators, patients, and treated surfaces.
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Recontamination of Healthcare Surfaces by Repeated Wiping with Biocide-Loaded Wipes: " One Wipe, One Surface, One Direction, Dispose" as Best Practice in the Clinical Environment. Int J Mol Sci 2020; 21:ijms21249659. [PMID: 33352868 PMCID: PMC7766459 DOI: 10.3390/ijms21249659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 01/29/2023] Open
Abstract
The wiping of high-touch healthcare surfaces made of metals, ceramics and plastics to remove bacteria is an accepted tool in combatting the transmission of healthcare-associated infections (HCAIs). In practice, surfaces may be repeatedly wiped using a single wipe, and the potential for recontamination may be affected by various factors. Accordingly, we studied how the surface to be wiped, the type of fibre in the wipe and how the presence of liquid biocide affected the degree of recontamination. Experiments were conducted using metal, ceramic and plastic healthcare surfaces, and two different wipe compositions (hygroscopic and hydrophilic), with and without liquid biocide. Despite initially high removal efficiencies of >70% during initial wiping, all healthcare surfaces were recontaminated with E. coli, S. aureus and E. faecalis when wiped more than once using the same wipe. Recontamination occurred regardless of the fibre composition of the wipe or the presence of a liquid biocide. The extent of recontamination by E. coli, S. aureus and E. faecalis bacteria also increased when metal healthcare surfaces possessed a higher microscale roughness (<1 μm), as determined by Atomic Force Microscopy (AFM). The high propensity for healthcare surfaces to be re-contaminated following initial wiping suggests that a “One wipe, One surface, One direction, Dispose” policy should be implemented and rigorously enforced.
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Scarano A, Inchingolo F, Lorusso F. Environmental Disinfection of a Dental Clinic during the Covid-19 Pandemic: A Narrative Insight. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8896812. [PMID: 33145359 PMCID: PMC7596431 DOI: 10.1155/2020/8896812] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 09/27/2020] [Accepted: 10/16/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The control of biological hazard risk in health care and dental clinic environments represents a critical point in relation to the Covid-19 infection outbreak and international public health emergency. The purpose of the present review was to evaluate the scientific literature on the no-touch disinfection procedures in dental clinics aiming to limit transmission via airborne particles or fomites using no-touch procedures for environmental decontamination of dental clinics. METHODS An electronic database literature search was performed to retrieve research papers about Covid-19 and no-touch disinfection topics including full-length articles, editorials, commentaries, and outbreak studies. A total of 86 papers were retrieved by the electronic research. RESULTS No clinical article about the decontamination of a dental clinic during the Covid-19 pandemic was detected. About the topic of hospital decontamination, we found different no-touch disinfection procedures used in hospital against highly resistant organisms, but no data were found in the search for such procedures with respect to SARS-CoV-2: (1) aerosolized hydrogen peroxide, (2) H2O2 vapor, (3) ultraviolet C light, (4) pulsed xenon, and (5) gaseous ozone. One paper was retrieved concerning SARS-CoV-2; 32 documents focused on SARS and MERS. The cleaning and disinfection protocol of health care and dental clinic environment surfaces are essential elements of infection prevention programs, especially during the SARS-CoV-2 pandemic. CONCLUSION The decontamination technique that best suits the needs of the dental clinic is peroxide and hypochlorous which can be sprayed via a device at high turbine speed with the ability of producing small aerosol particles, recommendable also for their low cost.
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Affiliation(s)
- Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
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Vasudevan R, Shin JH, Chopyk J, Peacock WF, Torriani FJ, Maisel AS, Pride DT. Aseptic Barriers Allow a Clean Contact for Contaminated Stethoscope Diaphragms. Mayo Clin Proc Innov Qual Outcomes 2020; 4:21-30. [PMID: 32055768 PMCID: PMC7010972 DOI: 10.1016/j.mayocpiqo.2019.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/15/2019] [Indexed: 11/30/2022] Open
Abstract
Objective To determine whether a single-use stethoscope diaphragm barrier surface remains aseptic when placed on pathogen-contaminated stethoscopes. Methods From May 31 to August 5, 2019, we tested 2 separate barriers using 3 different strains of 7 human pathogens, including extended-spectrum β-lactamase-producing Escherichia coli, methicillin-resistant Staphylococcus aureus, and vancomycin resistant Enterococcus faecium. Results For all diaphragms with either of the 2 barriers tested, no growth was recorded for any of the pathogens. Stethoscopes with aseptic barriers remained sterile for up to 24 hours. These single-use barriers also provided aseptic surfaces when stethoscope diaphragms were inoculated with human specimens, including saliva, stool, urine, and sputum. Conclusion Disposable aseptic diaphragm barriers may provide robust and efficient solutions to reduce transmission of pathogens via stethoscopes.
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Key Words
- B+, stethoscope diaphragms with disc barriers
- BC, disc barriers colonized with microorganisms
- B−, colonized diaphragms without disc barriers
- CFU, colony-forming unit
- Ctrl, control
- ESBL, extended-spectrum β-lactamase–producing Escherichia coli
- HAI, health care–associated infection
- HP, health care provider
- MDR, multidrug resistant
- MDRO, multidrug-resistant organism
- MRSA, methicillin-resistant Staphylococcus aureus
- VRE, vancomycin-resistant Enterococcus
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Affiliation(s)
- Rajiv Vasudevan
- Department of Medicine, University of California, San Diego, TX
| | - Ji H Shin
- Department of Pathology, University of California, San Diego, TX
| | - Jessica Chopyk
- Department of Pathology, University of California, San Diego, TX
| | - William F Peacock
- Department of Emergency Medicine, Baylor College of Medicine, Houston, TX
| | | | - Alan S Maisel
- Department of Medicine, University of California, San Diego, TX
| | - David T Pride
- Department of Medicine, University of California, San Diego, TX.,Department of Pathology, University of California, San Diego, TX
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Unlocking the Secret of Bio-additive Components in Rubber Compounding in Processing Quality Nitrile Glove. Appl Biochem Biotechnol 2020; 191:1-28. [DOI: 10.1007/s12010-019-03207-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 12/05/2019] [Indexed: 12/25/2022]
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DeJonge P, Martin ET, Hayashi M, Hashikawa AN. Variation in surface decontamination practices among Michigan child care centers compared to state and national guidelines. Am J Infect Control 2019; 47:1176-1180. [PMID: 31036400 DOI: 10.1016/j.ajic.2019.03.019] [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: 01/31/2019] [Revised: 03/14/2019] [Accepted: 03/17/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Environmental decontamination is one of the most effective methods to prevent transmission of infectious pathogens in child care centers (CCCs). Alongside state recommendations, national organizations-including the American Academy of Pediatrics (AAP)-offer best-practice policies. In Michigan, these sets of guidelines differ, and the extent to which CCC practices agree with either set of protocols is unknown. METHODS A survey of environmental decontamination practices was administered at a professional meeting of CCC directors (N = 24) in a single Michigan county. CCC practices (eg, products, locations, frequencies) were compared to state and AAP guidelines. Bivariate analyses investigated CCC characteristics as predictors of decontamination policy agreement. RESULTS CCC agreement with established policy was slightly higher for national AAP guidelines (66%) than Michigan standards (59%). The use of an outside child care health consultant was strongly associated with a significantly higher level of agreement with state decontamination policy (P = .01). CONCLUSION We noted substantial disagreement between county CCC practices and state/national guidelines, regardless of CCC size or director experience. Results highlight opportunities to improve CCC director familiarity with current state and nationally advised protocols, to consolidate state licensing and AAP guidelines, and to promote the use of child care health consultants.
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Villacís JE, Lopez M, Passey D, Santillán MH, Verdezoto G, Trujillo F, Paredes G, Alarcón C, Horvath R, Stibich M. Efficacy of pulsed-xenon ultraviolet light for disinfection of high-touch surfaces in an Ecuadorian hospital. BMC Infect Dis 2019; 19:575. [PMID: 31269912 PMCID: PMC6609374 DOI: 10.1186/s12879-019-4200-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 06/17/2019] [Indexed: 01/01/2023] Open
Abstract
Background Hospital environment in patient care has been linked on healthcare-associated infections (HAI). No touch disinfection technologies that utilize pulsed xenon ultraviolet light has been recognized to prevent infection in contaminated environments. The purpose of this study was: 1) to evaluate the effectiveness of pulsed-xenon ultraviolet light (PX-UV) disinfection for the reduction of bacteria on environmental surfaces of Hospital General Enrique Garcés, and 2) to evaluate the in-vitro efficacy against multi-drug resistance microorganisms. Methods This was a quality-improvement study looking at cleaning and disinfection of patient areas. During the study, a total of 146 surfaces from 17 rooms were sampled in a secondary 329-bed public medical center. Microbiological samples of high-touch surfaces were taken after terminal manual cleaning and after pulsed xenon ultraviolet disinfection. Cleaning staff were blinded to the study purpose and told clean following their usual protocols. For positive cultures PCR identification for carbapenemase-resistance genes (blaKPC, blaIMP, blaVIM, and blaNDM) were analyzed and confirmed by sequencing. The total number of colony forming units (CFU) were obtained and statistical analyses were conducted using Wilcoxon Rank Sum tests to evaluate the difference in CFU between terminal manual cleaning and after pulsed xenon ultraviolet disinfection. Results After manual disinfection of 124 surfaces showed a total of 3569 CFU which dropped to 889 CFU in 80 surfaces after pulsed xenon disinfection (p < 0.001). Overall, the surface and environmental contamination was reduced by 75% after PX-UV compared to manual cleaning and disinfection. There were statistically significant decreases in CFU counts of high touch surfaces in OR 87% (p < 0.001) and patient rooms 76% (p < 0.001). Four rooms presented serine carbapenemases blaKPC, and metallo beta-lactamases blaNDM, blaVIM, blaIMP. confirmed by PCR and sequencing. The in-vitro testing with endemic strains found that after five minutes of pulsed xenon ultraviolet exposure an 8-log reduction was achieved in all cases. Conclusion This study is one of the first of its kind in an Ecuador Hospital. We found that pulsed-xenon ultraviolet disinfection technology is an efficacious complement to the established manual cleaning protocols and guidelines in the significant reduction of MDRO.
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Affiliation(s)
- José E Villacís
- Science department, 360Life Technologies, 6 de Diciembre y Batallas, Quito, Ecuador. .,Carrera de Bioquímica Clínica, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador.
| | - Mario Lopez
- Science department, 360Life Technologies, 6 de Diciembre y Batallas, Quito, Ecuador
| | - Deborah Passey
- Xenex Disinfection Services, San Antonio, Texas, 78209, USA
| | | | - Germán Verdezoto
- Science department, 360Life Technologies, 6 de Diciembre y Batallas, Quito, Ecuador
| | | | | | | | - Ronny Horvath
- Science department, 360Life Technologies, 6 de Diciembre y Batallas, Quito, Ecuador
| | - Mark Stibich
- Xenex Disinfection Services, San Antonio, Texas, 78209, USA
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Aptamers as the Agent in Decontamination Assays (Apta-Decontamination Assays): From the Environment to the Potential Application In Vivo. J Nucleic Acids 2017; 2017:3712070. [PMID: 29225967 PMCID: PMC5684557 DOI: 10.1155/2017/3712070] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 09/10/2017] [Indexed: 12/21/2022] Open
Abstract
The binding specificity and affinity of aptamers have long been harnessed as the key elements in the development of aptamer-based assays, particularly aptasensing application. One promising avenue that is currently explored based on the specificity and affinity of aptamers is the application of aptamers in the decontamination assays. Aptamers have been successfully harnessed as the decontamination agents to remove contaminants from the environment and to decontaminate infectious elements. The reversible denaturation property inherent in aptamers enables the repeated usage of aptamers, which can immensely save the cost of decontamination. Analogous to the point-of-care diagnostics, there is no doubt that aptamers can also be deployed in the point-of-care aptamer-based decontamination assay, whereby decontamination can be performed anywhere and anytime for instantaneous decision-making. It is also prophesied that aptamers can also serve more than as a decontaminant, probably as a tool to capture and kill hazardous elements, particularly pathogenic agents.
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Morris DO, Loeffler A, Davis MF, Guardabassi L, Weese JS. Recommendations for approaches to meticillin-resistant staphylococcal infections of small animals: diagnosis, therapeutic considerations and preventative measures.: Clinical Consensus Guidelines of the World Association for Veterinary Dermatology. Vet Dermatol 2017; 28:304-e69. [PMID: 28516494 DOI: 10.1111/vde.12444] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Multiple drug resistance (MDR) in staphylococci, including resistance to the semi-synthetic penicillinase-resistant penicillins such as meticillin, is a problem of global proportions that presents serious challenges to the successful treatment of staphylococcal infections of companion animals. OBJECTIVES The objective of this document is to provide harmonized recommendations for the diagnosis, prevention and treatment of meticillin-resistant staphylococcal infections in dogs and cats. METHODS The authors served as a Guideline Panel (GP) and reviewed the literature available prior to September 2016. The GP prepared a detailed literature review and made recommendations on selected topics. The World Association of Veterinary Dermatology (WAVD) provided guidance and oversight for this process. A draft of the document was presented at the 8th World Congress of Veterinary Dermatology (May 2016) and was then made available via the World Wide Web to the member organizations of the WAVD for a period of three months. Comments were solicited and posted to the GP electronically. Responses were incorporated by the GP into the final document. CONCLUSIONS Adherence to guidelines for the diagnosis, laboratory reporting, judicious therapy (including restriction of use policies for certain antimicrobial drugs), personal hygiene, and environmental cleaning and disinfection may help to mitigate the progressive development and dissemination of MDR staphylococci.
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Affiliation(s)
- Daniel O Morris
- Department of Clinical Studies - Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St, Philadelphia, PA, 19104, USA
| | - Anette Loeffler
- Department of Clinical Sciences and Services, Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA, UK
| | - Meghan F Davis
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Luca Guardabassi
- Department of Biomedical Sciences, School of Veterinary Medicine, Ross University, Basseterre, St Kitts and Nevis, West Indies
| | - J Scott Weese
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada, N1G 2W1
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Saha A, Botha SL, Weaving P, Satta G. A pilot study to assess the effectiveness and cost of routine universal use of peracetic acid sporicidal wipes in a real clinical environment. Am J Infect Control 2016; 44:1247-1251. [PMID: 27238941 DOI: 10.1016/j.ajic.2016.03.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 03/20/2016] [Accepted: 03/21/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Peracetic acid sporicidal wipes have been shown to be an effective disinfectant, but in controlled test environments. Their high cost may restrict use. AIMS This pilot study investigated the efficacy and compared the costs of routine universal use of peracetic acid sporicidal wipes versus sporicidal quaternary ammonium compound and alcohol wipes in the disinfection of a hospital environment. METHODS The routine universal use of peracetic acid wipes (Clinell Sporicidal; GAMA Healthcare Ltd, London, UK) was allocated to a study ward, whereas the control ward continued with the use of quaternary ammonium compound wipes (Tuffie 5; Vernacare, Bolton, UK) and alcohol wipes (PDI Sani-Cloth 70; PDI, Flint, UK). Twenty high-touch areas in the 2 wards were sampled for the presence of indicator organisms. The weekly detection rates of indicator organisms and weekly healthcare associated infection (HCAI) rates in the 2 wards were compared and examined for decreasing trends over the trial period. RESULTS The detection rates of indicator organisms and HCAI rates were not significantly different in the 2 wards, and did not decrease significantly over the trial period. However, the peracetic acid wipes seem to be more effective against gram-negative organisms but at a significantly higher cost. CONCLUSIONS Further prospective studies are needed to assess the cost-effectiveness of peracetic acid wipes.
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Lee WS, Hsieh TC, Shiau JC, Ou TY, Chen FL, Liu YH, Yen MY, Hsueh PR. Bio-Kil, a nano-based disinfectant, reduces environmental bacterial burden and multidrug-resistant organisms in intensive care units. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2016; 50:737-746. [PMID: 27262208 DOI: 10.1016/j.jmii.2016.04.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 04/14/2016] [Accepted: 04/25/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND/PURPOSE This prospective before-after study was intended to investigate the effect of Bio-Kil on reducing environmental bacterial burden and healthcare-associated infections (HAIs) in intensive care units (ICUs) at the Municipal Wan-Fang Hospital, Taipei, Taiwan in 2014. METHODS Four rooms in the medical and surgical ICUs were investigated and designated as study rooms (n = 2) or control rooms (n = 2). Routine disinfection was performed during the pre-intervention period in both room types. Bio-Kil was applied to the fomites and surroundings of the study rooms during the intervention period. Total bacterial burden and proportion of colonization of fomites and surroundings by multidrug-resistance organisms (MDROs) were determined before and after the intervention. The demographic characteristics, underlying conditions, and clinical outcomes of patients were analyzed. RESULTS After application of Bio-Kil, the bacterial burden declined in both groups, although the reduction was greater in the study rooms as compared with the control rooms (p = 0.001). During the pre-intervention period, 16 patients were admitted to control rooms and 18 patients to study rooms. After the intervention, 22 patients were admitted to control rooms and 21 patients to study rooms. The number of cases of new-onset sepsis declined in the intervention group (from 33% to 23.8%), but increased in the control group (from 25% to 40.9%); however, there was no significant difference in incidence of new-onset sepsis between the study and control rooms after intervention. CONCLUSION Application of Bio-Kil reduced the environmental bacterial burden and MDROs in ICUs. Further studies are needed to evaluate the efficacy of this nanotechnology-based disinfectant in reducing HAIs.
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Affiliation(s)
- Wen-Sen Lee
- Division of Infectious Disease, Department of Internal Medicine, Wan Fang Medical Center and School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tai-Chin Hsieh
- Division of Infectious Disease, Department of Internal Medicine, Wan Fang Medical Center and School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Justine C Shiau
- Department of Biology, Eberly College of Science, Pennsylvania State University, State College, PA, USA
| | - Tsong-Yih Ou
- Division of Infectious Disease, Department of Internal Medicine, Wan Fang Medical Center and School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Fu-Lun Chen
- Division of Infectious Disease, Department of Internal Medicine, Wan Fang Medical Center and School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Hsin Liu
- Division of Infectious Disease, Department of Internal Medicine, Wan Fang Medical Center and School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Muh-Yong Yen
- Division of Infectious Disease, Taipei City Hospital and National Yang-Ming University, School of Medicine, Taipei, Taiwan.
| | - Po-Ren Hsueh
- Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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Shimoda T, Yano R, Nakamura S, Yoshida M, Matsuo J, Yoshimura S, Yamaguchi H. ATP bioluminescence values are significantly different depending upon material surface properties of the sampling location in hospitals. BMC Res Notes 2015; 8:807. [PMID: 26689425 PMCID: PMC4687287 DOI: 10.1186/s13104-015-1757-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/26/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Our previous study into assessing hospital cleanliness in Japan by two common methods, ATP bioluminescence and the stamp agar method, revealed considerable variability in the data of both methods (BMC Research Notes, 7: 121, 2014). To investigate the reason(s) for the variability, we reanalyzed the data (n = 752) from the point of view of the material surface properties of sampling sites. METHODS Data obtained from surfaces with unknown properties and different purposes such as floor were omitted, and the remaining data (n = 488) were used for this study. The material surface properties on sampling sites were divided into six categories: melamine coated (n = 216), vinyl chloride (n = 16), stainless steel (n = 144), wood (n = 63), and acrylonitrile-butadiene styrene resin coated (n = 48). The data between individual material properties were compared. RESULTS The ATP values of high-touch places were significantly different depending on the type of surface, but no significant difference in stamp values between material properties was seen, indicating that in contrast to stamp values, ATP-accumulation more depends on the physical properties of the material surface such as electronic charges or roughness. To confirm this, we assessed a degree of roughness on vinyl chloride material surface (disutilized floor samples actually used for each of the hospitals) by observation with scanning electron microscope (SEM). As a result, SEM observation similarly revealed considerable roughness on the materials, which may allow microbes to contaminate the materials without noticing it. CONCLUSION Material properties must be considered when evaluating hospital cleanliness with ATP values, and provide a strong warning into evaluating hospital cleanliness.
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Affiliation(s)
- Tomoko Shimoda
- Department of Fundamental Nursing, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Rika Yano
- Department of Fundamental Nursing, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Shinji Nakamura
- Laboratory of Morphology and Image Analysis, Biomedical Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Mitsutaka Yoshida
- Laboratory of Morphology and Image Analysis, Biomedical Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Junji Matsuo
- Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Nishi-5 Kita-12 Jo, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.
| | - Sadako Yoshimura
- Department of Fundamental Nursing, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Hiroyuki Yamaguchi
- Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Nishi-5 Kita-12 Jo, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.
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Trajtman AN, Manickam K, Alfa MJ. Microfiber cloths reduce the transfer of Clostridium difficile spores to environmental surfaces compared with cotton cloths. Am J Infect Control 2015; 43:686-9. [PMID: 25907782 DOI: 10.1016/j.ajic.2015.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/05/2015] [Accepted: 03/05/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Environmental surfaces in health care facilities contaminated with Clostridium difficile spores can be a reservoir that contribute to transmission of hospital-acquired infections. Microfiber cleaning cloths may improve the effectiveness of surface cleaning. The objective of this study was to assess the removal and transfer of C difficile spores on surfaces cleaned by microfiber compared with cotton cloths. METHODS C difficile spores (approximately 4.2 log(10)/site) were applied to ceramic surfaces. Microfiber or cotton cloths were used to wipe the surfaces that were sprayed with either buffer or a nonsporicidal cleaning agent. To ensure reproducible pressure and surface contact time, a drill apparatus was used. The pressure was 1.5-1.77 N, and the total number of rotations was 10. Viable counts were used to assess the efficiency of microfiber and cotton cloths in removing and transferring spores. RESULTS Of 4.4 log(10)C difficile spores inoculated on a ceramic surface, microfiber and cotton cloths removed 2.4 and 1.7 log(10), respectively. Microfiber cloths containing 4.2 log(10)C difficile spores transferred 1.7 log(10) C difficile spores when used to wipe a ceramic surface compared with cotton cloths that transferred 2.4 log(10). Similarly microfiber wipes transferred fewer spores on consecutive surfaces wiped compared with cotton cloths (0.8 log(10) vs 1.80 log(10)). CONCLUSION The use of microfiber cloths may reduce the risk of C difficile spore transfer during surface cleaning.
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Affiliation(s)
- Adriana N Trajtman
- Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada; St. Boniface Research Centre, Winnipeg, MB, Canada
| | - Kanchana Manickam
- Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada; Diagnostic Services of Manitoba, Winnipeg, MB, Canada
| | - Michelle J Alfa
- Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada; Diagnostic Services of Manitoba, Winnipeg, MB, Canada; St. Boniface Research Centre, Winnipeg, MB, Canada.
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Lasting hand self-disinfection: A backup for hospital hand hygiene? Am J Infect Control 2015; 43:697-701. [PMID: 25952619 DOI: 10.1016/j.ajic.2015.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 03/13/2015] [Accepted: 03/17/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Hand disinfection should be performed on the occasion of 5 separate moments during patient care, but some occasions are skipped. Can using hand antiseptics with residual effect reduce the problem of infection spread? We evaluated a 30-minute residual effect by different antiseptic products on endogenous and acquired microbiota. METHODS The products tested were 2% and 5% chlorhexidine, 1% and 10% iodine povidone, 60° n-propanol, 0.2% mecetronium + isopropanol, and 0.6% chlorhexidine + isopropanol + 0.1% benzalconium chloride. The microorganisms identified were 3 ATCC and 9 multiresistant strains isolated from intensive care unit patients (used as acquired microbiota). Logarithmic (log10) reductions of the colony forming units obtained with each antiseptic product and for each microorganism were calculated via in vivo (6 volunteers) and in vitro tests. RESULTS The better in vivo and in vitro products with a residual effect > 2 log10 after 30 minutes on hands were 2%-5% chlorhexidine and 0.6% chlorhexidine + isopropanol + 0.1% benzalconium chloride. This reduction was significantly different (P < .01) from the other 4 antiseptics. This residual effect (> 2 log10) can be considered a self-disinfecting hand status in daily practice. CONCLUSIONS Hand antiseptics used in hospitals must pass tests of residual efficacy (after 30 minutes on acquired microbiota) showing a reduction > 2 log10 in vivo and in vitro. A good product can be the mixture of chlorhexidine + alcohol + benzalconium chloride.
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Costa SADS, Paula OFPD, Silva CRGE, Leão MVP, Santos SSFD. Stability of antimicrobial activity of peracetic acid solutions used in the final disinfection process. Braz Oral Res 2015; 29:S1806-83242015000100239. [PMID: 25715037 DOI: 10.1590/1807-3107bor-2015.vol29.0038] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 11/14/2014] [Indexed: 11/22/2022] Open
Abstract
The instruments and materials used in health establishments are frequently exposed to microorganism contamination, and chemical products are used before sterilization to reduce occupational infection. We evaluated the antimicrobial effectiveness, physical stability, and corrosiveness of two commercial formulations of peracetic acid on experimentally contaminated specimens. Stainless steel specimens were contaminated with Staphylococcus aureus, Escherichia coli, Candida albicans, blood, and saliva and then immersed in a ready peracetic acid solution: 2% Sekusept Aktiv (SA) or 0.25% Proxitane Alpha (PA), for different times. Then, washes of these instruments were plated in culture medium and colony-forming units counted. This procedure was repeated six times per day over 24 non-consecutive days. The corrosion capacity was assessed with the mass loss test, and the concentration of peracetic acid and pH of the solutions were measured with indicator tapes. Both SA and PA significantly eliminated microorganisms; however, the SA solution was stable for only 4 days, whereas PA remained stable throughout the experiment. The concentration of peracetic acid in the SA solutions decreased over time until the chemical was undetectable, although the pH remained at 5. The PA solution had a concentration of 500-400 mg/L and a pH of 2-3. Neither formulation induced corrosion and both reduced the number of microorganisms (p = 0.0001). However, the differences observed in the performance of each product highlight the necessity of establishing a protocol for optimizing the use of each one.
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Ong KH, Emo B, Lewis RD, Kennedy J, Thummalakunta LNA, Elliott M. Inactivation of Mold Spores from Moist Carpet Using Steam Vapor: Contact Time and Temperature. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2015; 12:D131-D136. [PMID: 25625432 DOI: 10.1080/15459624.2015.1009988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Steam vapor has been shown to reduce viable mold spores in carpet, but the minimal effective temperature and contact time has not been established. This study evaluated the effectiveness of steam vapor in reducing the number of viable mold spores in carpet as a function of temperature and contact time. Seventy carpet samples were inoculated with a liquid suspension of Cladosporium sphaerospermum and incubated over a water-saturated foam carpet pad for 24 hr. Steam was applied to the samples as the temperature was measured from the carpet backing. Contact time was closely monitored over seven time intervals: 0, 2, 4, 8, 12, 16, and 20 sec. Following steam vapor treatment, mold spores were extracted from the carpet samples and the extract was plated on DG-18 plates at 1:1, 1:10, 1:100 dilutions followed by one week of incubation. Raw colony forming units were determined using an automated colony counter and adjusted based on dilution factor, extraction volume, and plated volume. Analysis of variance and linear regression were used to test for statistically significant relationships. Steam contact time exhibited a linear relationship to observed temperature of carpet backing (F = 90.176, R(2) = 0.609). Observed temperature of carpet backing had a positive relationship to percent reduction of mold (F = 76.605, R(2) = 0.569). Twelve seconds of steam vapor contact time was needed to achieve over 90% mold reduction on moist carpet.
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Affiliation(s)
- Kee-Hean Ong
- a Saint Louis University College for Public Health and Social Justice, Department of Environmental and Occupational Health , St. Louis , Missouri
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Vandini A, Temmerman R, Frabetti A, Caselli E, Antonioli P, Balboni PG, Platano D, Branchini A, Mazzacane S. Hard surface biocontrol in hospitals using microbial-based cleaning products. PLoS One 2014; 9:e108598. [PMID: 25259528 PMCID: PMC4178175 DOI: 10.1371/journal.pone.0108598] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 08/23/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Healthcare-Associated Infections (HAIs) are one of the most frequent complications occurring in healthcare facilities. Contaminated environmental surfaces provide an important potential source for transmission of many healthcare-associated pathogens, thus indicating the need for new and sustainable strategies. AIM This study aims to evaluate the effect of a novel cleaning procedure based on the mechanism of biocontrol, on the presence and survival of several microorganisms responsible for HAIs (i.e. coliforms, Staphyloccus aureus, Clostridium difficile, and Candida albicans) on hard surfaces in a hospital setting. METHODS The effect of microbial cleaning, containing spores of food grade Bacillus subtilis, Bacillus pumilus and Bacillus megaterium, in comparison with conventional cleaning protocols, was evaluated for 24 weeks in three independent hospitals (one in Belgium and two in Italy) and approximately 20000 microbial surface samples were collected. RESULTS Microbial cleaning, as part of the daily cleaning protocol, resulted in a reduction of HAI-related pathogens by 50 to 89%. This effect was achieved after 3-4 weeks and the reduction in the pathogen load was stable over time. Moreover, by using microbial or conventional cleaning alternatively, we found that this effect was directly related to the new procedure, as indicated by the raise in CFU/m2 when microbial cleaning was replaced by the conventional procedure. Although many questions remain regarding the actual mechanisms involved, this study demonstrates that microbial cleaning is a more effective and sustainable alternative to chemical cleaning and non-specific disinfection in healthcare facilities. CONCLUSIONS This study indicates microbial cleaning as an effective strategy in continuously lowering the number of HAI-related microorganisms on surfaces. The first indications on the actual level of HAIs in the trial hospitals monitored on a continuous basis are very promising, and may pave the way for a novel and cost-effective strategy to counteract or (bio)control healthcare-associated pathogens.
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Affiliation(s)
- Alberta Vandini
- CIAS Laboratory, Centre for the Study of physical, chemical and microbiological Contamination of Highly Sterile Environments, Department of Architecture, University of Ferrara, Ferrara, Italy
| | - Robin Temmerman
- Laboratory of Microbial Ecology and Technology, Ghent University, Ghent, Belgium
- Chrisal R & D Department, Lommel, Belgium
| | - Alessia Frabetti
- CIAS Laboratory, Centre for the Study of physical, chemical and microbiological Contamination of Highly Sterile Environments, Department of Architecture, University of Ferrara, Ferrara, Italy
| | - Elisabetta Caselli
- Department of Medical Sciences, Microbiology Section, University of Ferrara, Ferrara, Italy
| | - Paola Antonioli
- Department of Infection Prevention Control and Risk Management, Ferrara University Hospital, Ferrara, Italy
| | - Pier Giorgio Balboni
- Department of Medical Sciences, Microbiology Section, University of Ferrara, Ferrara, Italy
| | - Daniela Platano
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Alessio Branchini
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Sante Mazzacane
- CIAS Laboratory, Centre for the Study of physical, chemical and microbiological Contamination of Highly Sterile Environments, Department of Architecture, University of Ferrara, Ferrara, Italy
- * E-mail:
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Ariza-Heredia EJ, Chemaly RF. Infection Control Practices in Patients With Hematological Malignancies and Multidrug-Resistant Organisms: Special Considerations and Challenges. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2014; 14 Suppl:S104-10. [DOI: 10.1016/j.clml.2014.06.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 04/10/2014] [Accepted: 06/04/2014] [Indexed: 02/01/2023]
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Saroa R, Mitra S, Sinha S. Reusable ultrasound probe covers. Indian J Crit Care Med 2014; 18:479-80. [PMID: 25097367 PMCID: PMC4118520 DOI: 10.4103/0972-5229.136083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Richa Saroa
- Department of Anaesthesiology and Critical Care, Government Medical College and Hospital, Chandigarh, India
| | - Sukanya Mitra
- Department of Anaesthesiology and Critical Care, Government Medical College and Hospital, Chandigarh, India
| | - Shradha Sinha
- Department of Anaesthesiology and Critical Care, Government Medical College and Hospital, Chandigarh, India
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21
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A 10-year survey of fungal aerocontamination in hospital corridors: a reliable sentinel to predict fungal exposure risk? J Hosp Infect 2014; 87:34-40. [DOI: 10.1016/j.jhin.2014.02.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 02/19/2014] [Indexed: 11/20/2022]
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Goyal SM, Chander Y, Yezli S, Otter JA. Evaluating the virucidal efficacy of hydrogen peroxide vapour. J Hosp Infect 2014; 86:255-9. [PMID: 24656442 PMCID: PMC7132520 DOI: 10.1016/j.jhin.2014.02.003] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 02/11/2014] [Indexed: 01/20/2023]
Abstract
BACKGROUND Surface contamination has been implicated in the transmission of certain viruses, and surface disinfection can be an effective measure to interrupt the spread of these agents. AIM To evaluate the in-vitro efficacy of hydrogen peroxide vapour (HPV), a vapour-phase disinfection method, for the inactivation of a number of structurally distinct viruses of importance in the healthcare, veterinary and public sectors. The viruses studied were: feline calicivirus (FCV, a norovirus surrogate); human adenovirus type 1; transmissible gastroenteritis coronavirus of pigs (TGEV, a severe acute respiratory syndrome coronavirus [SARS-CoV] surrogate); avian influenza virus (AIV); and swine influenza virus (SwIV). METHODS The viruses were dried on stainless steel discs in 20- or 40-μL aliquots and exposed to HPV produced by a Clarus L generator (Bioquell, Horsham, PA, USA) in a 0.2-m(3) environmental chamber. Three vaporized volumes of hydrogen peroxide were tested in triplicate for each virus: 25, 27 and 33 mL. FINDINGS No viable viruses were identified after HPV exposure at any of the vaporized volumes tested. HPV was virucidal (>4-log reduction) against FCV, adenovirus, TGEV and AIV at the lowest vaporized volume tested (25 mL). For SwIV, due to low virus titre on the control discs, >3.8-log reduction was shown for the 25-mL vaporized volume and >4-log reduction was shown for the 27-mL and 33-mL vaporized volumes. CONCLUSION HPV was virucidal for structurally distinct viruses dried on surfaces, suggesting that HPV can be considered for the disinfection of virus-contaminated surfaces.
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Affiliation(s)
- S M Goyal
- Department of Veterinary Population Medicine, University of Minnesota, Saint Paul, MN, USA.
| | - Y Chander
- Department of Veterinary Population Medicine, University of Minnesota, Saint Paul, MN, USA
| | - S Yezli
- Bioquell UK Ltd, Andover, UK
| | - J A Otter
- Bioquell UK Ltd, Andover, UK; Centre for Clinical Infection and Diagnostics Research (CIDR), Department of Infectious Diseases, King's College London School of Medicine and Guy's and St Thomas' NHS Foundation Trust, UK
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23
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Watanabe R, Shimoda T, Yano R, Hayashi Y, Nakamura S, Matsuo J, Yamaguchi H. Visualization of hospital cleanliness in three Japanese hospitals with a tendency toward long-term care. BMC Res Notes 2014; 7:121. [PMID: 24593868 PMCID: PMC3996023 DOI: 10.1186/1756-0500-7-121] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 01/30/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hospital cleanliness in hospitals with a tendency toward long-term care in Japan remains unevaluated. We therefore visualized hospital cleanliness in Japan over a 2-month period by two distinct popular methods: ATP bioluminescence (ATP method) and the standard stamp agar method (stamp method). METHODS The surfaces of 752 sites within nurse and patient areas in three hospitals located in a central area of Sapporo, Japan were evaluated by the ATP and stamp methods, and each surface was sampled 8 times in 2 months. These areas were located in different ward units (Internal Medicine, Surgery, and Obstetrics and Gynecology). Detection limits for the ATP and stamp methods were determined by spike experiments with a diluted bacterial solution and a wipe test on student tables not in use during winter vacation, respectively. Values were expressed as the fold change over the detection limit, and a sample with a value higher than the detection limit by either method was defined as positive. RESULTS The detection limits were determined to be 127 relative light units (RLU) per 100 cm2 for the ATP method and 5.3 colony-forming units (CFU) per 10 cm2 for the stamp method. The positive frequency of the ATP and stamp methods was 59.8% (450/752) and 47.7% (359/752), respectively, although no significant difference in the positive frequency among the hospitals was seen. Both methods revealed the presence of a wide range of organic contamination spread via hand touching, including microbial contamination, with a preponderance on the entrance floor and in patient rooms. Interestingly, the data of both methods indicated considerable variability regardless of daily visual assessment with usual wiping, and positive surfaces were irregularly seen. Nurse areas were relatively cleaner than patient areas. Finally, there was no significant correlation between the number of patients or medical personnel in the hospital and organic or microbiological contamination. CONCLUSIONS Ongoing daily hospital cleanliness is not sufficient in Japanese hospitals with a tendency toward long-term care.
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Affiliation(s)
| | | | | | | | | | | | - Hiroyuki Yamaguchi
- Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Nishi-5 Kita-12 Jo, Kita-ku, Sapporo, Hokkaido 060-0812, Japan.
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Carling PC, Huang SS. Improving healthcare environmental cleaning and disinfection: current and evolving issues. Infect Control Hosp Epidemiol 2013; 34:507-13. [PMID: 23571368 DOI: 10.1086/670222] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Philip C Carling
- Infectious Diseases Section, Carney Hospital and Boston University School of Medicine, 2100 Dorchester Avenue, Boston, MA 02124, USA.
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Flächendesinfektion im Kontext von Infektionsprävention auf Intensivstationen. Med Klin Intensivmed Notfmed 2013; 108:113-8. [DOI: 10.1007/s00063-012-0156-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 01/21/2013] [Indexed: 11/30/2022]
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Buchholz F, Lerchner J, Mariana F, Kuhlicke U, Neu TR, Harms H, Maskow T. Chip-calorimetry provides real time insights into the inactivation of biofilms by predatory bacteria. BIOFOULING 2012; 28:351-362. [PMID: 22509741 DOI: 10.1080/08927014.2012.673593] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Control or removal of undesired biofilms has frequently been found to be quite difficult. In addition to biocidal or antibiotic chemicals or materials designed to prevent biofouling, biological control agents appear to be promising. Reports of bacterial predators eradicating biofilms or eliminating pathogens motivate a more systematic screening of biofilm-eliminating bacterial predators. Unfortunately, the analysis of the eradication process is demanding. In the present study, chip-calorimetry was applied to monitor the elimination of Pseudomonas sp. biofilms by Bdellovibrio bacteriovorus. The method uses metabolic heat as a real-time parameter for biofilm activity. The method is non-invasive, fast and convenient due to real-time data acquisition. In addition, heat-production data can reveal information about the energetics of the predator-prey interaction. The calorimetric results were validated by confocal laser scanning microscopy. The approach described may be useful for the screening of biofilm susceptibility to different predators.
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Affiliation(s)
- F Buchholz
- Department of Environmental Microbiology, UFZ-Helmholtz Centre for Environmental Research, Leipzig, Germany
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Affiliation(s)
- Simon Hill
- Poole Hospital NHS Foundation Trust, Dorset.
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28
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Murphy CL, Macbeth DA, Derrington P, Gerrard J, Faloon J, Kenway K, Lavender S, Leonard S, Orr A, Tobin D, Carling P. An assessment of high touch object cleaning thoroughness using a fluorescent marker in two Australian hospitals. ACTA ACUST UNITED AC 2011. [DOI: 10.1071/hi11024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Bache SE, Maclean M, MacGregor SJ, Anderson JG, Gettinby G, Coia JE, Taggart I. Clinical studies of the High-Intensity Narrow-Spectrum light Environmental Decontamination System (HINS-light EDS), for continuous disinfection in the burn unit inpatient and outpatient settings. Burns 2011; 38:69-76. [PMID: 22103991 DOI: 10.1016/j.burns.2011.03.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 03/09/2011] [Accepted: 03/18/2011] [Indexed: 11/27/2022]
Abstract
Infections are the leading cause of morbidity and mortality in burn patients and prevention of contamination from exogenous sources including the hospital environment is becoming increasingly emphasised. The High-Intensity Narrow-Spectrum light Environmental Decontamination System (HINS-light EDS) is bactericidal yet safe for humans, allowing continuous disinfection of the environment surrounding burn patients. Environmental samples were collected from inpatient isolation rooms and the outpatient clinic in the burn unit, and comparisons were then made between the bacterial contamination levels observed with and without use of the HINS-light EDS. Over 1000 samples were taken. Inpatient studies, with sampling carried out at 0800 h, demonstrated a significant reduction in the average number of bacterial colonies following HINS-light EDS use of between 27% and 75%, (p<0.05). There was more variation when samples were taken at times of increased activity in the room. Outpatient studies during clinics demonstrated a 61% efficacy in the reduction of bacterial contamination on surfaces throughout the room during the course of a clinic (p=0.02). The results demonstrate that use of the HINS-light EDS allows efficacious bacterial reductions over and above that achieved by standard cleaning and infection control measures in both inpatient and outpatient settings in the burn unit.
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Affiliation(s)
- Sarah E Bache
- Burn Unit, Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom.
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Hulkower RL, Casanova LM, Rutala WA, Weber DJ, Sobsey MD. Inactivation of surrogate coronaviruses on hard surfaces by health care germicides. Am J Infect Control 2011; 39:401-407. [PMID: 21256627 PMCID: PMC7132663 DOI: 10.1016/j.ajic.2010.08.011] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2010] [Revised: 08/04/2010] [Accepted: 08/05/2010] [Indexed: 01/31/2023]
Abstract
Background In the 2003 severe acute respiratory syndrome outbreak, finding viral nucleic acids on hospital surfaces suggested surfaces could play a role in spread in health care environments. Surface disinfection may interrupt transmission, but few data exist on the effectiveness of health care germicides against coronaviruses on surfaces. Methods The efficacy of health care germicides against 2 surrogate coronaviruses, mouse hepatitis virus (MHV) and transmissible gastroenteritis virus (TGEV), was tested using the quantitative carrier method on stainless steel surfaces. Germicides were o-phenylphenol/p-tertiary amylphenol) (a phenolic), 70% ethanol, 1:100 sodium hypochlorite, ortho-phthalaldehyde (OPA), instant hand sanitizer (62% ethanol), and hand sanitizing spray (71% ethanol). Results After 1-minute contact time, for TGEV, there was a log10 reduction factor of 3.2 for 70% ethanol, 2.0 for phenolic, 2.3 for OPA, 0.35 for 1:100 hypochlorite, 4.0 for 62% ethanol, and 3.5 for 71% ethanol. For MHV, log10 reduction factors were 3.9 for 70% ethanol, 1.3 for phenolic, 1.7 for OPA, 0.62 for 1:100 hypochlorite, 2.7 for 62% ethanol, and 2.0 for 71% ethanol. Conclusion Only ethanol reduced infectivity of the 2 coronaviruses by >3-log10 after 1 minute. Germicides must be chosen carefully to ensure they are effective against viruses such as severe acute respiratory syndrome coronavirus.
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Ferreira AM, Andrade DD, Rigotti MA, Ferreira MVF. Condition of cleanliness of surfaces close to patients in an intensive care unit. Rev Lat Am Enfermagem 2011. [DOI: 10.1590/s0104-11692011000300015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Surface cleaning is a well-known control procedure against the dissemination of microorganisms in the hospital environment. This prospective study, carried out in an intensive care unit over the course of 14 days, describes the cleaning/disinfection conditions of four surfaces near patients. In total, 100 assessments of the surfaces were carried out after they were cleaned. Three methods were used to evaluate cleanliness: a visual inspection, an adenosine triphosphate (ATP) bioluminescence assay and testing for the presence of Staphylococcus aureus and meticillin-resistant Staphylococcus aureus/MRSA. Respectively, 20%, 80% and 16% of the assessments by the visual method, ATP and the presence of Staphylococcus aureus/MRSA failed. There were statistically significant differences (p<0.05) between the rates of failure of the cleaning using the ATP method, compared to the visual and microbiological methods. The visual inspection was not a reliable measure to evaluate surface cleanliness. The results demonstrated that the adopted cleaning routine should be reconsidered.
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Lorenzi SD, Romanini L, Finzi G, Salvatorelli G. Biocide activity of microfiber mops with and without silver after contamination. Braz J Infect Dis 2011; 15:200-3. [DOI: 10.1016/s1413-8670(11)70175-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 02/10/2011] [Indexed: 11/15/2022] Open
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Maclean M, Macgregor SJ, Anderson JG, Woolsey GA, Coia JE, Hamilton K, Taggart I, Watson SB, Thakker B, Gettinby G. Environmental decontamination of a hospital isolation room using high-intensity narrow-spectrum light. J Hosp Infect 2011; 76:247-51. [PMID: 20864210 DOI: 10.1016/j.jhin.2010.07.010] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Accepted: 07/09/2010] [Indexed: 11/26/2022]
Abstract
The performance of a new decontamination technology, referred to as 'high-intensity narrow-spectrum light environmental decontamination system' (HINS-light EDS) was evaluated by a series of three studies carried out in a hospital isolation room used to treat burns patients. The ceiling-mounted HINS-light EDS emits high-intensity 405nm light which, although bactericidal, is harmless to patients and staff thereby permitting continuous environmental disinfection throughout the day. Performance efficacy was assessed by contact agar plate sampling and enumeration of staphylococcal bacteria on environmental surfaces within the room before, during and after HINS-light EDS treatment. When the room was unoccupied, use of HINS-light EDS resulted in ∼90% reduction of surface bacterial levels and when the room was occupied by an MRSA-infected burns patient, reductions between 56% and 86% were achieved, with the highest reduction (86%) measured following an extended period of HINS-light EDS operation. In an on/off intervention study, surface bacterial levels were reduced by 62% by HINS-light EDS treatment and returned to normal contamination levels two days after the system was switched off. These reductions of staphylococci, including Staphylococcus aureus and meticillin-resistant S. aureus, by HINS-light EDS treatment were greater than the reductions achieved by normal infection control and cleaning activities alone. The findings provide strong evidence that HINS-light EDS, used as a supplementary procedure, can make a significant contribution to bacterial decontamination in clinical environments.
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Affiliation(s)
- M Maclean
- Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), University of Strathclyde, Glasgow, UK.
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Buccheri C, Mammina C, Giammanco S, Giammanco M, Guardia ML, Casuccio A. Knowledge, attitudes and self-reported practices of food service staff in nursing homes and long-term care facilities. Food Control 2010. [DOI: 10.1016/j.foodcont.2010.04.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Alfa MJ, Lo E, Wald A, Dueck C, DeGagne P, Harding GKM. Improved eradication of Clostridium difficile spores from toilets of hospitalized patients using an accelerated hydrogen peroxide as the cleaning agent. BMC Infect Dis 2010; 10:268. [PMID: 20843348 PMCID: PMC2949757 DOI: 10.1186/1471-2334-10-268] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2009] [Accepted: 09/15/2010] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND C. difficle spores in the environment of patients with C. difficile associated disease (CDAD) are difficult to eliminate. Bleach (5000 ppm) has been advocated as an effective disinfectant for the environmental surfaces of patients with CDAD. Few alternatives to bleach for non-outbreak conditions have been evaluated in controlled healthcare studies. METHODS This study was a prospective clinical comparison during non-outbreak conditions of the efficacy of an accelerated hydrogen peroxide cleaner (0.5% AHP) to the currently used stabilized hydrogen peroxide cleaner (0.05% SHP at manufacturer recommended use-dilution) with respect to spore removal from toilets in a tertiary care facility. The toilets used by patients who had diarrhea with and without C. difficile associated disease (CDAD) were cultured for C. difficile and were monitored using an ultraviolet mark (UVM) to assess cleaning compliance on a daily basis 5 days per week. A total of 243 patients and 714 samples were analysed. The culture results were included in the analysis only if the UVM audit from the same day confirmed that the toilet had been cleaned. RESULTS Our data demonstrated that the efficacy of spore killing is formulation specific and cannot be generalized. The OxivirTB AHP formulation resulted in statistically significantly (p = 0.0023) lower levels of toxigenic C. difficile spores in toilets of patients with CDAD compared to the SHP formulation that was routinely being used (28% vs 45% culture positive). The background level of toxigenic C. difficile spores was 10% in toilets of patients with diarrhea not due to CDAD. The UVM audit indicated that despite the enhanced twice-daily cleaning protocol for CDAD patients cleaning was not achieved on approximately 30 - 40% of the days tested. CONCLUSION Our data indicate that the AHP formulation evaluated that has some sporicidal activity was significantly better than the currently used SHP formulation. This AHP formulation provides a one-step process that significantly lowers the C. difficile spore level in toilets during non-outbreak conditions without the workplace safety concerns associated with 5000 ppm bleach.
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Affiliation(s)
- Michelle J Alfa
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada.
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Andersen B, Syversen G, Thoresen H, Rasch M, Hochlin K, Seljordslia B, Snevold I, Berg E. Failure of dry mist of hydrogen peroxide 5% to kill Mycobacterium tuberculosis. J Hosp Infect 2010; 76:80-3. [DOI: 10.1016/j.jhin.2010.03.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2009] [Accepted: 03/19/2010] [Indexed: 10/19/2022]
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Ransjö U, Lytsy B, Melhus Å, Aspevall O, Artinger C, Eriksson BM, Günther G, Hambraeus A. Hospital outbreak control requires joint efforts from hospital management, microbiology and infection control. J Hosp Infect 2010; 76:26-31. [DOI: 10.1016/j.jhin.2010.01.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Accepted: 01/15/2010] [Indexed: 11/30/2022]
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López-Alcalde J, Dancer S, Martí-Carvajal AJ, Conterno LO, Guevara-Eslava M, Mateos-Mazón M, Gracia J, Solà I. Decontamination of environmental surfaces in hospitals to reduce hospital acquired infections. Hippokratia 2010. [DOI: 10.1002/14651858.cd008627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Jesús López-Alcalde
- Agency Laín Entralgo (Cochrane Collaborating Centre); UETS, Health Technology Assessment Unit. UCICEC de Atención Primaria; Gran Vía 27, 7ª Planta Madrid Madrid Spain 28013
| | - Stephanie Dancer
- NHS Lanarkshire; Microbiology; Hairmyres Hospital Eaglesham Road East Kilbride Glasgow UK G75 8RG
| | | | - Lucieni O Conterno
- Marilia Medical School; Department of General Internal Medicine and Clinical Epidemiology Unit; Avenida Monte Carmelo 800 Fragata Marilia São Paulo Brazil 17519-030
| | - Marcela Guevara-Eslava
- Institute of Public Health Navarra; Epidemiology Department; C/ Leyre 15 Pamplona Navarre Spain E-31003
| | - Marta Mateos-Mazón
- Catalan Institute of Oncology; Cancer Prevention and Control Unit; Gran Vía s/n Km 2,7 L´Hospitalet de Llobregat Cataluña Spain 08907
| | - Javier Gracia
- Lain Entralgo Agency, Regional Government of the Community of Madrid; Health Technology Assessment; Gran Via 27 Madrid Spain 28013
| | - Ivan Solà
- IIB Sant Pau; Iberoamerican Cochrane Centre; Sant Antoni Maria Claret 171 Edifici Casa de Convalescència Barcelona Catalunya Spain 08041
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Bloß R, Meyer S, Kampf G. Adsorption of active ingredients of surface disinfectants depends on the type of fabric used for surface treatment. J Hosp Infect 2010; 75:56-61. [DOI: 10.1016/j.jhin.2009.11.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Accepted: 11/27/2009] [Indexed: 11/26/2022]
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Bartels M, Kristoffersen K, Boye K, Westh H. Rise and subsequent decline of community-associated methicillin resistant Staphylococcus aureus ST30-IVc in Copenhagen, Denmark through an effective search and destroy policy. Clin Microbiol Infect 2010; 16:78-83. [DOI: 10.1111/j.1469-0691.2009.02829.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Experimental evaluation of the efficacy of sanitation procedures in operating rooms. Am J Infect Control 2009; 37:658-64. [PMID: 19595481 DOI: 10.1016/j.ajic.2009.03.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Revised: 03/03/2009] [Accepted: 03/06/2009] [Indexed: 11/20/2022]
Abstract
BACKGROUND There remains much debate on how to define an adequate sanitation protocol in hospital environments. METHODS The efficacy of a sanitation protocol in the operating room (OR) of a modern hospital was evaluated by measuring bacterial load on different types of finishing materials of all internal surfaces (ie, walls, floors, and furnishings). Samples were obtained before cleaning and over the subsequent 24 hours. A total of 2124 microbiological samples were collected using RODAC plates and sterile swabs. RESULTS The data demonstrate a very significant postsanitation reduction of bacterial load on floors and furnishings; however, no significant data on walls were obtained, because of the low levels of initial contamination (1.50 to 5.98 cfu/100 cm2). The increase in postsanitation bacterial load over time was greater on smooth materials than on porous materials, on which a further reduction in contamination was seen. The study outcomes were confirmed by simulation experiments in which different materials were contaminated with a predetermined bacterial load and then subjected to the sanitation protocol. These simulation experiments were carried out both in vitro and in an eddy-flux testing room that simulated a full-scale OR similar (in terms of architectonic systems) to a real setting. CONCLUSION Our data demonstrate that the spatial (vertical/horizontal) disposition of materials affects the initial contamination level, which is always much lower on vertical surfaces than on horizontal ones. Moreover, postsanitation bacterial load recovery is dependent on the physical properties of the surface.
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Abstract
As part of a package of measures aimed at preventing cross-infection the isolation of patients in single rooms or through cohort nursing is a well-documented policy. However, the evidence base for an isolation policy is unclear it can cause logistical problems through inadequate resources and may result in physical, psychological and social harm to patients. Notwithstanding these problems, isolation can be said to have a practical utility in that it may impact on a nurses behaviour as they enact compliance as part of their infection control duties. It is nevertheless important for policymakers to note that it is not the location of the patient per se that is of primary importance in the transmission of contact spread organisms, but the behaviour of staff within the isolated environment.
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Affiliation(s)
- Mark Cole
- University of Nottingham, Grantham & District Hospital, Lincolnshire
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Falagas M, Makris G. Probiotic bacteria and biosurfactants for nosocomial infection control: a hypothesis. J Hosp Infect 2009; 71:301-6. [DOI: 10.1016/j.jhin.2008.12.008] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Accepted: 12/09/2008] [Indexed: 11/16/2022]
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Rohr U, Kaminski A, Wilhelm M, Jurzik L, Gatermann S, Muhr G. Colonization of patients and contamination of the patients’ environment by MRSA under conditions of single-room isolation. Int J Hyg Environ Health 2009; 212:209-15. [DOI: 10.1016/j.ijheh.2008.05.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2007] [Revised: 05/27/2008] [Accepted: 05/27/2008] [Indexed: 11/26/2022]
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Humphreys H, Grundmann H, Skov R, Lucet JC, Cauda R. Prevention and control of methicillin-resistant Staphylococcus aureus. Clin Microbiol Infect 2009; 15:120-4. [DOI: 10.1111/j.1469-0691.2009.02699.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Taylor L, Phillips P, Hastings R. Reduction of bacterial contamination in a healthcare environment by silver antimicrobial technology. J Infect Prev 2009. [DOI: 10.1177/1757177408099083] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
This paper describes a pilot study undertaken in a major acute trust investigating reduction of bacterial contamination in a healthcare environment attributable to the use of silver antimicrobial (BioCote®) technology. The four month study assessed the impact of various BioCote®-treated products on the counts of viable bacteria cultured from the treated environment compared to a control. A mean reduction in bacterial counts of 95.8% was demonstrated on the BioCote®treated surfaces compared with untreated surfaces. A mean reduction of 43.5% was demonstrated on untreated products positioned in the same environment as BioCote®-treated products compared with control untreated products. This suggests decontamination is not limited to treated materials but can extend to the wider environment because of the presence of antimicrobial materials. In the light of increasing evidence implicating the role of the environment in healthcare acquired infection, the potential of BioCote®-treated products to provide an additional infection control mechanism is highlighted.
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Affiliation(s)
- L. Taylor
- Microbiologist, BioCote Ltd, Wolverhampton Science Park, Technology Centre, Glashier Drive, Wolverhampton WV10 9RU
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Maillard JY, Cheeseman K. Response to: Price EH, Ayliffe G, ‘Hot hospitals and what happened to wash, rinse and dry? Recent changes to cleaning, disinfection and environmental ventilation’. J Hosp Infect 2008; 70:376-8; author reply 378-9. [DOI: 10.1016/j.jhin.2008.07.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Accepted: 07/16/2008] [Indexed: 11/29/2022]
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Floor cleaning: effect on bacteria and organic materials in hospital rooms. J Hosp Infect 2008; 71:57-65. [PMID: 19013671 DOI: 10.1016/j.jhin.2008.09.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2007] [Accepted: 09/16/2008] [Indexed: 10/21/2022]
Abstract
Routine surface cleaning is recommended to control the spread of pathogens in hospital environments. In Norway, ordinary cleaning of patient rooms is traditionally performed with soap and water. In this study, four floor-mopping methods--dry, spray, moist and wet mopping--were compared by two systems using adenosine triphosphate (ATP) bioluminescence (Hygiena and Biotrace). These systems assess residual organic soil on surfaces. The floor-mopping methods were also assessed by microbiological samples from the floor and air, before and after cleaning. All methods reduced organic material on the floors but wet and moist mopping seemed to be the most effective (P < 0.001, P < 0.011, respectively, ATP Hygiena). The two ATP methods were easy to use, although each had their own reading scales. Cleaning reduced organic material to 5-36% of the level present before cleaning, depending upon mopping method. All four mopping methods reduced bacteria on the floor from about 60-100 to 30-60 colony-forming units (cfu)/20cm2 floor. Wet, moist and dry mopping seemed to be more effective in reducing bacteria on the floor, than the spray mopping (P=0.007, P=0.002 and P=0.011, respectively). The burden of bacteria in air increased for all methods just after mopping. The overall best cleaning methods seemed to be moist and wet mopping.
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Nde CW, Jang HJ, Toghrol F, Bentley WE. Toxicogenomic response of Pseudomonas aeruginosa to ortho-phenylphenol. BMC Genomics 2008; 9:473. [PMID: 18847467 PMCID: PMC2577666 DOI: 10.1186/1471-2164-9-473] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2008] [Accepted: 10/10/2008] [Indexed: 11/13/2022] Open
Abstract
Background Pseudomonas aeruginosa (P. aeruginosa) is the most common opportunistic pathogen implicated in nosocomial infections and in chronic lung infections in cystic fibrosis patients. Ortho-phenylphenol (OPP) is an antimicrobial agent used as an active ingredient in several EPA registered disinfectants. Despite its widespread use, there is a paucity of information on its target molecular pathways and the cellular responses that it elucidates in bacteria in general and in P. aeruginosa in particular. An understanding of the OPP-driven gene regulation and cellular response it elicits will facilitate more effective utilization of this antimicrobial and possibly lead to the development of more effective disinfectant treatments. Results Herein, we performed a genome-wide transcriptome analysis of the cellular responses of P. aeruginosa exposed to 0.82 mM OPP for 20 and 60 minutes. Our data indicated that OPP upregulated the transcription of genes encoding ribosomal, virulence and membrane transport proteins after both treatment times. After 20 minutes of exposure to 0.82 mM OPP, genes involved in the exhibition of swarming motility and anaerobic respiration were upregulated. After 60 minutes of OPP treatment, the transcription of genes involved in amino acid and lipopolysaccharide biosynthesis were upregulated. Further, the transcription of the ribosome modulation factor (rmf) and an alternative sigma factor (rpoS) of RNA polymerase were downregulated after both treatment times. Conclusion Results from this study indicate that after 20 minutes of exposure to OPP, genes that have been linked to the exhibition of anaerobic respiration and swarming motility were upregulated. This study also suggests that the downregulation of the rmf and rpoS genes may be indicative of the mechanism by which OPP causes decreases in cell viability in P. aeruginosa. Consequently, a protective response involving the upregulation of translation leading to the increased synthesis of membrane related proteins and virulence proteins is possibly induced after both treatment times. In addition, cell wall modification may occur due to the increased synthesis of lipopolysaccharide after 60 minutes exposure to OPP. This gene expression profile can now be utilized for a better understanding of the target cellular pathways of OPP in P. aeruginosa and how this organism develops resistance to OPP.
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Affiliation(s)
- Chantal W Nde
- Center for Biosystems Research, University of Maryland Biotechnology Institute, College Park, Maryland 20742, USA.
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Bartels M, Kristoffersen K, Slotsbjerg T, Rohde S, Lundgren B, Westh H. Environmental meticillin-resistant Staphylococcus aureus (MRSA) disinfection using dry-mist-generated hydrogen peroxide. J Hosp Infect 2008; 70:35-41. [DOI: 10.1016/j.jhin.2008.05.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2007] [Accepted: 05/13/2008] [Indexed: 10/21/2022]
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