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Croke L. Whole-Room Disinfection Using Germicidal Light. AORN J 2024; 119:P5-P7. [PMID: 38407376 DOI: 10.1002/aorn.14104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 02/27/2024]
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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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Kyriacou C, Robinson E, Barcroft J, Parker N, Tuomey M, Stalder C, Gould D, Al‐Memar M, Bourne T. Time-effectiveness and convenience of transvaginal ultrasound probe disinfection using ultraviolet vs chlorine dioxide multistep wipe system: prospective survey study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2022; 60:132-138. [PMID: 34919771 PMCID: PMC9414347 DOI: 10.1002/uog.24834] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/26/2021] [Accepted: 12/01/2021] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To compare the efficiency, ease of use and user satisfaction of two methods of transvaginal ultrasound probe high-level disinfection: ultraviolet-C radiation (UV-C) and a chlorine dioxide multistep wipe system. METHODS This was a prospective survey study. UV-C units were introduced into a busy early pregnancy assessment service and compared with a multiwipe system for disinfection. Before seeing each patient, healthcare professionals (HCPs) measured with a stopwatch the time taken to complete a cycle of disinfection using either UV-C or chlorine dioxide multistep wipes and responded to a quick-response (QR) code-linked survey. Additional essential tasks that could be completed before seeing the next patient during probe disinfection were also documented. Using another QR code-linked survey, data on ease of use, satisfaction with the system used and preferred system were collected. The ease of use and satisfaction with the system were rated on a 0 to 10 Likert scale (0 poor, 10 excellent). A free-text section for comments was then completed. RESULTS Disinfection using UV-C (n = 331) was 60% faster than the chlorine dioxide multiwipe system (n = 332) (101 vs 250 s; P < 0.0001). A greater number of tasks were completed during probe disinfection when using UV-C, saving a further 74 s per patient (P < 0.0001). The HCPs using UV-C (n = 71) reported greater ease of use (median Likert score, 10 vs 3; P < 0.0001) and satisfaction (median Likert score, 10 vs 2; P < 0.0001) compared with those using the multiwipe system (n = 43). HCPs reported that the chlorine dioxide system was time-consuming and environmentally unfriendly, while the UV-C system was efficient and easy to use. Overall, 98% of the HCPs preferred using the UV-C system. CONCLUSIONS UV-C technology is more time-efficient and allows more essential tasks to be completed during disinfection. For a 4-h ultrasound list of 15 patients, the use of UV-C would save 55 min 45 s. HCPs found UV-C preferable and easier to use. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- C. Kyriacou
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
| | - E. Robinson
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
| | - J. Barcroft
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
| | - N. Parker
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
| | - M. Tuomey
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
| | - C. Stalder
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
| | - D. Gould
- St Mary's Hospital, Department of Obstetrics and GynaecologyImperial College LondonLondonUK
| | - M. Al‐Memar
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
| | - T. Bourne
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
- Department of Obstetrics and GynecologyUniversity Hospitals LeuvenLeuvenBelgium
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Kunduru KR, Kutner N, Nassar‐Marjiya E, Shaheen‐Mualim M, Rizik L, Farah S. Disinfectants role in the prevention of spreading the
COVID
‐19 and other infectious diseases: The need for functional polymers! POLYM ADVAN TECHNOL 2022; 33:3853-3861. [PMID: 35572096 PMCID: PMC9088588 DOI: 10.1002/pat.5689] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 12/13/2022]
Abstract
The spreading of coronavirus through droplets and aerosols of an infected person is a well‐known mechanism. The main protection methods from this virus are using disinfectants/sanitizers, face masks, keeping social distance, and vaccination. With the rapid mutations of the virus accompanied by its features and contagions changing, new advanced functional materials development is highly needed. The usage of disinfectants/sanitizers in excess generates poisonous effects among the general public. Effective and simultaneously, human‐friendly sanitizers or disinfectants are required to prevent the poisoning and the associated issues. They minimize the toxic effects of the currently available materials by rapid action, high potential, long‐term stability, and excellent biocompatible nature. Here, we summarize the available antiviral materials, their features, and their limitations. We highlight the need to develop an arsenal of advanced functional antiviral polymers with intrinsic bioactive functionalities or released bioactive moieties in a controlled manner for rapid and long‐term actions for current and future anticipated viral outbreaks.
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Affiliation(s)
- Konda Reddy Kunduru
- The Laboratory for Advanced Functional/Medicinal Polymers & Smart Drug Delivery Technologies, The Wolfson Faculty of Chemical Engineering Technion‐Israel Institute of Technology Haifa Israel
| | - Neta Kutner
- The Laboratory for Advanced Functional/Medicinal Polymers & Smart Drug Delivery Technologies, The Wolfson Faculty of Chemical Engineering Technion‐Israel Institute of Technology Haifa Israel
| | - Eid Nassar‐Marjiya
- The Laboratory for Advanced Functional/Medicinal Polymers & Smart Drug Delivery Technologies, The Wolfson Faculty of Chemical Engineering Technion‐Israel Institute of Technology Haifa Israel
| | - Merna Shaheen‐Mualim
- The Laboratory for Advanced Functional/Medicinal Polymers & Smart Drug Delivery Technologies, The Wolfson Faculty of Chemical Engineering Technion‐Israel Institute of Technology Haifa Israel
| | - Luna Rizik
- The Laboratory for Advanced Functional/Medicinal Polymers & Smart Drug Delivery Technologies, The Wolfson Faculty of Chemical Engineering Technion‐Israel Institute of Technology Haifa Israel
| | - Shady Farah
- The Laboratory for Advanced Functional/Medicinal Polymers & Smart Drug Delivery Technologies, The Wolfson Faculty of Chemical Engineering Technion‐Israel Institute of Technology Haifa Israel
- The Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa Israel
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5
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Croke L. Using continuous cleaning technology to enhance standard disinfection practices. AORN J 2021; 113:P7-P9. [PMID: 33929745 DOI: 10.1002/aorn.13405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Angarano V, Akkermans S, Smet C, Chieffi A, Van Impe JF. The potential of violet, blue, green and red light for the inactivation of P. fluorescens as planktonic cells, individual cells on a surface and biofilms. FOOD AND BIOPRODUCTS PROCESSING 2020. [DOI: 10.1016/j.fbp.2020.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Warren BG, Turner N, Smith B, Addison R, Marden S, Weber DJ, Rutala WA, Anderson DJ. Measuring the Impact of Continuous Disinfection Strategies on Environmental Burden in Outpatient Settings: A Prospective Randomized Controlled Trial. Open Forum Infect Dis 2020. [DOI: 10.1093/ofid/ofaa431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Our primary objective was to determine the effectiveness of 2 enhanced disinfection strategies compared with standard disinfection: “near-UV” light (Arm 1) and a persistent organosilane quaternary ammonium disinfectant (Arm 2) using a triple-blind study design. Our secondary objective was to characterize environmental contamination of outpatient clinics.
Methods
This trial was conducted at 2 clinics: the wound and pulmonary outpatient clinics at Duke University Health System in Durham, North Carolina. In Arm 1, room overhead lights were replaced with 405-nm near-UV visible light bulbs. In Arm 2, the organosilane quaternary ammonium disinfectant was applied to all room surfaces. The control arm received no intervention. All arms received routine disinfection. Room contamination was measured twice daily (before and after clinic) over 25 clinic days.
Results
The primary outcome was the change in total contamination, measured in colony forming units (CFUs), on environmental surfaces at the end of the clinic day compared with the beginning of the clinic day. Results from each intervention arm were compared against results from the control arm. The median delta total CFU for Arm 1 was 2092 CFUs (interquartile range [IQR], −1815 to 8566); the median delta for Arm 2 was 2016 CFUs (IQR, −1443 to 7430). Compared with the control arm (median delta = 1987 [IQR, −1611 to 15 857]), neither intervention led to a significant decrease in daily room contamination change (P for Arm 1 = 0.78 and P for Arm 2 = 0.71).
Conclusions
Neither near-UV lights or a persistent organosilane quaternary ammonium disinfectant reduced environmental contamination in 2 outpatient clinics compared with control rooms but did reduce the number of clinically important pathogens recovered.
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Affiliation(s)
- Bobby G Warren
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA
| | - Nicholas Turner
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA
| | - Becky Smith
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA
| | - Rachel Addison
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA
| | - Samantha Marden
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA
| | - David J Weber
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - William A Rutala
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Deverick J Anderson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA
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Self-Disinfecting Copper Beds Sustain Terminal Cleaning and Disinfection Effects throughout Patient Care. Appl Environ Microbiol 2019; 86:AEM.01886-19. [PMID: 31704675 DOI: 10.1128/aem.01886-19] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 10/10/2019] [Indexed: 12/29/2022] Open
Abstract
Microbial burden associated with near-patient touch surfaces results in a greater risk of health care-associated infections (HAIs). Acute care beds may be a critical fomite, as traditional plastic surfaces harbor the highest concentrations of bacteria associated with high-touch surfaces in a hospital room's patient zone. Five high-touch intensive care unit (ICU) bed surfaces encountered by patients, health care workers, and visitors were monitored by routine culture to assess the effect U.S. Environmental Protection Agency (U.S. EPA)-registered antimicrobial copper materials have on the microbial burden. Despite both daily and discharge cleaning and disinfection, each control bed's plastic surfaces exceeded bacterial concentrations recommended subsequent to terminal cleaning and disinfection (TC&D) of 2.5 aerobic CFU/cm2 Beds with self-disinfecting (copper) surfaces harbored significantly fewer bacteria throughout the patient stay than control beds, at levels below those considered to increase the likelihood of HAIs. With adherence to routine daily and terminal cleaning regimes throughout the study, the copper alloy surfaces neither tarnished nor required additional cleaning or special maintenance. Beds encapsulated with U.S. EPA-registered antimicrobial copper materials were found to sustain the microbial burden below the TC&D risk threshold levels throughout the patient stay, suggesting that outfitting acute care beds with such materials may be an important supplement to controlling the concentration of infectious agents and thereby potentially reducing the overall HAI risk.IMPORTANCE Despite cleaning efforts of environmental service teams and substantial compliance with hand hygiene best practices, the microbial burden in patient care settings often exceeds concentrations at which transfer to patients represents a substantial acquisition risk for health care-associated infections (HAIs). Approaches to limit HAI risk have relied on designing health care equipment and furnishings that are easier to clean and/or the use of no-touch disinfection interventions such as germicidal UV irradiation or vapor deposition of hydrogen peroxide. In a clinical trial evaluating the largest fomite in the patient care setting, the bed, a bed was encapsulated with continuously disinfecting antimicrobial copper surfaces, which reduced the bacteria on surfaces by 94% and sustained the microbial burden below the terminal cleaning and disinfection risk threshold throughout the patient's stay. Such an intervention, which continuously limits microbes on high-touch surfaces, should be studied in a broader range of health care settings to determine its potential long-range efficacy for reducing HAI.
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Weber DJ, Rutala WA, Sickbert-Bennett EE, Kanamori H, Anderson D. Continuous room decontamination technologies. Am J Infect Control 2019; 47S:A72-A78. [PMID: 31146855 DOI: 10.1016/j.ajic.2019.03.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The contaminated surface environment in the rooms of hospitalized patients is an important risk factor for the colonization and infection of patients with multidrug-resistant pathogens. Improved terminal cleaning and disinfection have been demonstrated to reduce the incidence of health care-associated infections. In the United States, hospitals generally perform daily cleaning and disinfection of patient rooms. However, cleaning and disinfection are limited by the presence of the patient in room (eg, current ultraviolet devices and hydrogen peroxide systems cannot be used) and the fact that after disinfection pathogenic bacteria rapidly recolonize surfaces and medical devices/equipment. For this reason, there has been great interest in developing methods of continuous room disinfection and/or "self-disinfecting" surfaces. This study will review the research on self-disinfecting surfaces (eg, copper-coated surfaces and persistent chemical disinfectants) and potential new room disinfection methods (eg, "blue light" and diluted hydrogen peroxide systems).
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Rutala WA, Weber DJ. Best practices for disinfection of noncritical environmental surfaces and equipment in health care facilities: A bundle approach. Am J Infect Control 2019; 47S:A96-A105. [PMID: 31146858 DOI: 10.1016/j.ajic.2019.01.014] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Over the past decade, there is excellent evidence in the scientific literature that contaminated environmental surfaces and noncritical patient care items play an important role in the transmission of several key health care-associated pathogens including methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Acinetobacter, norovirus, and Clostridium difficile. Thus, surface disinfection of noncritical environmental surfaces and medical devices is one of the infection prevention strategies to prevent pathogen transmission. This article will discuss a bundle approach to facilitate effective surface cleaning and disinfection in health care facilities. A bundle is a set of evidence-based practices, generally 3-5, that when performed collectively and reliably have been proven to improve patient outcomes. This bundle has 5 components and the science associated with each component will be addressed. These components are: creating evidence-based policies and procedures; selection of appropriate cleaning and disinfecting products; educating staff to include environmental services, patient equipment, and nursing; monitoring compliance (eg, thoroughness of cleaning, product use) with feedback (ie, just in time coaching); and implementing a "no touch" room decontamination technology and to ensure compliance for patients on contact and enteric precautions. This article will also discuss new technologies (eg, continuous room decontamination technology) that may enhance our infection prevention strategies in the future.
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Affiliation(s)
- William A Rutala
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC.
| | - David J Weber
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC; Department of Hospital Epidemiology, University of North Carolina Hospitals, Chapel Hill, NC
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