Occurrence of bacteria and biochemical markers on public surfaces

High clonal diversity of Staphylococcus aureus isolates from children's playgrounds in Hungary

Staphylococcus aureus is one of the most important human pathogenic bacteria and environmental surfaces play an important role in the spread of the bacterium. Presence of S. aureus on children's playgrounds and on toys was described in international studies, however, little is known about the prevalence and characteristics of S. aureus at playgrounds in Europe. In this study, 355 samples were collected from playgrounds from 16 cities in Hungary. Antibiotic susceptibility of the isolates was tested for nine antibiotics. Presence of virulence factors was detected by PCR. Clonal diversity of the isolates was tested by PFGE and MLST. The overall prevalence of S. aureus was 2.81% (10/355) and no MRSA isolates were found. Presence of spa (10), fnbA (10), fnbB (5), icaA (8), cna (7), sea (2), hla (10), hlb (2) and hlg (6) virulence genes were detected. The isolates had diverse PFGE pulsotypes. With MLST, we have detected isolates belonging to ST8 (CC8), ST22 (CC22), ST944 and ST182 (CC182), ST398 (CC398), ST6609 (CC45), ST3029 and ST2816. We have identified a new sequence type, ST6609 of CC45. S. aureus isolates are present on Hungarian playgrounds, especially on plastic surfaces. The isolates were clonally diverse and showed resistance to commonly used antibiotics. These data reinforce the importance of the outdoor environment in the spread for S. aureus in the community.

An excimer lamp to provide far-ultraviolet C irradiation for dining-table disinfection

Dining tables may present a risk to diners by transmitting bacteria and/or viruses. Currently, there is a lack of an environmental-friendly and convenient means to protect diners when they are sitting together. This investigation constructed far-UVC excimer lamps to disinfect dining-table surfaces. The lamps were mounted at different heights and orientations, and the irradiance on table surfaces was measured. The irradiation doses to obtain different inactivation efficiencies for Escherichia coli (E. coli) were provided. In addition, numerical modeling was conducted for irradiance and the resulting inactivation efficiency. The surface-to-surface (S2S) model was validated with the measured irradiance. The germicidal performance of far-UVC irradiation, the far-UVC doses to which diners were exposed, and the risk of exposure to the generated ozone were evaluated. The results revealed that an irradiation dose of 12.8 mJ/cm2 can disinfect 99.9% of E. coli on surfaces. By varying the lamp irradiance output, the number and positions of the lamps, the far-UVC irradiation can achieve a 3-log reduction for a dining duration of 5 min. Besides, the far-UVC lamp has a low damage risk to diners when achieving an effective inactivation rate. Moreover, there is virtually no ozone exposure risk in a mechanically ventilated dining hall.

Antimicrobial properties of a multi-component alloy

High traffic touch surfaces such as doorknobs, countertops, and handrails can be transmission points for the spread of pathogens, emphasizing the need to develop materials that actively self-sanitize. Metals are frequently used for these surfaces due to their durability, but many metals also possess antimicrobial properties which function through a variety of mechanisms. This work investigates metallic alloys comprised of several metals which individually possess antimicrobial properties, with the target of achieving broad-spectrum, rapid sanitation through synergistic activity. An entropy-motivated stabilization paradigm is proposed to prepare scalable alloys of copper, silver, nickel and cobalt. Using combinatorial sputtering, thin-film alloys were prepared on 100 mm wafers with ≈50% compositional grading of each element across the wafer. The films were then annealed and investigated for alloy stability. Antimicrobial activity testing was performed on both the as-grown alloys and the annealed films using four microorganisms-Phi6, MS2, Bacillus subtilis and Escherichia coli-as surrogates for human viral and bacterial pathogens. Testing showed that after 30 s of contact with some of the test alloys, Phi6, an enveloped, single-stranded RNA bacteriophage that serves as a SARS-CoV-2 surrogate, was reduced up to 6.9 orders of magnitude (> 99.9999%). Additionally, the non-enveloped, double-stranded DNA bacteriophage MS2, and the Gram-negative E. coli and Gram-positive B. subtilis bacterial strains showed a 5.0, 6.4, and 5.7 log reduction in activity after 30, 20 and 10 min, respectively. Antimicrobial activity in the alloy samples showed a strong dependence on the composition, with the log reduction scaling directly with the Cu content. Concentration of Cu by phase separation after annealing improved activity in some of the samples. The results motivate a variety of themes which can be leveraged to design ideal antimicrobial surfaces.

SARS-CoV-2 in the Environment: Its Transmission, Mitigation, and Prospective Strategies of Safety and Sustainability

The emergence and spread of SARS-CoV-2 have threatened the world’s public health security. The COVID-19 pandemic has affected many countries and significantly smashed the global economy, and also affected the health of the environment. This has upraised many apprehensions about its high transmission rate. Even though the most important routes of its transmission include direct contact and respiratory droplets, the infection through non-direct contacts also plays an important role. The increasing demand for intensive healthcare, escalating death toll and disruption in supply chains and trade have directed to mass implementation of testing, quarantine, and lockdown to restrain virus transmission. The lockdown has been a boon and a bane as well when it comes to the health of the environment. It had improved the air and water quality since the industrial activities were banned and therefore there was no addition of pollutants in the environment, but the usage of plastic-based personal protective equipment (PPE) and other medical waste has simultaneously resulted in huge plastic pollution that is choking seas and marine lives. The precautionary measures given by the United Nations Environment Programme in its COVID response factsheets suggest ways to reduce medical waste and to prevent the spread of the present pandemic. The recent green innovations and environmental stringency programs have resulted in reducing the threats to the environment that would eventually help in inhibiting the spread of such pandemics. In addition, proper measures should be adopted to safeguard the complete health of humans and the environment to execute safety and sustainable development that will help in achieving a stable biome.

Effect of TiO2 Concentration on Microstructure and Properties of Composite Cu-Sn-TiO2 Coatings Obtained by Electrodeposition

In this work, Cu–Sn–TiO₂ composite coatings were electrochemically obtained from a sulfate bath containing 0–10 g/L of TiO₂ nanoparticles. The effect of TiO₂ particles on kinetics of cathodic electrodeposition has been studied by linear sweep voltammetry and chronopotentiometry. As compared to the Cu–Sn alloy, the Cu–Sn–TiO₂ composite coatings show rougher surfaces with TiO₂ agglomerates embedded in the metal matrix. The highest average amount of included TiO₂ is 1.7 wt.%, in the case of the bath containing 5 g/L thereof. Composite coatings showed significantly improved antibacterial properties towards E. coli ATCC 8739 bacteria as compared to the Cu–Sn coatings of the same composition. Such improvement has been connected with the corrosion resistance of the composites studied by linear polarization and electrochemical impedance spectroscopy. In the bacterial media and 3% NaCl solutions, Cu–Sn–TiO₂ composite coatings have lower corrosion resistance as compared to Cu–Sn alloys, which is caused by the nonuniformity of the surface.

Isolation and identification of microorganisms associated with automated teller machines on Federal Polytechnic Ede campus

Automated Teller Machines (ATM) are visited everyday by millions of people. This machine is accessible to the general public irrespective of class, age or race. The contact point of all ATM machines is the hand which on their own are ‘vaults’ of microorganisms. An elaborate survey was taken for complete assessment of possible microbial contamination in the Federal Polytechnic Ede campus. Selected ATM machines on campus were used as case study to characterize, identify and determine the degree of bacterial contamination of microorganisms and their potential as reservoir of microbes. Swabs were collected from each ATM screen, buttons, floor, user’s hand, and exposure of plates. After collection of the samples, they were plated in nutrient agar. The results showed the presence of increased bacterial count subsequently, most pathogens on characterization revealed the genus of the particular organisms E. coli, Pseudomonas, Staphylococcus aureus, Klebsiella, Micrococcus, Salmonella and Serratia. The study showed the potential hazard inherent in ATM machine usage and draws attention to our level of hand hygiene compliance.

Can Copper Products and Surfaces Reduce the Spread of Infectious Microorganisms and Hospital-Acquired Infections?

Pathogen transfer and infection in the built environment are globally significant events, leading to the spread of disease and an increase in subsequent morbidity and mortality rates. There are numerous strategies followed in healthcare facilities to minimize pathogen transfer, but complete infection control has not, as yet, been achieved. However, based on traditional use in many cultures, the introduction of copper products and surfaces to significantly and positively retard pathogen transmission invites further investigation. For example, many microbes are rendered unviable upon contact exposure to copper or copper alloys, either immediately or within a short time. In addition, many disease-causing bacteria such as E. coli O157:H7, hospital superbugs, and several viruses (including SARS-CoV-2) are also susceptible to exposure to copper surfaces. It is thus suggested that replacing common touch surfaces in healthcare facilities, food industries, and public places (including public transport) with copper or alloys of copper may substantially contribute to limiting transmission. Subsequent hospital admissions and mortality rates will consequently be lowered, with a concomitant saving of lives and considerable levels of resources. This consideration is very significant in times of the COVID-19 pandemic and the upcoming epidemics, as it is becoming clear that all forms of possible infection control measures should be practiced in order to protect community well-being and promote healthy outcomes.

Bacterial growth and recovery on hospital biometric devices: effect of two types of disinfectants

Objectives:

The aim of the study was to evaluate the presence of bacterial contamination on biometric identification devices in a public hospital; identify the species of bacteria implicated in the contamination and assess bacterial recovery after the use of 2 types of disinfectants: alcohol 70% and isopropyl alcohol chlorhexidine.

Design:

Before and after trial.

Setting:

Public hospital, tertiary referral center.

Participants:

All existing biometric identification devices in the hospital (n = 20).

Methods:

Collection of 2 microbiological samples from the fingerprint reading surface of biometric devices immediately before and after applying the solution with alcohol 70% and in separate time periods with isopropyl alcohol chlorhexidine.

Results:

It have been identified 21 different bacterial species in a total of 78 samples, mostly Staphylococcus epidermidis (32 samples) and S aureus (7 samples). S epidermidis was eliminated in 61.5% of the samples after disinfecting with alcohol 70% and in 92.3% of the samples disinfected with isopropyl alcohol chlorhexidine. S aureus was eliminated in 33.3% and 100% of the samples, respectively. We found no bacterial growth in 10% of the devices after disinfection with 70% alcohol and in 78.9% of devices after disinfection with isopropyl alcohol chlorhexidine. We also found that there was a decrease in the frequency of species isolated after using both disinfection solutions, although isopropyl alcohol chlorhexidine appeared to be more effective.

Conclusions:

The biometric identification devices used in this hospital seem to be safe regardless of the products used for its cleaning. The majority of the bacteria found are commensal skin microorganisms. We did not find pathogenic bacteria for immunocompetent individuals, in particular methicillin-resistant S aureus.

Atomic force microscopy as a biophysical tool for nanoscale forensic investigations

The atomic force microscope (AFM) has found its way to the arsenal of tools available to the forensic practitioner for the analysis of samples at the nano and microscales. As a non-destructive probing tool that requires minimal sample preparation, the AFM is very attractive, particularly in the case of minimal or precious sample. To date, the use of the AFM has primarily been in the arena of imaging where it has been complementary to other microscopic examination tools. Forensic applications in the visual examination of evidence such as blood stains, questioned documents, and hair samples have been reported. While a number of reviews have focused on the use of AFM as an imaging tool for forensic analyses, here we not only discuss these works, but also point to a versatile enhancement in the capabilities of this nanoscale tool - namely its use for force spectroscopy. In this mode, the AFM can determine elastic moduli, adhesion forces, energy dissipation, and the interaction forces between cognate ligands, that can be spatially mapped to provide a unique spatial visualization of properties. Our goals in this review are to provide a context for this capability of the AFM, explain its workings, cover some exemplary works pertaining to forensic sciences, and present a critical analysis on the advantages and disadvantages of this modality. Equipped with this high-resolution tool, imaging and biophysical analysis by the AFM can provide a unique complement to other tools available to the researcher for the analysis and characterization of forensic evidence.

Microbial contamination and efficacy of disinfection procedures of companion robots in care homes

Background

Paro and other robot animals can improve wellbeing for older adults and people with dementia, through reducing depression, agitation and medication use. However, nursing and care staff we contacted expressed infection control concerns. Little related research has been published. We assessed (i) how microbiologically contaminated robot animals become during use by older people within a care home and (ii) efficacy of a cleaning procedure.

Methods

This study had two stages. In stage one we assessed microbial load on eight robot animals after interaction with four care home residents, and again following cleaning by a researcher. Robot animals provided a range of shell-types, including fur, soft plastic, and solid plastic. Stage two involved a similar process with two robot animals, but a care staff member conducted cleaning. The cleaning process involved spraying with anti-bacterial product, brushing fur-type shells, followed by vigorous top-to-tail cleaning with anti-bacterial wipes on all shell types. Two samples were taken from each of eight robots in stage one and two robots in stage two (20 samples total). Samples were collected using contact plate stamping and evaluated using aerobic colony count and identification (gram stain, colony morphology, coagulase agglutination). Colony counts were measured by colony forming units per square centimetre (CFU/cm²).

Results

Most robots acquired microbial loads well above an acceptable threshold of 2.5 CFU/cm² following use. The bacteria identified were micrococcus species, coagulase negative staphylococcus, diptheriods, aerobic spore bearers, and staphylococcus aureus, all of which carry risk for human health. For all devices the CFU/cm² reduced to well within accepted limits following cleaning by both researcher and care staff member.

Conclusions

Companion robots will acquire significant levels of bacteria during normal use. The simple cleaning procedure detailed in this study reduced microbial load to acceptable levels in controlled experiments. Further work is needed in the field and to check the impact on the transmission of viruses.

Women's Perceptions of Public Restrooms and the Relationships with Toileting Behaviors and Bladder Symptoms: A Cross-Sectional Study

PURPOSE

Because current knowledge about public restroom use and bladder health is limited, we sought to identify why women avoid public restrooms and the associations of lower urinary tract symptoms and toileting behaviors.

MATERIALS AND METHODS

Between October and December 2017 we recruited a convenience sample of U.S. women to complete a cross-sectional, anonymous questionnaire about public restroom use, lower urinary tract symptoms (International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms [ICIQ-FLUTS]) and toileting behavior (Web-Based Toileting Behavior [TB-WEB]). We compared women who reported limiting public restroom use all or most of the time to those who did not limit or did so occasionally or sometimes.

RESULTS

Of the 6,004 women in the study 26% limited public restroom use most or all of the time and were more concerned with cleanliness than those who did not limit public restroom use. They also reported more often using nonsitting positions when away from home and holding urine to avoid public restrooms, higher ICIQ-FLUTS scores, more frequent overactive bladder and fewer than 7 voids a day.

CONCLUSIONS

A large number of women reported avoiding public restrooms, often over concerns of cleanliness, availability of amenities and privacy. Women who habitually limit public restroom use more frequently reported unhealthy toilet behaviors and lower urinary tract conditions. These findings will help guide future research and inform public policy and bladder health awareness.

Dual-Functional, Superhydrophobic Coatings with Bacterial Anticontact and Antimicrobial Characteristics

Bacterial pathogens are responsible for millions of cases of illnesses and deaths each year throughout the world. The development of novel surfaces and coatings that effectively inhibit and prevent bacterial attachment, proliferation, and growth is one of the crucial steps for tackling this global challenge. Herein, we report a dual-functional coating for aluminum surfaces that relies on the controlled immobilization of lysozyme enzyme (muramidase) into interstitial spaces of presintered, nanostructured thin film based on ∼200 nm silica nanoparticles and the sequential chemisorption of an organofluorosilane to the available interfacial areas. The mean diameter of the resultant lysozyme microdomains was 3.1 ± 2.5 μm with an average spacing of 8.01 ± 6.8 μm, leading to a surface coverage of 15.32%. The coating had an overall root-mean-square (rms) roughness of 539 ± 137 nm and roughness factor of 1.50 ± 0.1, and demonstrated static, advancing, and receding water contact angles of 159.0 ± 1.0°, 155.4 ± 0.6°, and 154.4 ± 0.6°, respectively. Compared to the planar aluminum, the coated surfaces produced a 6.5 ± 0.1 (>99.99997%) and 4.0 ± 0.1 (>99.99%) log-cycle reductions in bacterial surfaces colonization against Gram-negative Salmonella Typhimurium LT2 and Gram-positive Listeria innocua, respectively. We anticipate that the implementation of such a coating strategy on healthcare environments and surfaces and food-contact surfaces can significantly reduce or eliminate potential risks associated with various contamination and cross-contamination scenarios.

Occurrence of potentially pathogenic bacteria on shared bicycles

BACKGROUND

Shared bicycles offer the potential to be sources for interindividual bacterial community transfer. However, the overall ecology of the bacterial community persisting on the shared bicycles is still unknown.

METHODS

We used 16S rRNA sequencing techniques in combination with multiple bioinformatic analyses to profile bacterial communities on shared bicycle handles and saddles in selected five locations in a metropolitan area (Chengdu, China). Samples of air around shared bicycles were collected as a control.

RESULTS

We demonstrate that the species richness and diversity of samples from shared bicycles are significantly higher than those of surrounding air samples. Taxonomical composition indicates that community structure of shared bicycle handles and saddles are also different. Additionally, high occurrence of pathogenic or potentially pathogenic genera is found on the surfaces of shared bicycles, including Sphingomonas, Acinetobacter, Staphylococcus, and Cutibacterium. Moreover, PICRUSt (Phylogenetic Investigation of Communities by Reconstruction of Unobserved States) further verifies that bacteria involved in signaling pathways related to human diseases are at significantly higher levels in shared bicycle samples, while bacteria associated with environmental information processing pathways are at significantly higher levels in the air samples.

CONCLUSION

Our results reveal the profiles of bacterial communities on shared bicycles, and suggest that potentially pathogenic bacteria may impair human health through shared bicycles, especially in susceptible individuals. Notably, this investigation will prompt the public to pay more attention to the management of bicycle sharing programs worldwide, and it also provides research basis for the government to formulate corresponding public health policies.

Metagenomics analysis of bacterial structure communities within natural biofilm

The bacterial profiles of natural household biofilm have not been widely investigated. The majorities of these bacterial lineages are not cultivable. Thus, this study aims (i) to enumerate some potential bacterial lineages using culture based method within biofilm samples and confirmed using Biolog GEN III and polymerase chain reaction (PCR). (ii) To investigate the bacterial profiles of communities in two biofilm samples using next generation sequencing (NGS). Forty biofilm samples were cultured and colonies of each selected prevailing potential lineages (E. coli, Salmonella entrica, Pseudomonas aeruginosa, Staphylococcus aureus and Listeria monocytogenes) were selected for confirmation. From obtained results, the counts of the tested bacterial lineages in kitchen biofilm samples were greater than those in bathroom samples. Precision of PCR was higher than Biolog GEN III to confirm the bacterial isolates. Using NGS analysis, the results revealed that a total of 110,554 operational taxonomic units (OTUs) were obtained for two biofilm samples, representing kitchen and bathroom biofilm samples. The numbers of phyla in the kitchen biofilm sample (35 OTUs) was higher than that in bathroom sample (18 OTUs). A total of 435 genera were observed in the bathroom biofilm sample compared to only 256 in the kitchen sample. Evidences have shown that the empirical gadgets for biofilm investigation are becoming convenient and affordable. Many distinct bacterial lineages observed in biofilm are one of the most significant issues that threaten human health and lead to disease outbreaks.

Enteric bacteria, methicillin resistant S. aureus and antimicrobial susceptibility patterns from buses surfaces in Mekelle city, Tigray, Ethiopia

Objective

To assess the enteric bacteria, methicillin resistant S. aureus and antimicrobial susceptibility patterns from buses surfaces in Mekelle, Tigray, Ethiopia.

Results

A total of 300 swab samples were collected from the handle surfaces of the six city buses. The bacterial isolates revealed from the swab samples were E. coli, Enterobacter spp. and S. aureus. The overall positivity rates of E. coli, Enterobacter spp. and S. aureus were 8 (4%), 4 (1.3%) and 54 (18%) respectively. Methicillin resistant S. aureus was seen in 17 (5.7%) of the total 300 swab samples collected and 17 (31.5%) of the S. aureus isolates. All (100%) of the isolates of E. coli and Enterobacter spp. showed resistance for ampicillin and three-fourth of the isolates of E. coli and Enterobacter spp. displayed resistance for chloramphenicol (75%). Five antimicrobials (ampicillin, chloramphenicol, tetracycline, ciprofloxacin, and cotrimoxazole) have showed resistant for one isolate of E. coli. Likewise four antimicrobials (ampicillin, chloramphenicol, ciprofloxacin, and cotrimoxazole) have revealed resistant for one isolate of Enterobacter spp. Moreover, three isolates of S. aureus were also found resistance to four antibiotics.

Mesoporous Silica Materials as Drug Delivery: "The Nightmare" of Bacterial Infection

Mesoporous silica materials (MSM) have a great surface area and a high pore volume, meaning that they consequently have a large loading capacity, and have been demonstrated to be unique candidates for the treatment of different pathologies, including bacterial infection. In this text, we review the multiple ways of action in which MSM can be used to fight bacterial infection, including early detection, drug release, targeting bacteria or biofilm, antifouling surfaces, and adjuvant capacity. This review focus mainly on those that act as a drug delivery system, and therefore that have an essential characteristic, which is their great loading capacity. Since MSM have advantages in all stages of combatting bacterial infection; its prevention, detection and finally in its treatment, we can venture to talk about them as the "nightmare of bacteria".

Degree of Bacterial Contamination of Mobile Phone and Computer Keyboard Surfaces and Efficacy of Disinfection with Chlorhexidine Digluconate and Triclosan to Its Reduction

The main aim of our study was to verify the effectiveness of simple disinfection using wet wipes for reduction of microbial contamination of mobile phones and computer keyboards. Bacteriological swabs were taken before and after disinfection with disinfectant wipes with active ingredients chlorhexidine digluconate and triclosan. The incidence and type of microorganisms isolated before and after disinfection was evaluated; the difference was expressed as percentage of contamination reduction. Our results confirmed the high degree of surface contamination with bacteria, some of which are opportunistic pathogens for humans. Before the process of disinfection, on both surfaces, mobile phones, and computer keyboards, the common skin commensal bacteria like coagulase-negative staphylococci were diagnosed most frequently. On the keyboards, species of the genus Bacillus and representatives of the family Enterobacteriaceae were abundant. The potentially pathogenic species were represented by Staphylococcus aureus. Cultivation of swabs performed 5 min after disinfection and subsequent calculation of the reduction of contamination have shown that simple wiping with antibacterial wet wipe led to a significant reduction of microbial contamination of surfaces, with effect ranging from 36.8 to 100%.

Faecal contamination of commuters' hands in main vehicle stations in Dhaka city, Bangladesh

BACKGROUND

Faecal-oral carriage via hands is an important transmission pathway for diarrhoeal pathogens. The level of faecal contamination of commuters' hands in Dhaka, Bangladesh, was examined in this study.

METHODS

A total of 900 hand washing samples, including both left and right hands, were collected during one year to cover three different seasons in Bangladesh: winter, summer and rainy seasons. Standard membrane filtration technique was used to quantify total coliforms (TC), faecal coliforms (FC), faecal streptococci (FS), Escherichia coli (EC) and Clostridium perfringens (CP).

RESULTS

The hands of the commuters were contaminated with TC, FC, FS, CP and EC. The TC, FC, FS, CP and EC counts were 1.95, 1.65, 4.04, 1.54 and1.46 log10 colony forming units (cfu) in the left hand; and 2.13, 1.82, 4.11, 1.52 and 1.61 log10 cfu in the right hand, respectively. There were no statistically significant differences in counts of left and right hands. The highest counts were observed for FS in all seasons.

CONCLUSIONS

This evidence based study may be used to provide interventions to reduce the contamination of commuters' hands through washing with detergent and, thus, help to prevent the spread of infectious diseases.

Evaluation of standardized sample collection, packaging, and decontamination procedures to assess cross-contamination potential during Bacillus anthracis incident response operations

Sample collection procedures and primary receptacle (sample container and bag) decontamination methods should prevent contaminant transfer between contaminated and non-contaminated surfaces and areas during bio-incident operations. Cross-contamination of personnel, equipment, or sample containers may result in the exfiltration of biological agent from the exclusion (hot) zone and have unintended negative consequences on response resources, activities and outcomes. The current study was designed to: (1) evaluate currently recommended sample collection and packaging procedures to identify procedural steps that may increase the likelihood of spore exfiltration or contaminant transfer; (2) evaluate the efficacy of currently recommended primary receptacle decontamination procedures; and (3) evaluate the efficacy of outer packaging decontamination methods. Wet- and dry-deposited fluorescent tracer powder was used in contaminant transfer tests to qualitatively evaluate the currently-recommended sample collection procedures. Bacillus atrophaeus spores, a surrogate for Bacillus anthracis, were used to evaluate the efficacy of spray- and wipe-based decontamination procedures. Both decontamination procedures were quantitatively evaluated on three types of sample packaging materials (corrugated fiberboard, polystyrene foam, and polyethylene plastic), and two contamination mechanisms (wet or dry inoculums). Contaminant transfer results suggested that size-appropriate gloves should be worn by personnel, templates should not be taped to or removed from surfaces, and primary receptacles should be selected carefully. The decontamination tests indicated that wipe-based decontamination procedures may be more effective than spray-based procedures; efficacy was not influenced by material type but was affected by the inoculation method. Incomplete surface decontamination was observed in all tests with dry inoculums. This study provides a foundation for optimizing current B. anthracis response procedures to minimize contaminant exfiltration.

Microbial Community Patterns Associated with Automated Teller Machine Keypads in New York City

Automated teller machine (ATM) keypads represent a specific and unexplored microhabitat for microbial communities. Although the number of built environment and urban microbial ecology studies has expanded greatly in recent years, the majority of research to date has focused on mass transit systems, city soils, and plumbing and ventilation systems in buildings. ATM surfaces, potentially retaining microbial signatures of human inhabitants, including both commensal taxa and pathogens, are interesting from both a biodiversity perspective and a public health perspective. By focusing on ATM keypads in different geographic areas of New York City with distinct population demographics, we aimed to characterize the diversity and distribution of both prokaryotic and eukaryotic microbes, thus making a unique contribution to the growing body of work focused on the “urban microbiome.” In New York City, the surface area of urban surfaces in Manhattan far exceeds the geographic area of the island itself. We have only just begun to describe the vast array of microbial taxa that are likely to be present across diverse types of urban habitats.

In densely populated urban environments, the distribution of microbes and the drivers of microbial community assemblages are not well understood. In sprawling metropolitan habitats, the “urban microbiome” may represent a mix of human-associated and environmental taxa. Here we carried out a baseline study of automated teller machine (ATM) keypads in New York City (NYC). Our goal was to describe the biodiversity and biogeography of both prokaryotic and eukaryotic microbes in an urban setting while assessing the potential source of microbial assemblages on ATM keypads. Microbial swab samples were collected from three boroughs (Manhattan, Queens, and Brooklyn) during June and July 2014, followed by generation of Illumina MiSeq datasets for bacterial (16S rRNA) and eukaryotic (18S rRNA) marker genes. Downstream analysis was carried out in the QIIME pipeline, in conjunction with neighborhood metadata (ethnicity, population, age groups) from the NYC Open Data portal. Neither the 16S nor 18S rRNA datasets showed any clustering patterns related to geography or neighborhood demographics. Bacterial assemblages on ATM keypads were dominated by taxonomic groups known to be associated with human skin communities (Actinobacteria, Bacteroides, Firmicutes, and Proteobacteria), although SourceTracker analysis was unable to identify the source habitat for the majority of taxa. Eukaryotic assemblages were dominated by fungal taxa as well as by a low-diversity protist community containing both free-living and potentially pathogenic taxa (Toxoplasma, Trichomonas). Our results suggest that ATM keypads amalgamate microbial assemblages from different sources, including the human microbiome, eukaryotic food species, and potentially novel extremophilic taxa adapted to air or surfaces in the built environment. DNA obtained from ATM keypads may thus provide a record of both human behavior and environmental sources of microbes.

IMPORTANCEAutomated teller machine (ATM) keypads represent a specific and unexplored microhabitat for microbial communities. Although the number of built environment and urban microbial ecology studies has expanded greatly in recent years, the majority of research to date has focused on mass transit systems, city soils, and plumbing and ventilation systems in buildings. ATM surfaces, potentially retaining microbial signatures of human inhabitants, including both commensal taxa and pathogens, are interesting from both a biodiversity perspective and a public health perspective. By focusing on ATM keypads in different geographic areas of New York City with distinct population demographics, we aimed to characterize the diversity and distribution of both prokaryotic and eukaryotic microbes, thus making a unique contribution to the growing body of work focused on the “urban microbiome.” In New York City, the surface area of urban surfaces in Manhattan far exceeds the geographic area of the island itself. We have only just begun to describe the vast array of microbial taxa that are likely to be present across diverse types of urban habitats.

Effect of Surface Sampling and Recovery of Viruses and Non-Spore-Forming Bacteria on a Quantitative Microbial Risk Assessment Model for Fomites

Quantitative microbial risk assessment (QMRA) is a powerful decision analytics tool, yet it faces challenges when modeling health risks for the indoor environment. One limitation is uncertainty in fomite recovery for evaluating the efficiency of decontamination. Addressing this data gap has become more important as a result of response and recovery from a potential malicious pathogen release. To develop more accurate QMRA models, recovery efficiency from non-porous fomites (aluminum, ceramic, glass, plastic, steel, and wood laminate) was investigated. Fomite material, surface area (10, 100, and 900 cm(2)), recovery tool (swabs and wipes), initial concentration on the fomites and eluent (polysorbate 80, trypticase soy broth, and beef extract) were evaluated in this research. Recovery was shown to be optimized using polysorbate 80, sampling with wipes, and sampling a surface area of 10-100 cm(2). The QMRA model demonstrated, through a relative risk comparison, the need for recovery efficiency to be used in these models to prevent underestimated risks.

A molecular exploration of human DNA/RNA co-extracted from the palmar surface of the hands and fingers

"Touch DNA" refers to the DNA that is left behind when a person touches or comes into contact with an item. However, the source of touch DNA is still debated and the large variability in DNA yield from casework samples suggests that, besides skin, various body fluids can be transferred through contact. Another important issue concerning touch DNA is the possible occurrence of secondary transfer, but the data published in the literature in relation to the background levels of foreign DNA present on the hand surfaces of the general population are very limited. As the present study aimed at better understanding the nature and characteristics of touch DNA, samples were collected from the palmar surface of the hands and fingers ("PHF" samples) of 30 male and 30 female donors by tape-lifting/swabbing and subjected to DNA/RNA co-extraction. Multiplex mRNA profiling showed that cellular material different from skin could be observed in 15% of the PHF samples. The total amount of DNA recovered from these samples (median 5.1 ng) was significantly higher than that obtained from samples containing skin cells only (median 1.6 ng). The integrity of the DNA isolated from the donors' hands and fingers as well as the prevalence of DNA mixtures were evaluated by STR typing and compared with reference STR profiles from buccal swabs. DNA integrity appeared significantly higher in the male rather than in the female subsample, as the average percentage of the donors' alleles effectively detected in PHF profiles was 75.1% and 60.1%, respectively. The prevalence of mixtures with a foreign DNA contribution ≥20% was 19.2% (30.0% in the female PHF samples and 8.3% in the male PHF samples). The obtained results support the hypothesis that transfer of cellular material different from skin may underlie the occasional recovery of quality STR profiles from handled items. These results also suggest that gender may represent an important factor influencing the propensity of individuals to carry and transfer DNA through hand contact, possibly because of the differences in personal and hygiene habits between males and females.

Bacterial contamination of cell phones of medical students at King Abdulaziz University, Jeddah, Saudi Arabia

Cell phones are commonly used in healthcare settings for rapid communication within hospitals. Concerns have been increased about the use of these devices in hospitals, as they can be used everywhere, even in toilets. Therefore, they can be vehicles for transmitting pathogens to patients. This study aimed to examine the presence of pathogenic bacteria on the surfaces of cell phones that are used frequently by preclinical medical students. This cross-sectional study identified both pathogenic and nonpathogenic bacteria on cell phones of 105 medical students at King Abdulaziz University, Jeddah, Saudi Arabia, using standard microbiological methods. Out of 105 cell phones screened, 101 (96.2%) were contaminated with bacteria. Coagulase-negative staphylococci were the most abundant isolates (68%). Seventeen (16.2%) cell phones were found to harbor Staphylococcus aureus. Gram-positive bacilli were isolated from 20 (19%) samples. Viridans streptococci and Pantoea species were also isolated but at lower levels. Our findings indicate that cell phones can act as reservoirs of both pathogenic and nonpathogenic organisms. Therefore, full guidelines about restricting the use of cell phones in clinical environments, hand hygiene, and frequent decontamination of mobile devices are recommended at an early stage in medical schools, to limit the risk of cross-contamination and healthcare-associated infections caused by cell phones.

An observational study of frequency of provider hand contacts in child care facilities in North Carolina and South Carolina

BACKGROUND

Children enrolled in child care are 2.3-3.5 times more likely to experience acute gastrointestinal illness than children cared for in their own homes. The purpose of this study was to determine the frequency surfaces were touched by child care providers to identify surfaces that should be cleaned and sanitized.

METHODS

Observation data from a convenience sample of 37 child care facilities in North Carolina and South Carolina were analyzed. Trained data collectors used iPods (Apple, Cupertino, CA) to record hand touch events of 1 child care provider for 45 minutes in up to 2 classrooms in each facility.

RESULTS

Across the 37 facilities, 10,134 hand contacts were observed in 51 classrooms. Most (4,536) were contacts with porous surfaces, with an average of 88.9 events per classroom observation. The most frequently touched porous surface was children's clothing. The most frequently touched nonporous surface was food contact surfaces (18.6 contacts/observation). Surfaces commonly identified as high-touch surfaces (ie, light switches, handrails, doorknobs) were touched the least.

CONCLUSION

General cleaning and sanitizing guidelines should include detailed procedures for cleaning and sanitizing high-touch surfaces (ie, clothes, furniture, soft toys). Guidelines are available for nonporous surfaces but not for porous surfaces (eg, clothing, carpeting). Additional research is needed to inform the development of evidence-based practices to effectively treat porous surfaces.

Diversity of bacterial communities of fitness center surfaces in a U.S. metropolitan area

Public fitness centers and exercise facilities have been implicated as possible sources for transmitting community-acquired bacterial infections. However, the overall diversity of the bacterial community residing on the surfaces in these indoor environments is still unknown. In this study, we investigated the overall bacterial ecology of selected fitness centers in a metropolitan area (Memphis, TN, USA) utilizing culture-independent pyrosequencing of the 16S rRNA genes. Samples were collected from the skin-contact surfaces (e.g., exercise instruments, floor mats, handrails, etc.) within fitness centers. Taxonomical composition revealed the abundance of Firmicutes phyla, followed by Proteobacter and Actinobacteria, with a total of 17 bacterial families and 25 bacterial genera. Most of these bacterial genera are of human and environmental origin (including, air, dust, soil, and water). Additionally, we found the presence of some pathogenic or potential pathogenic bacterial genera including Salmonella, Staphylococcus, Klebsiella, and Micrococcus. Staphylococcus was found to be the most prevalent genus. Presence of viable forms of these pathogens elevates risk of exposure of any susceptible individuals. Several factors (including personal hygiene, surface cleaning and disinfection schedules of the facilities) may be the reasons for the rich bacterial diversity found in this study. The current finding underscores the need to increase public awareness on the importance of personal hygiene and sanitation for public gym users.

Application of quantitative microbial risk assessment for selection of microbial reduction targets for hard surface disinfectants

BACKGROUND

This quantitative microbial risk assessment (QMRA) included problem formulation for fomites and hazard identification for 7 microorganisms, including pathogenic Escherichia coli and E coli 0157:H7, Listeria monocytogenes, norovirus, Pseudomonas spp, Salmonella spp, and Staphylococcus aureus. The goal was to address a risk-based process for choosing the log10 reduction recommendations, in contrast to the current US Environmental Protection Agency requirements.

METHOD

For each microbe evaluated, the QMRA model included specific dose-response models, occurrence determination of aerobic bacteria and specific organisms on fomites, exposure assessment, risk characterization, and risk reduction. Risk estimates were determined for a simple scenario using a single touch of a contaminated surface and self-inoculation. A comparative analysis of log10 reductions, as suggested by the US Environmental Protection Agency, and the risks based on this QMRA approach was also undertaken.

RESULTS

The literature review and meta-analysis showed that aerobic bacteria were the most commonly studied on fomites, averaging 100 colony-forming units (CFU)/cm(2). Pseudomonas aeruginosa was found at a level of 3.3 × 10(-1) CFU/cm(2); methicillin-resistant S aureus (MRSA), at 6.4 × 10(-1) CFU/cm(2). Risk estimates per contact event ranged from a high of 10(-3) for norovirus to a low of 10(-9) for S aureus.

CONCLUSION

This QMRA analysis suggests that a reduction in bacterial numbers on a fomite by 99% (2 logs) most often will reduce the risk of infection from a single contact to less than 1 in 1 million.

Evaluation of a disinfectant wipe intervention on fomite-to-finger microbial transfer

Inanimate surfaces, or fomites, can serve as routes of transmission of enteric and respiratory pathogens. No previous studies have evaluated the impact of surface disinfection on the level of pathogen transfer from fomites to fingers. Thus, the present study investigated the change in microbial transfer from contaminated fomites to fingers following disinfecting wipe use. Escherichia coli (10(8) to 10(9) CFU/ml), Staphylococcus aureus (10(9) CFU/ml), Bacillus thuringiensis spores (10(7) to 10(8) CFU/ml), and poliovirus 1 (10(8) PFU/ml) were seeded on ceramic tile, laminate, and granite in 10-μl drops and allowed to dry for 30 min at a relative humidity of 15 to 32%. The seeded fomites were treated with a disinfectant wipe and allowed to dry for an additional 10 min. Fomite-to-finger transfer trials were conducted to measure concentrations of transferred microorganisms on the fingers after the disinfectant wipe intervention. The mean log10 reduction of the test microorganisms on fomites by the disinfectant wipe treatment varied from 1.9 to 5.0, depending on the microorganism and the fomite. Microbial transfer from disinfectant-wipe-treated fomites was lower (up to <0.1% on average) than from nontreated surfaces (up to 36.3% on average, reported in our previous study) for all types of microorganisms and fomites. This is the first study quantifying microbial transfer from contaminated fomites to fingers after the use of disinfectant wipe intervention. The data generated in the present study can be used in quantitative microbial risk assessment models to predict the effect of disinfectant wipes in reducing microbial exposure.

Effects of knowledge and internal locus of control in groups of health care workers judging likelihood of pathogen transfer

OBJECTIVE

A study was conducted to measure the effects of attitudes and beliefs on the risk judgments of health care workers.

BACKGROUND

Lack of hand hygiene compliance is a worldwide issue in health care, contributing to infections, fatalities, and increased health care costs. Human factors methods are a promising solution to the problem of compliance, although thus far, the concentration has been on process and engineering methods, such as the design of no-touch sinks. Factors internal to the health care worker, such as their attitudes and beliefs about hand hygiene, have received less attention.

METHOD

For this study, three groups of health care workers completed measures of attitudes, control beliefs, and hand hygiene knowledge. They then provided risk judgments of touching various surfaces via a factorial survey.

RESULTS

Attitudes, knowledge, control beliefs, and surface type all predicted the risk judgments of the sample of health care workers, with differences between professional groups.

CONCLUSION

Health care workers perceive less risk when touching surfaces,which may explain historically low rates of hand hygiene compliance after surface contact.

APPLICATION

Although more research is needed to directly connect risk judgments to failures of hand hygiene, the current results can inform interventions targeting the internal attitudes and beliefs of health care workers.

Bacterial communities on food court tables and cleaning equipment in a shopping mall

The food court at a shopping mall is a potential transfer point for pathogenic microbes, but to date, this environment has not been the subject of detailed molecular microbiological study. We used a combination of culture-based and culture-independent approaches to investigate the types and numbers of bacteria present on food court tables, and on a food court cleaning cloth. Bacteria were found at 10²-10⁵ c.f.u./m² on food court tables and 10¹⁰ c.f.u./m² on the cleaning cloth. Tag-pyrosequencing of amplified 16S rRNA genes revealed that the dominant bacterial types on the cleaning cloth were genera known to include pathogenic species (Stenotrophomonas, Aeromonas), and that these genera were also evident at lower levels on table surfaces, suggesting possible cross-contamination. The evidence suggests a public health threat is posed by bacteria in the food court, and that this may be due to cross-contamination between cleaning equipment and table surfaces.

Transfer efficiency of bacteria and viruses from porous and nonporous fomites to fingers under different relative humidity conditions

Fomites can serve as routes of transmission for both enteric and respiratory pathogens. The present study examined the effect of low and high relative humidity on fomite-to-finger transfer efficiency of five model organisms from several common inanimate surfaces (fomites). Nine fomites representing porous and nonporous surfaces of different compositions were studied. Escherichia coli, Staphylococcus aureus, Bacillus thuringiensis, MS2 coliphage, and poliovirus 1 were placed on fomites in 10-μl drops and allowed to dry for 30 min under low (15% to 32%) or high (40% to 65%) relative humidity. Fomite-to-finger transfers were performed using 1.0 kg/cm(2) of pressure for 10 s. Transfer efficiencies were greater under high relative humidity for both porous and nonporous surfaces. Most organisms on average had greater transfer efficiencies under high relative humidity than under low relative humidity. Nonporous surfaces had a greater transfer efficiency (up to 57%) than porous surfaces (<6.8%) under low relative humidity, as well as under high relative humidity (nonporous, up to 79.5%; porous, <13.4%). Transfer efficiency also varied with fomite material and organism type. The data generated can be used in quantitative microbial risk assessment models to assess the risk of infection from fomite-transmitted human pathogens and the relative levels of exposure to different types of fomites and microorganisms.

Characteristics of antibiotic resistance of airborne Staphylococcus isolated from metro stations

This study focused on the presence of antibiotic-resistant bacteria in a metro system as an example of a public transportation system. The molecular characteristics of Staphylococcus were investigated to discern which strains were isolated from metro stations in Shanghai. These were compared with strains isolated from hospital treatment rooms and parks. Airborne Staphylococcus samples in the metro were resistant to an average of 2.64 antibiotic types, and 58.0% of the strain samples were resistant to at least three antibiotics; this was a significantly higher rate than strains from the park, but was lower than those from hospitals. The presence of two antibiotic resistance genes of Staphylococcus strains, mecA (28.0%) and qac (40.0%), were also found at significantly higher levels in metro samples than park samples, but did not differ significantly from hospital samples. Furthermore, 22.0% of the metro Staphylococcus samples were found to be biofilm-positive. The high rate of antibiotic resistance found in Staphylococcus samples collected from metro stations, and the discovery of antibiotic-resistant genes, indicate that the closed indoor environment and crowded passengers may accelerate the spread of antibiotic resistant strains. More attention should be paid to the inspection and control of antibiotic resistant strains in public transportation systems.

Bacterial contamination on household toys and association with water, sanitation and hygiene conditions in Honduras

There is growing evidence that household water treatment interventions improve microbiological water quality and reduce diarrheal disease risk. Few studies have examined, however, the impact of water treatment interventions on household-level hygiene and sanitation. This study examined the association of four water and sanitation conditions (access to latrines, improved sanitation, improved water and the plastic biosand filter) on the levels of total coliforms and E. coli on existing and introduced toys during an on-going randomized controlled trial of the plastic biosand filter (plastic BSF). The following conditions were associated with decreased bacterial contamination on children’s toys: access to a latrine, access to improved sanitation and access to the plastic BSF. Overall, compared to existing toys, introduced toys had significantly lower levels of both E. coli and total coliforms. Results suggest that levels of fecal indicator bacteria contamination on children’s toys may be associated with access to improved water and sanitation conditions in the home. In addition, the fecal indicator bacteria levels on toys probably vary with duration in the household. Additional information on how these toys become contaminated is needed to determine the usefulness of toys as indicators or sentinels of water, sanitation and hygiene conditions, behaviors and risks.

Workplace hand hygiene and wellness: a survey of knowledge, beliefs, and practices

Community hand hygiene interventions have reduced the spread of infectious disease in elementary schools, daycare centers, and private homes. Despite this success, and the potential for reducing workplace absenteeism and presenteeism, few peer-reviewed hand hygiene intervention studies among workers have been published. This research used the Theory of Planned Behavior (TPB) to guide the development of a model to understand and predict motivations for performing hand hygiene, and to examine related illness, absenteeism, and presenteeism among employees from 39 bank branches in Ohio. Although the TPB has been used extensively to elucidate hand hygiene practices among employees in the health care and food industries, little is known about the ability of the TPB to predict hand hygiene practices among workers in public settings. These survey findings indicate a need for hand hygiene improvement, and support the use of attitudinal beliefs and social norms to guide multimodal approaches for workplace hand hygiene interventions.

Role of environmental persistence in pathogen transmission: a mathematical modeling approach

Although diseases such as influenza, tuberculosis and SARS are transmitted through an environmentally mediated mechanism, most modeling work on these topics is based on the concepts of infectious contact and direct transmission. In this paper we use a paradigm model to show that environmental transmission appears like direct transmission in the case where the pathogen persists little time in the environment. Furthermore, we formulate conditions for the validity of this modeling approximation and we illustrate them numerically for the cases of cholera and influenza. According to our results based on recently published parameter estimates, the direct transmission approximation fails for both cholera and influenza. While environmental transmission is typically chosen over direct transmission in modeling cholera, this is not the case for influenza.

A diversity of Antibiotic-resistant Staphylococcus spp. in a Public Transportation System

OBJECTIVES

Our goal was to determine the diversity and abundance of Staphylococcus bacteria on different components of a public transportation system in a mid-sized US city (Portland, Oregon) and to examine the level of drug resistance in these bacteria.

METHODS

We collected 70 samples from 2 cm × 4 cm sections from seven different areas on buses and trains in Portland, USA, taking 10 samples from each area. We isolated a subset of 14 suspected Staphylococcus spp. colonies based on phenotype, and constructed a phylogeny from16S rRNA sequences to assist in identification. We used the Kirbye-Bauer disk diffusion method to determine resistance levels to six common antibiotics.

RESULTS

We found a range of pathogenic Staphylococcus species. The mean bacterial colony counts were 97.1 on bus and train floors, 80.1 in cloth seats, 9.5 on handrails, 8.6 on seats and armrests at bus stops, 3.8 on the underside of seats, 2.2 on windows, and 1.8 on vinyl seats per 8 cm(2) sample area. These differences were significant (p < 0.001). Of the 14 isolates sequenced, 11 were staphylococci, and of these, five were resistant to penicillin and ampicillin, while only two displayed intermediate resistance to bacitracin. All 11 isolates were sensitive to trimethoprim-sulfamethoxazole, vancomycin, and tetracycline.

CONCLUSIONS

We found six different strains of Staphylococcus, and while there were varying levels of drug resistance, we did not find extensive levels of multidrug-resistant bacteria, and no S. aureus was found. We found floors and cloth seats to be areas on buses and trains that showed particularly high levels of bacteria.

Individual differences in judgments of hand hygiene risk by health care workers

BACKGROUND

The hand hygiene practices of health care workers (HCWs) have long been the main vector for nosocomial infection in hospitals. The purpose of this study was to examine influences on risk judgment from the individual differences in knowledge levels and health beliefs among US HCWs.

METHODS

Knowledge levels were assessed by questions taken from published questionnaires. The health locus of control scale was used to characterize internal health beliefs. HCWs assessed the risks of pathogen transfer in situations that varied according to the surface touched and the person doing the touching.

RESULTS

HCWs reported lower risk assessments for touching surfaces compared with touching skin. Risk assessment was influenced by individual differences, including in knowledge level and internal health locus of control.

CONCLUSION

Our data describe the individual differences of HCWs related to hand hygiene in ways that can be used to create targeted interventions and products to improve hand hygiene.

Toward a “Smart” Nightstand Prototype: An Examination of Nightstand Table Contents and Preferences

Objective:

Two studies were conducted to obtain an understanding of the types of items seniors keep in their nightstands and to understand how users feel about the possibility of “smart” furniture.

Background:

To enable aging in place and universal design, it is vital to understand the needs of a broad range of aging individuals, especially since there is little research on nightstand usage and design.

Methods:

Study 1 allowed for the development of a structured inventory of nightstand use today in assisted living and rehabilitation facilities. Study 1 led to Study 2, demonstrating the need to conceptualize new ideas for smart nightstands. Feedback was obtained from intergenerational participants who could discuss their needs and preferences for a smart nightstand.

Results:

In Study 1, more than 150 items were recorded and categorized into 25 different groups. The authors found that participants utilized the top portion of their nightstand as opposed to the lower sections; most items were found on top of the nightstand or in the top drawer. In Study 2, the authors found that the vast majority of participants are willing to consider the use of a smart nightstand. Participants discussed key functions and design preferences, which included carefully designed storage, the ability to move the nightstand up and down, contemporary design, and interaction through voice activation.

Conclusion:

Existing nightstands do not meet the needs of current users. This research provides greater understanding of the existing limitations associated with nightstands. Study 2 confirmed that user-centered design and the use of technology can be used to enhance daily living. Smart furniture may play a role in promoting the health and independence of diverse user groups.

Microbial contamination in kitchens and bathrooms of rural Cambodian village households

AIMS

To quantify microbial contamination on kitchen and bathroom surfaces (fomites) in rural Cambodian homes and to compare these concentrations to similar data from the United States and Japan.

METHODS AND RESULTS

This study monitored the numbers of faecal coliforms (i.e. thermotolerant coliforms), total coliforms, Escherichia coli and heterotrophic plate count bacteria on household surfaces in a rural village of Cambodia. Faecal coliform levels in Cambodia were highest on moist locations such as the plastic ladle used for sink water, the toilet seat surface and the cutting board surface with 100-fold higher levels of faecal coliform bacteria than E. coli and 100-fold higher levels of faecal coliforms than the US and Japanese studies.

CONCLUSIONS

A single public health intervention barrier, such as an improved latrine, is only partially effective for household sanitation. For complete sanitation, multiple environmental barriers may be necessary. These barriers occur in a house constructed with easily washable surfaces, a chlorinated water distribution system, house climate control and cleaning product availability.

SIGNIFICANCE AND IMPACT OF THE STUDY

Results of this study can be used to emphasize the importance of increasing household environmental sanitation barriers.

Disinfection alternatives for contact surfaces and toys at child care centers

Child care surfaces are vehicles for disease-causing organisms. Disinfectant procedures prevent microbial dispersion. This study reports the effectiveness of CITRUS Farm Edition® (CFE), Clorox® GreenWorks™ (CGW) and Clorox® Anywhere® (CA) against Salmonella Typhimurium and Staphylococcus aureus inoculated (1 ml of 9Log(10) CFU/ml) on a high chair and ball toy. Disinfectants were sprayed and bacteria recovered from surfaces by sponge method. Exposing an inoculated high chair to CA resulted in the highest reduction of S. aureus (3.92 Log(10)) and S. Typhimurium (3.22 Log(10)). CGW reduced S. aureus and S. Typhimurium by 2.84 and 2.12 Log(10) from the inoculated high chair, while the inoculated ball toy showed a 2.50 and 1.80 Log(10) reduction, respectively. CFE showed the lowest reduction with 1.42 and 1.53 Log(10) of S. aureus and S. Typhimurium from the inoculated ball toy. CA was the best disinfectant no matter which bacteria or surface was analyzed. Emphasis on the effectiveness of disinfectant products is needed to be included in child care center infection control programs.