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Torres HM, Marino J, Simon MS, Singh HK, Westblade LF, Calfee DP. High touch surface bioburden associated with the use of disinfectants with and without continuously active disinfection in ambulatory care settings. Infect Control Hosp Epidemiol 2024; 45:790-792. [PMID: 38374787 PMCID: PMC11102821 DOI: 10.1017/ice.2024.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/13/2023] [Accepted: 01/17/2024] [Indexed: 02/21/2024]
Abstract
A quaternary ammonium and alcohol-based disinfectant with reported continuous activity demonstrated reduced microbial buildup on surfaces over time compared to routine disinfectants without continuous activity in in vitro and hospital studies. We compared these disinfectants in ambulatory settings and found no difference in bioburden on high-touch surfaces over time.
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Affiliation(s)
- Heidi M. Torres
- Weill Cornell Medicine, New York, NY, USA
- NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA
| | | | - Matthew S. Simon
- Weill Cornell Medicine, New York, NY, USA
- NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA
| | - Harjot K. Singh
- Weill Cornell Medicine, New York, NY, USA
- NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA
| | - Lars F. Westblade
- Weill Cornell Medicine, New York, NY, USA
- NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA
| | - David P. Calfee
- Weill Cornell Medicine, New York, NY, USA
- NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA
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2
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Omardien S, Pingulkar S, Thayagan M, Buniotto L, de Oliveira Negreiros M. The antibacterial performance of a residual disinfectant against Staphylococcus aureus on environmental surfaces. Front Microbiol 2024; 15:1338238. [PMID: 38351915 PMCID: PMC10861741 DOI: 10.3389/fmicb.2024.1338238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/10/2024] [Indexed: 02/16/2024] Open
Abstract
Environmental surfaces play a key role in transmitting pathogens that can survive on surfaces for long durations. The interest in long-lasting or residual disinfectants are, therefore, growing as it might protect surfaces for longer than traditional disinfectants. In this study, a quat-based product claiming residual disinfecting performance against bacteria, among other microorganisms, was tested using an approved standardized method, in a controlled laboratory study and on environmental surfaces in an office building. The results obtained showed that the residual disinfectant can reduce the bacterial counts significantly compared to a traditional quat-based disinfectant when used on horizontal surfaces, twenty-four hours after application. During the standardized test method, the residual disinfectant provided a 6-log reduction, whereas the traditional disinfectant provided only a 1.9-log reduction. Similarly, the residual disinfectant provided a 2.5 log reduction in the laboratory study, whereas the traditional disinfectant had too-numerous-to-count colonies. When tested on environmental surfaces, an ANOVA statistical analysis indicated that surfaces treated with the residual disinfectant had significantly less bacteria present twenty-four hours after application. The antibacterial performance of the residual disinfectant showed to be limited by the orientation of the treated surface, and the thickness of the product film dried on the surface. This study showed the potential of residual disinfectants that warrants further investigation and could potentially aid the further development of the technology.
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Nadimpalli G, Johnson JK, Magder LS, Haririan A, Stevens D, Harris AD, O'Hara LM. Efficacy of a continuously active disinfectant wipe on the environmental bioburden in the intensive care unit: A randomized controlled study. Infect Control Hosp Epidemiol 2023; 44:2036-2043. [PMID: 37395041 DOI: 10.1017/ice.2023.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To evaluate the efficacy of a new continuously active disinfectant (CAD) to decrease bioburden on high-touch environmental surfaces compared to a standard disinfectant in the intensive care unit. DESIGN A single-blind randomized controlled trial with 1:1 allocation. SETTING Medical intensive care unit (MICU) at an urban tertiary-care hospital. PARTICIPANTS Adult patients admitted to the MICU and on contact precautions. INTERVENTION A new CAD wipe used for daily cleaning. METHODS Samples were collected from 5 high-touch environmental surfaces before cleaning and at 1, 4, and 24 hours after cleaning. The primary outcome was the mean bioburden 24 hours after cleaning. The secondary outcome was the detection of any epidemiologically important pathogen (EIP) 24 hours after cleaning. RESULTS In total, 843 environmental samples were collected from 43 unique patient rooms. At 24 hours, the mean bioburden recovered from the patient rooms cleaned with the new CAD wipe (intervention) was 52 CFU/mL, and the mean bioburden was 92 CFU/mL in the rooms cleaned the standard disinfectant (control). After log transformation for multivariable analysis, the mean difference in bioburden between the intervention and control arm was -0.59 (95% CI, -1.45 to 0.27). The odds of EIP detection were 14% lower in the rooms cleaned with the CAD wipe (OR, 0.86; 95% CI, 0.31-2.32). CONCLUSIONS The bacterial bioburden and odds of detection of EIPs were not statistically different in rooms cleaned with the CAD compared to the standard disinfectant after 24 hours. Although CAD technology appears promising in vitro, larger studies may be warranted to evaluate efficacy in clinical settings.
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Affiliation(s)
- Gita Nadimpalli
- Department of Epidemiology and Public Health, The University of Maryland School of Medicine, Baltimore, Maryland
| | - J Kristie Johnson
- Department of Pathology, The University of Maryland School of Medicine, Baltimore, Maryland
| | - Laurence S Magder
- Department of Epidemiology and Public Health, The University of Maryland School of Medicine, Baltimore, Maryland
| | - Abdolreza Haririan
- Division of Nephrology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Deborah Stevens
- Department of Epidemiology and Public Health, The University of Maryland School of Medicine, Baltimore, Maryland
| | - Anthony D Harris
- Department of Epidemiology and Public Health, The University of Maryland School of Medicine, Baltimore, Maryland
| | - Lyndsay M O'Hara
- Department of Epidemiology and Public Health, The University of Maryland School of Medicine, Baltimore, Maryland
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Rutala WA, Donskey CJ, Weber DJ. Disinfection and sterilization: New technologies. Am J Infect Control 2023; 51:A13-A21. [PMID: 37890943 DOI: 10.1016/j.ajic.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Adherence to professional guidelines and/or manufacturer's instructions for use regarding proper disinfection and sterilization of medical devices is crucial to preventing cross transmission of pathogens between patients. Emerging pathogens (e.g., Candida auris) and complex medical devices provide new challenges. METHODS A search for published English articles on new disinfection and sterilization technologies was conducted by Google, Google scholar and PubMed. RESULTS Several new disinfection methods or products (e.g., electrostatic spraying, new sporicides, colorized disinfectants, "no touch" room decontamination, continuous room decontamination) and sterilization technologies (e.g., new sterilization technology for endoscopes) were identified. CONCLUSIONS These technologies should reduce patient risk.
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Affiliation(s)
- William A Rutala
- Statewide Program for Infection Control and Epidemiology, University of North Carolina (UNC) School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC.
| | - Curtis J Donskey
- Geriatric Research, Education and Clinical Care, Louis Stokes Cleveland VA Medical Center, Cleveland, OH
| | - David J Weber
- Statewide Program for Infection Control and Epidemiology, University of North Carolina (UNC) School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC; Infection Prevention, University of North Carolina Medical Center, Chapel Hill, NC
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Weber DJ, Rutala WA, Sickbert-Bennett E. Emerging infectious diseases, focus on infection prevention, environmental survival and germicide susceptibility: SARS-CoV-2, Mpox, and Candida auris. Am J Infect Control 2023; 51:A22-A34. [PMID: 37890950 DOI: 10.1016/j.ajic.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND New and emerging infectious diseases continue to represent a public health threat. Emerging infectious disease threats include pathogens increasing in range (eg, Mpox), zoonotic microbes jumping species lines to cause sustained infections in humans via person-to-person transmission (SARS-CoV-2) and multidrug-resistant pathogens (eg, Candida auris). MATERIALS AND METHODS We searched the published English literature and reviewed the selected articles on SARS-CoV-2, Mpox, and Candida auris with a focus on environmental survival, contamination of the patient's hospital environment, susceptibility of the pathogen to antiseptics and disinfectants and infection prevention recommendations. RESULTS All three pathogens (ie, SARS-CoV-2, Mpox, and Candida auris) can survive on surfaces for minutes to hours and for Mpox and C auris for days. Currently available antiseptics (eg, 70%-90% alcohol hand hygiene products) are active against SARS-CoV-2, Mpox and C auris. The U.S Environmental Protection Agency provides separate lists of surface disinfectants active against SARS-CoV-2, Mpox, and C auris. DISCUSSION The risk of environment-to-patient transmission of SARS-CoV-2, Mpox and Candida auris, is very low, low-moderate and high, respectively. In the absence of appropriate patient isolation and use of personal protection equipment, the risk of patient-to-health care provider transmission of SARS-CoV-2, Mpox, and C auris is high, moderate and low, respectively. CONCLUSIONS Appropriate patient isolation, use of personal protective equipment by health care personnel, hand hygiene, and surface disinfection can protect patients and health care personnel from acquiring SARS-CoV-2, Mpox, and C auris from infected patients.
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Affiliation(s)
- David J Weber
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC; Department of Infection Prevention, UNC Medical Center, Chapel Hill, NC; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
| | - William A Rutala
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Emily Sickbert-Bennett
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC; Department of Infection Prevention, UNC Medical Center, Chapel Hill, NC; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
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Donskey CJ. Continuous surface and air decontamination technologies: Current concepts and controversies. Am J Infect Control 2023; 51:A144-A150. [PMID: 37890945 DOI: 10.1016/j.ajic.2023.03.017] [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: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 10/29/2023]
Abstract
Effective and safe continuous surface and air decontamination technologies could be a useful adjunct to routine cleaning and disinfection in health care settings. Continuously active quaternary ammonium disinfectants that provide residual antimicrobial activity on undisturbed surfaces for up to 24.ßhours have been shown to reduce the recovery of clinically important pathogens in some but not all real-world studies. Although quaternary ammonium-based supplemental coatings have been reported to provide prolonged residual efficacy in patient care settings, there is concern that some of these products may be removed by routine cleaning and disinfection. To address this concern, the Environmental Protection Agency has recently issued updated guidance requiring demonstration of efficacy after multiple abrasion and chemical exposures for registration of supplemental residual antimicrobial coatings. Far-ultraviolet-C and direct irradiation below exposure limits are promising technologies for continuous air and surface decontamination in occupied spaces, but additional studies are needed to evaluate their long-term safety and efficacy. Given the increasing use of electronic air cleaning technologies in community and health care settings, there is a need for studies to assess real-world efficacy and safety.
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Affiliation(s)
- Curtis J Donskey
- Geriatric Research, Education and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH.
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Continuously active disinfectant inactivates severe acute respiratory coronavirus virus 2 (SARS-CoV-2) and human coronavirus 229E two days after the disinfectant was applied and following wear exposures. Infect Control Hosp Epidemiol 2023; 44:507-509. [PMID: 34852869 PMCID: PMC9379261 DOI: 10.1017/ice.2021.481] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The surface environment in rooms of coronavirus disease 2019 (COVID-19) patients may be persistently contaminated despite disinfection. A continuously active disinfectant demonstrated excellent sustained antiviral activity following a 48-hour period of wear and abrasion exposures with reinoculations. Reductions of >4-log10 were achieved within a 1-minute contact time for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) and the human coronavirus, 229E.
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Khoo SC, Goh MS, Alias A, Luang-In V, Chin KW, Ling Michelle TH, Sonne C, Ma NL. Application of antimicrobial, potential hazard and mitigation plans. ENVIRONMENTAL RESEARCH 2022; 215:114218. [PMID: 36049514 PMCID: PMC9422339 DOI: 10.1016/j.envres.2022.114218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/06/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
The tremendous rise in the consumption of antimicrobial products had aroused global concerns, especially in the midst of pandemic COVID-19. Antimicrobial resistance has been accelerated by widespread usage of antimicrobial products in response to the COVID-19 pandemic. Furthermore, the widespread use of antimicrobial products releases biohazardous substances into the environment, endangering the ecology and ecosystem. Therefore, several strategies or measurements are needed to tackle this problem. In this review, types of antimicrobial available, emerging nanotechnology in antimicrobial production and their advanced application have been discussed. The problem of antimicrobial resistance (AMR) due to antibiotic-resistant bacteria (ARB)and antimicrobial resistance genes (AMG) had become the biggest threat to public health. To deal with this problem, an in-depth discussion of the challenges faced in antimicrobial mitigations and potential alternatives was reviewed.
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Affiliation(s)
- Shing Ching Khoo
- Henan Province Engineering Research Centre for Biomass Value-added Products, School of Forestry, Henan Agricultural University, Zhengzhou, 450002, China; BIOSES Research Interest Group, Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia
| | - Meng Shien Goh
- Henan Province Engineering Research Centre for Biomass Value-added Products, School of Forestry, Henan Agricultural University, Zhengzhou, 450002, China; BIOSES Research Interest Group, Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia
| | - Amirah Alias
- Eco-Innovation Research Interest Group, Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia
| | - Vijitra Luang-In
- Natural Antioxidant Innovation Research Unit, Department of Biotechnology, Faculty of Technology, Mahasarakham University, Khamriang, Kantarawichai, Maha Sarakham, 44150, Thailand
| | - Kah Wei Chin
- BIOSES Research Interest Group, Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia
| | - Tiong Hui Ling Michelle
- BIOSES Research Interest Group, Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia
| | - Christian Sonne
- Henan Province Engineering Research Centre for Biomass Value-added Products, School of Forestry, Henan Agricultural University, Zhengzhou, 450002, China; Aarhus University, Department of Bioscience, Arctic Research Centre (ARC), Frederiksborgvej 399, PO Box 358, DK-4000, Roskilde, Denmark.
| | - Nyuk Ling Ma
- Henan Province Engineering Research Centre for Biomass Value-added Products, School of Forestry, Henan Agricultural University, Zhengzhou, 450002, China; BIOSES Research Interest Group, Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia.
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Warren BG, Barrett A, Graves A, King C, Turner NA, Anderson DJ. An Enhanced Strategy for Daily Disinfection in Acute Care Hospital Rooms: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2242131. [PMID: 36378308 PMCID: PMC9667331 DOI: 10.1001/jamanetworkopen.2022.42131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE Environmental contamination is a source of transmission between patients, health care practitioners, and other stakeholders in the acute care setting. OBJECTIVE To compare the efficacy of an enhanced daily disinfection strategy vs standard disinfection in acute care hospital rooms. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial (RCT) was conducted in acute care hospital rooms at Duke University Hospital in Durham, North Carolina, from November 2021 to March 2022. Rooms were occupied by patients with contact precautions. Room surfaces (bed rails, overbed table, and in-room sink) were divided into 2 sides (right vs left), allowing each room to serve as its own control. Each side was randomized 1:1 to the intervention group or control group. INTERVENTIONS The intervention was a quaternary ammonium, salt-based, 24-hour continuously active germicidal wipe. It was applied in addition to routine disinfection for the intervention group. The control group received no intervention beyond routine disinfection. MAIN OUTCOMES AND MEASURES The primary outcome was the total contamination, measured in colony-forming units (CFUs) on the bed rails, overbed table, and sink on study day 1. The secondary outcomes were the proportion of sample areas with positive test results for clinically important pathogens, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and carbapenem-resistant Enterobacteriaceae; the similarity in baseline contamination between sample area sides on study day 0 before application of the intervention, and the proportion of sample areas with removed UV luminescent gel on study day 1. RESULTS A total of 50 study rooms occupied by 50 unique patients (median [IQR] age, 61 [45-69] years; 26 men [52%]) with contact precautions were enrolled. Of these patients, 41 (82%) were actively receiving antibiotics, 39 (78%) were bedridden, and 28 (56%) had active infections with study-defined clinically important pathogens. On study day 1, the median (IQR) total CFUs for the intervention group was lower than that for the control group (3561 [1292-7602] CFUs vs 5219 [1540-12 364] CFUs; P = .002). On study day 1, the intervention side was less frequently contaminated with patient-associated clinically important pathogens compared with the control side of the room (4 [14%] vs 11 [39%]; P = .04). CONCLUSIONS AND RELEVANCE Results of this RCT demonstrated that a quaternary ammonium, salt-based, 24-hour continuously active germicidal wipe decreased the environmental bioburden in acute care hospital rooms compared with routine disinfection. The findings warrant large-scale RCTs to determine whether enhanced daily disinfection strategies can decrease patient acquisition and adverse patient outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05560321.
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Affiliation(s)
- Bobby G. Warren
- Division of Infectious Diseases, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Disinfection, Resistance and Transmission Epidemiology (DiRTE) Lab, Duke University School of Medicine, Durham, North Carolina
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
| | - Aaron Barrett
- Division of Infectious Diseases, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Disinfection, Resistance and Transmission Epidemiology (DiRTE) Lab, Duke University School of Medicine, Durham, North Carolina
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
| | - Amanda Graves
- Division of Infectious Diseases, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Disinfection, Resistance and Transmission Epidemiology (DiRTE) Lab, Duke University School of Medicine, Durham, North Carolina
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
| | - Carly King
- Division of Infectious Diseases, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
| | - Nicholas A. Turner
- Division of Infectious Diseases, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Disinfection, Resistance and Transmission Epidemiology (DiRTE) Lab, Duke University School of Medicine, Durham, North Carolina
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
| | - Deverick J. Anderson
- Division of Infectious Diseases, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Disinfection, Resistance and Transmission Epidemiology (DiRTE) Lab, Duke University School of Medicine, Durham, North Carolina
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
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Zhang Y, Choi YW, Demir B, Ekbataniamiri F, Fulton ML, Ma M, Schang LM, Purevdorj-Gage L, Qiao M. Novel chlorine-extending polymer coating with prolonged antiviral activity against SARS-CoV-2. Lett Appl Microbiol 2022; 75:1346-1353. [PMID: 35965454 DOI: 10.1111/lam.13804] [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: 05/20/2022] [Revised: 07/14/2022] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
Abstract
We previously reported a novel polymeric surface coating, namely HaloFilmTM , that can immobilize and extend the antimicrobial activity of chlorine on surfaces. In this study, we demonstrated the continuous antiviral efficacy of HaloFilmTM when applied on stainless steel and cotton gauze as two representative models for non-porous and porous surfaces against SARS-CoV-2. Forty-eight hours post HaloFilm application and chlorination, and 2 hours post the viral challenge, the inoculum titer was reduced by 2.25±0.33 and ≥4.36±0.23 log10 TCIDA50 on non-porous and porous surfaces, respectively. The half-life of the virus was shorter (13.86 min) on a HaloFilmTM -coated surface compared to what has been reported on copper (46.44 min).
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Affiliation(s)
| | - Young W Choi
- Battelle Biomedical Research Center, West Jefferson, OH
| | | | | | | | - Minglin Ma
- Department of Biological and Environmental Engineering, Cornell University, Ithaca, NY
| | - Luis M Schang
- Department of Microbiology and Immunology, Baker Institute for Animal Health, Cornell University, Ithaca, NY
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Bandara HMHN, Samaranayake LP. Emerging strategies for environmental decontamination of the nosocomial fungal pathogen Candida auris. J Med Microbiol 2022; 71. [PMID: 35687657 DOI: 10.1099/jmm.0.001548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Candida auris is a recently emerged multidrug-resistant fungal pathogen that causes life-threatening infections to the human population worldwide. Recent rampant outbreaks of C. auris in coronavirus disease 2019 (COVID-19) patients, together with outbreaks in over 45 countries, highlight its threat to patients and healthcare economies. Unlike other pathogenic Candida species, C. auris is capable of surviving in abiotic surfaces of healthcare facilities for prolonged periods, leading to increased risk of transmission within nosocomial settings. C. auris is resistant to multiple classes of antifungal agents, forms dry biofilms and transmits independently to regional epicentres, making its eradication from nosocomial environment arduous. The lack of strategies for environmental decontamination of C. auris from nosocomial settings is evident from the generic guidance and recommendations provided by leading global healthcare bodies. Therefore, this minireview discusses the current guidelines for environmental decontamination of C. auris and compounds and strategies currently under investigation for potential future use. While established guidelines recommend the use of products mainly consisting of sodium hypochlorite and hydrogen peroxide, initial works have been reported on the promising anti-C. auris properties of various other compounds and some biocompatible alternatives. Further validation of these approaches, coupled up with environmentally friendly decontamination protocols, are warranted to achieve superior elimination of C. auris from healthcare settings.
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12
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Ikner LA, Torrey JR, Gundy PM, Gerba CP. Efficacy of an antimicrobial surface coating against human coronavirus 229E and SARS-CoV-2. Am J Infect Control 2021; 49:1569-1571. [PMID: 34499978 PMCID: PMC8420084 DOI: 10.1016/j.ajic.2021.08.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/26/2022]
Abstract
The COVID-19 pandemic has accelerated the demand for alternatives to standard cleaning and disinfection practices. Antiviral coatingsmay provide an alternative to common surface treatments. A newly developed quaternary ammonium polymer coating was applied to stainless steel coupons and evaluated for efficacy against human coronavirus 229E and SARS-CoV-2. The polymer coating reduced levels of both test viruses by greater than 99.9% relative to non-coated stainless steel coupons during a 2-hour contact time.
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D’Accolti M, Soffritti I, Bonfante F, Ricciardi W, Mazzacane S, Caselli E. Potential of an Eco-Sustainable Probiotic-Cleaning Formulation in Reducing Infectivity of Enveloped Viruses. Viruses 2021; 13:2227. [PMID: 34835033 PMCID: PMC8617880 DOI: 10.3390/v13112227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic has deeply influenced sanitization procedures, and high-level disinfection has been massively used to prevent SARS-CoV-2 spread, with potential negative impact on the environment and on the threat of antimicrobial resistance (AMR). Aiming to overcome these concerns, yet preserving the effectiveness of sanitization against enveloped viruses, we assessed the antiviral properties of the Probiotic Cleaning Hygiene System (PCHS), an eco-sustainable probiotic-based detergent previously proven to stably abate pathogen contamination and AMR. PCHS (diluted 1:10, 1:50 and 1:100) was tested in comparison to common disinfectants (70% ethanol and 0.5% sodium hypochlorite), in suspension and carrier tests, according with the European UNI EN 14476:2019 and UNI EN 16777:2019 standards. Human alpha- and beta-coronaviruses hCoV-229E and SARS-CoV-2, human herpesvirus type 1, human and animal influenza viruses, and vaccinia virus were included in the study. The results showed that PCHS was able to inactivate 99.99% of all tested viruses within 1-2 h of contact, both in suspension and on surface. Notably, while control disinfectants became inactive within 2 h after application, the PCHS antiviral action persisted up to 24 h post-application, suggesting that its use may effectively allow a continuous prevention of virus spread via contaminated environment, without worsening environmental pollution and AMR concern.
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Affiliation(s)
- Maria D’Accolti
- Section of Microbiology, Department of Chemical, Pharmaceutical and Agricultural Sciences, LTTA, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy; (M.D.); (I.S.)
- CIAS Research Center, University of Ferrara, Via Saragat 13, 44122 Ferrara, Italy;
| | - Irene Soffritti
- Section of Microbiology, Department of Chemical, Pharmaceutical and Agricultural Sciences, LTTA, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy; (M.D.); (I.S.)
- CIAS Research Center, University of Ferrara, Via Saragat 13, 44122 Ferrara, Italy;
| | - Francesco Bonfante
- Istituto Zooprofilattico Sperimentale delle Venezie, IZSVe, Viale dell’Università 10, 35020 Legnaro, Italy;
| | - Walter Ricciardi
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Roma, Italy;
| | - Sante Mazzacane
- CIAS Research Center, University of Ferrara, Via Saragat 13, 44122 Ferrara, Italy;
| | - Elisabetta Caselli
- Section of Microbiology, Department of Chemical, Pharmaceutical and Agricultural Sciences, LTTA, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy; (M.D.); (I.S.)
- CIAS Research Center, University of Ferrara, Via Saragat 13, 44122 Ferrara, Italy;
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Evaluation of a continuously active disinfectant for decontamination of portable medical equipment. Infect Control Hosp Epidemiol 2021; 43:387-389. [PMID: 34034834 PMCID: PMC8961336 DOI: 10.1017/ice.2021.66] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A single spray application of a continuously active disinfectant on portable equipment resulted in significant reductions in aerobic colony counts over 7 days and in recovery of Staphylococcus aureus and enterococci: 3 of 93 cultures (3%) versus 11 of 97 (11%) and 20 of 97 (21%) in quaternary ammonium disinfectant and untreated control groups, respectively.
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Boyce JM. A review of wipes used to disinfect hard surfaces in health care facilities. Am J Infect Control 2021; 49:104-114. [PMID: 32569612 DOI: 10.1016/j.ajic.2020.06.183] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 06/13/2020] [Accepted: 06/15/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite a plethora of wipes available for use in health care facilities, there is a paucity of articles describing wipe composition, potential interactions between wipes and disinfectants, the manner in which wipes are used, and their relative efficacy. The purpose of this article is to provide an in-depth review of wipes used for disinfection of hard surfaces in health care settings. METHODS Comprehensive searches of the Pubmed database and Internet were conducted, and articles published from 1953 through September 2019 and pertinent on-line documents were reviewed. Bibliographies of relevant articles were reviewed. RESULTS Wipes vary considerably in their composition, and the disinfectants with which they are used. With reusable dry wipes, the ratio of wipe material to disinfectant and the amount of disinfectant absorbed by the wipe and delivered to surfaces is difficult to standardize, which may affect their efficacy. The manner in which wipes are used by health care personnel is highly variable, due in part to insufficient instructions for use and inadequate education of relevant personnel. CONCLUSIONS Additional research is needed regarding the best practices for using different types of wipes, improved methods for educating staff, and establishing the relative efficacy of wipes in reducing environmental contamination and health care-associated infections.
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Burel C, Direur G, Rivas C, Purevdorj-Gage L. Colorimetric detection of residual quaternary ammonium compounds on dry surfaces and prediction of antimicrobial activity using bromophenol blue. Lett Appl Microbiol 2020; 72:358-365. [PMID: 33191523 DOI: 10.1111/lam.13429] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 01/22/2023]
Abstract
Controlling and monitoring the residual activity of quaternary ammonium compounds (QACs) are critical for maintaining safe yet effective levels of these agents in the environment. This study investigates the utility of bromophenol blue (BPB) as a safe, rapid and user-friendly indicator to detect in situ residual QACs dried on hard, non-porous surfaces, as well a means to assess their antimicrobial efficacy. At pH 7, BPB has a purple colour which turns blue upon its complexation with QACs such as didecyldimethylammonium chloride (DDAC). BPB itself has no antimicrobial properties up to 400 ppm. Within the range of 0-400 ppm, BPB colour change was tied to specific DDAC antimicrobial performances with a detection threshold of 100 ppm. BPB concentration and application volume could be adjusted such that a colour shift from purple to blue correlated with a set percent reduction (>99·9%) in test bacteria (Staphylococcus aureus and Klebsiella aerogenes). The BPB solutions developed in this study yielded similar colour shifts on polycarbonate and stainless steel surfaces and did not cross-react with chemical ingredients commonly found in sanitizers and disinfectant products. Overall, this study suggests that BPB provides a simple solution to safely monitor the post-application level and biocidal activity of residual dried QACs on surfaces.
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Affiliation(s)
- C Burel
- Complex Assemblies of Soft Matter Laboratory (COMPASS), UMI 3254, CNRS-Solvay-University of Pennsylvania, CRTB, Bristol, PA, USA
| | - G Direur
- Complex Assemblies of Soft Matter Laboratory (COMPASS), UMI 3254, CNRS-Solvay-University of Pennsylvania, CRTB, Bristol, PA, USA
| | - C Rivas
- Solvay, CRTB, Bristol, PA, USA
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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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Croke L. Strategies to decrease contamination of the anesthesia work area. AORN J 2020; 111:P8-P10. [DOI: 10.1002/aorn.13051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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