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Boyce JM. Hand and environmental hygiene: respective roles for MRSA, multi-resistant gram negatives, Clostridioides difficile, and Candida spp. Antimicrob Resist Infect Control 2024; 13:110. [PMID: 39334403 PMCID: PMC11437781 DOI: 10.1186/s13756-024-01461-x] [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: 06/27/2024] [Accepted: 09/04/2024] [Indexed: 09/30/2024] Open
Abstract
Healthcare-associated infections (HAIs) caused by multidrug-resistant organisms (MDROs) represent a global threat to human health and well-being. Because transmission of MDROs to patients often occurs via transiently contaminated hands of healthcare personnel (HCP), hand hygiene is considered the most important measure for preventing HAIs. Environmental surfaces contaminated with MDROs from colonized or infected patients represent an important source of HCP hand contamination and contribute to transmission of pathogens. Accordingly, facilities are encouraged to adopt and implement recommendations included in the World Health Organization hand hygiene guidelines and those from the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America/Association for Professionals in Infection Control and Epidemiology. Alcohol-based hand rubs are efficacious against MDROs with the exception of Clostridiodes difficile, for which soap and water handwashing is indicated. Monitoring hand hygiene adherence and providing HCP with feedback are of paramount importance. Environmental hygiene measures to curtail MDROs include disinfecting high-touch surfaces in rooms of patients with C. difficile infection daily with a sporicidal agent such as sodium hypochlorite. Some experts recommend also using a sporicidal agent in rooms of patients colonized with C. difficile, and for patients with multidrug-resistant Gram-negative bacteria. Sodium hypochlorite, hydrogen peroxide, or peracetic acid solutions are often used for daily and/or terminal disinfection of rooms housing patients with Candida auris or other MDROs. Products containing only a quaternary ammonium agent are not as effective as other agents against C. auris. Portable medical equipment should be cleaned and disinfected between use on different patients. Detergents are not recommended for cleaning high-touch surfaces in MDRO patient rooms, unless their use is followed by using a disinfectant. Facilities should consider using a disinfectant instead of detergents for terminal cleaning of floors in MDRO patient rooms. Education and training of environmental services employees is essential in assuring effective disinfection practices. Monitoring disinfection practices and providing personnel with performance feedback using fluorescent markers, adenosine triphosphate assays, or less commonly cultures of surfaces, can help reduce MDRO transmission. No-touch disinfection methods such as electrostatic spraying, hydrogen peroxide vapor, or ultraviolet light devices should be considered for terminal disinfection of MDRO patient rooms. Bundles with additional measures are usually necessary to reduce MDRO transmission.
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Affiliation(s)
- John M Boyce
- J.M. Boyce Consulting, LLC, 214 Hudson View Terrace, Hyde Park, NY, USA.
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Koff MD, Dexter F, Hwang SM, Wanta BT, Charnin JE, Loftus RW. Frequently Touched Sites in the Intensive Care Unit Environment Returning 100 Colony-Forming Units per Surface Area Sampled Are Associated With Increased Risk of Major Bacterial Pathogen Detection. Cureus 2024; 16:e68317. [PMID: 39350803 PMCID: PMC11441786 DOI: 10.7759/cureus.68317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND A threshold for surface hygiene has not been defined for the healthcare arena. We aimed to identify the magnitude of bacterial contamination of frequently touched sites in the intensive care unit (ICU) environment that could be used to guide quality improvement initiatives. METHODS Nineteen patients in a mixed ICU environment (providing care for medical and surgical patients) were followed from admission for 72 hours in 2010. Baseline cultures of frequently touched environmental sites were obtained at time zero following active decontamination and at 12, 24, 48, and 72 hours without further disinfection. We tested for an association of environmental reservoirs returning ≥ 100 colony-forming units (CFU) per surface area sampled with major bacterial pathogen detection. RESULTS There were 446 ICU room, day, and reservoir combinations sampled from 19 patients. There were pathogens detected in 40% (79/199) of samples with ≥ 100 CFU vs. 14% (35/247) of samples returning < 100 CFU. The relative risk was 2.80 (95% CI: 1.97-3.98, P <0.0001). The odds ratio adjusted for time in hours was 3.11 (95% CI: 1.84-5.34, P < 0.0001). CONCLUSIONS Frequently touched ICU environmental sites returning ≥ 100 CFU are associated with major bacterial pathogen detection. This threshold for surface hygiene can be used to ensure compliance with ICU environmental cleaning protocols and to guide quality improvement initiatives.
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Affiliation(s)
- Matthew D Koff
- Anesthesiology, Dartmouth Hitchcock Medical Center, Lebanon, USA
| | | | - Soyun M Hwang
- Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, USA
| | - Brendan T Wanta
- Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, USA
| | | | - Randy W Loftus
- Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, USA
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Verhougstraete M, Cooksey E, Walker JP, Wilson AM, Lewis MS, Yoder A, Elizondo-Craig G, Almoslem M, Forysiak E, Weir MH. Impact of terminal cleaning in rooms previously occupied by patients with healthcare-associated infections. PLoS One 2024; 19:e0305083. [PMID: 38985740 PMCID: PMC11236128 DOI: 10.1371/journal.pone.0305083] [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: 09/18/2023] [Accepted: 05/23/2024] [Indexed: 07/12/2024] Open
Abstract
Healthcare associated infections (HAIs) are costly but preventable. A limited understanding of the effects of environmental cleaning on the riskiest HAI associated pathogens is a current challenge in HAI prevention. This project aimed to quantify the effects of terminal hospital cleaning practices on HAI pathogens via environmental sampling in three hospitals located throughout the United States. Surfaces were swabbed from 36 occupied patient rooms with a laboratory-confirmed, hospital- or community-acquired infection of at least one of the four pathogens of interest (i.e., Acinetobacter baumannii (A. baumannii), methicillin resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus faecalis/faecium (VRE), and Clostridioides difficile (C. difficile)). Six nonporous, high touch surfaces (i.e., chair handrail, bed handrail, nurse call button, desk surface, bathroom counter near the sink, and a grab bar near the toilet) were sampled in each room for Adenosine Triphosphate (ATP) and the four pathogens of interest before and after terminal cleaning. The four pathogens of interest were detected on surfaces before and after terminal cleaning, but their levels were generally reduced. Overall, C. difficile was confirmed on the desk (n = 2), while MRSA (n = 24) and VRE (n = 25) were confirmed on all surface types before terminal cleaning. After cleaning, only MRSA (n = 6) on bed handrail, chair handrail, and nurse call button and VRE (n = 5) on bathroom sink, bed handrail, nurse call button, toilet grab bar, and C. difficile (n = 1) were confirmed. At 2 of the 3 hospitals, pathogens were generally reduced by >99% during terminal cleaning. One hospital showed that VRE increased after terminal cleaning, MRSA was reduced by 73% on the nurse call button, and VRE was reduced by only 50% on the bathroom sink. ATP detections did not correlate with any pathogen concentration. This study highlights the importance of terminal cleaning and indicates room for improvement in cleaning practices to reduce surface contamination throughout hospital rooms.
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Affiliation(s)
- Marc Verhougstraete
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona United States of America
| | - Emily Cooksey
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona United States of America
| | - Jennifer-Pearce Walker
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona United States of America
| | - Amanda M Wilson
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona United States of America
| | - Madeline S Lewis
- Sustainability Institute, The Ohio State University, Columbus, Ohio, United States of America
| | - Aaron Yoder
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona United States of America
| | - Gabriela Elizondo-Craig
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona United States of America
| | - Munthir Almoslem
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona United States of America
| | - Emily Forysiak
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona United States of America
| | - Mark H Weir
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona United States of America
- Sustainability Institute, The Ohio State University, Columbus, Ohio, United States of America
- College of Public Health, The Ohio State University, Columbus, Ohio, United States of America
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4
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Frantzis I, Levasseur S, Huebner J, Mahida M, Larussa P, James W, Abebe W, Ngwenya C, Mupere E, Rosenthal SL, Patterson J, Johnson J, Strehlau R, Lulseged S, Stanberry LR, Saiman L. Infection prevention and control and related practices in African neonatal units: The Pan-African neonatal care assessment study (PANCAS). Int J Hyg Environ Health 2024; 259:114357. [PMID: 38564877 PMCID: PMC11163474 DOI: 10.1016/j.ijheh.2024.114357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND The burden of neonatal mortality is primarily borne by low- and middle-income countries (LMICs), including deaths due to healthcare-associated infections (HAIs). Few studies have assessed infection prevention and control (IP&C) practices in African units caring for small and/or sick newborns aimed to reduce HAIs. METHODS We performed a mixed-methods study composed of a survey and virtual tour to assess IP&C and related practices. We created a survey composed of multiple-choice and open-ended questions delivered to site respondents via Zoom or video equivalent. Respondents provided a virtual tour of their unit via video and the study team used a checklist to evaluate specific practices. RESULTS We recruited 45 units caring for small and sick newborns in 20 African countries. Opportunities to optimize hand hygiene, Water, Sanitation and Hygiene (WASH) practices, Kangaroo Mother Care, and IP&C training were noted. The virtual tour offered further understanding of IP&C challenges unique to individual sites. All respondents expressed the need for additional space, equipment, supplies, education, and IP&C staff and emphasized that attention to maternal comfort was important to IP&C success. DISCUSSION This study identified opportunities to improve IP&C practices using low-cost measures including further education and peer support through learning collaboratives. Virtual tours can be used to provide site-specific assessment and feedback from peers, IP&C specialists and environmental engineering experts.
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Affiliation(s)
- Irene Frantzis
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA.
| | - Stéphanie Levasseur
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Jack Huebner
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Maitry Mahida
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Philip Larussa
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Wilmot James
- Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, USA
| | - Workeabeba Abebe
- Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia
| | - Crispen Ngwenya
- Paediatrics department at Midlands State University faculty of Medicine, Gweru, Zimbabwe
| | - Ezekiel Mupere
- Department of Paediatrics and Child Health School of Medicine College of Health Sciences, Makerere University, Kampala, Uganda
| | - Susan L Rosenthal
- Departments of Pediatrics and Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Janna Patterson
- Global Child Health and Life Support, American Academia of Pediatrics, Itasca, IL, USA
| | - Julia Johnson
- Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Renate Strehlau
- VIDA Nkanyezi Research Unit, Department of Paediatrics and Child Health, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sileshi Lulseged
- Department of Pediatrics and Child Health, College of Health Sciences, Addis Abbaba, Ethiopia
| | - Lawrence R Stanberry
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Lisa Saiman
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA; Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York, NY, USA
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Hygiene requirements for cleaning and disinfection of surfaces: recommendation of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute. GMS HYGIENE AND INFECTION CONTROL 2024; 19:Doc13. [PMID: 38655122 PMCID: PMC11035912 DOI: 10.3205/dgkh000468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
This recommendation of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) addresses not only hospitals, but also outpatient health care facilities and compiles current evidence. The following criteria are the basis for the indications for cleaning and disinfection: Infectious bioburden and tenacity of potential pathogens on surfaces and their transmission routes, influence of disinfecting surface cleaning on the rate of nosocomial infections, interruption of cross infections due to multidrug-resistant organisms, and outbreak control by disinfecting cleaning within bundles. The criteria for the selection of disinfectants are determined by the requirements for effectiveness, the efficacy spectrum, the compatibility for humans and the environment, as well as the risk potential for the development of tolerance and resistance. Detailed instructions on the organization and implementation of cleaning and disinfection measures, including structural and equipment requirements, serve as the basis for their implementation. Since the agents for surface disinfection and disinfecting surface cleaning have been classified as biocides in Europe since 2013, the regulatory consequences are explained. As possible addition to surface disinfection, probiotic cleaning, is pointed out. In an informative appendix (only in German), the pathogen characteristics for their acquisition of surfaces, such as tenacity, infectious dose and biofilm formation, and the toxicological and ecotoxicological characteristics of microbicidal agents as the basis for their selection are explained, and methods for the evaluation of the resulting quality of cleaning or disinfecting surface cleaning are presented.
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Ozen N, Sis Celik A, Terzioglu F, Ozen V, Ozmen O, Kose S, Tosun B, Dogan N, Ardic B, Atabeyoglu Cimen B, Kilic D, Uslu H. Prevention of microbial colonization of feeding tubes in the intensive care unit. Nurs Crit Care 2023; 28:1087-1096. [PMID: 35702975 DOI: 10.1111/nicc.12812] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 05/16/2022] [Accepted: 05/22/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Various microorganisms which increase the mortality rate in the intensive care unit (ICU) cause microbial colonization of the nasogastric tube (NGT) and use the NGT as a reservoir. AIM To detect the colonization on the NGT and to determine the effect that training regarding hand hygiene, NGT management, and enteral feeding (EF) provided to ICU nurses and auxiliary service staff (ASS) has on the level of NGT colonization. STUDY DESIGN A quasi-experimental pre-test and post-test control design was used in this study. Microbial samples were taken from the outer and inner parts of NGT. The microorganisms were categorized as: group 1, no risk; group 2, low risk pathogenic; group 3, high-risk pathogenic group. The training was given to nurses (n = 15) and ASS (n = 7). Hand hygiene, NGT, and EF care training are provided to nurses and ASS by researchers. A total of three training sessions were scheduled to be held in 3 weeks so that all health care staff members were trained. Each session lasted 2 h in total. Patients were assigned to a group if one of the microorganisms presented on the outer surface of the patient's feeding tube and/or on the hub. The hand hygiene compliance was evaluated by direct observation according to the World Health Organization hand hygiene indications. RESULTS The study was conducted with 46 patients. Evaluating the patients for the presence of microorganisms before education revealed that 4.3% were in group 1, 21.8% were in group 2, and 73.9% were in group 3. After the education, evaluating the samples for the presence of microorganisms revealed that 39.1% were in group 1, 13% were in group 2, and 47.8% were in group 3. A statistically significant difference was found between the number of samples included in the groups after the participants had received training (H = 8.186; p = .017). CONCLUSIONS An NGT could act as a reservoir of microbial colonization and high-risk microorganisms could be on the tube. Providing training not only to nurses but also to ASS will help reduce the risk of colonization. RELEVANCE TO CLINICAL PRACTICE Eliminating such colonization with effective hand hygiene during NGT feeding is a cost-effective method. Providing training not only to nurses but also to ASS will help obtain the optimum benefit from patient care.
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Affiliation(s)
- Nurten Ozen
- Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University, Istanbul, Turkey
| | - Aslı Sis Celik
- Department of Birth, Women Health and Gynecology Nursing, Nursing Faculty, Ataturk University, Erzurum, Turkey
| | | | - Volkan Ozen
- Department of Anesthesiology and Reanimation, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Ozgur Ozmen
- Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey
| | - Sema Kose
- Department of Nursing, Faculty of Health Sciences, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Betul Tosun
- Department of Nursing, Faculty of Health Sciences, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Nazim Dogan
- Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey
| | - Busra Ardic
- Department of Medical Biology and Microbiology, Kackar City Hospital, Rize, Turkey
| | | | - Dilek Kilic
- Department of Public Health Nursing, Nursing Faculty, Ataturk University, Erzurum, Turkey
| | - Hakan Uslu
- Department of Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
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Cui J, Cho S, Kamruzzaman M, Bielskas M, Vullikanti A, Prakash BA. Using spectral characterization to identify healthcare-associated infection (HAI) patients for clinical contact precaution. Sci Rep 2023; 13:16197. [PMID: 37758756 PMCID: PMC10533902 DOI: 10.1038/s41598-023-41852-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
Healthcare-associated infections (HAIs) are a major problem in hospital infection control. Although HAIs can be suppressed using contact precautions, such precautions are expensive, and we can only apply them to a small fraction of patients (i.e., a limited budget). In this work, we focus on two clinical problems arising from the limited budget: (a) choosing the best patients to be placed under precaution given a limited budget to minimize the spread (the isolation problem), and (b) choosing the best patients to release when limited budget requires some of the patients to be cleared from precaution (the clearance problem). A critical challenge in addressing them is that HAIs have multiple transmission pathways such that locations can also accumulate 'load' and spread the disease. One of the most common practices when placing patients under contact precautions is the regular clearance of pathogen loads. However, standard propagation models like independent cascade (IC)/susceptible-infectious-susceptible (SIS) cannot capture such mechanisms directly. Hence to account for this challenge, using non-linear system theory, we develop a novel spectral characterization of a recently proposed pathogen load based model, 2-MODE-SIS model, on people/location networks to capture spread dynamics of HAIs. We formulate the two clinical problems using this spectral characterization and develop effective and efficient algorithms for them. Our experiments show that our methods outperform several natural structural and clinical approaches on real-world hospital testbeds and pick meaningful solutions.
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Affiliation(s)
- Jiaming Cui
- College of Computing, Georgia Institute of Technology, Atlanta, GA, 30332, USA.
| | - Sungjun Cho
- College of Computing, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Methun Kamruzzaman
- Biocomplexity Institute, University of Virginia, Charlottesville, VA, 22904, USA
| | - Matthew Bielskas
- Biocomplexity Institute, University of Virginia, Charlottesville, VA, 22904, USA
- Department of Computer Science, University of Virginia, Charlottesville, VA, 22904, USA
| | - Anil Vullikanti
- Biocomplexity Institute, University of Virginia, Charlottesville, VA, 22904, USA
- Department of Computer Science, University of Virginia, Charlottesville, VA, 22904, USA
| | - B Aditya Prakash
- College of Computing, Georgia Institute of Technology, Atlanta, GA, 30332, USA.
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Resendiz M, Blanchard D, West GF. A systematic review of the germicidal effectiveness of ultraviolet disinfection across high-touch surfaces in the immediate patient environment. J Infect Prev 2023; 24:166-177. [PMID: 37333872 PMCID: PMC10273798 DOI: 10.1177/17571774231159388] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
Background There is not yet a consensus regarding the in-use effectiveness of ultraviolet irradiation (UV-C) as a supplementary tool for terminal room disinfection. Aims and Objectives To summarize and evaluate literature detailing the germicidal effectiveness of UV-C disinfection on high-touch surfaces in the patient environment. Methods A literature search was carried out utilizing PRISMA guidelines. Studies were included if intervention included UV-C after standard room disinfection in hospital rooms evaluated microbiologically by surface type. Findings/Results Twelve records met our criteria for inclusion. Studies predominantly focused on terminal disinfection of patient rooms, including five reports carried out in isolation rooms and three studies including operating room (OR) surfaces. Bedrails, remote controls, phones, tray tables, assist rails, floors, and toilets were the most commonly reported surfaces. Across study designs, surfaces, and room types, flat surfaces tended to showcase UV-C effectiveness best, particularly isolation room floors. In contrast, handheld surfaces (i.e., bed controls and assist bars) tended to show reduced efficacies (81-93%). In the OR, complex surfaces similarly demonstrated reduced UV-C effectiveness. Bathroom surfaces demonstrated 83% UV-C effectiveness overall, with surface characteristics uniquely impacted depending on the room type. Isolation room studies tended to include effectiveness comparison with standard treatment, reporting UV-C superiority most of the time. Discussion This review highlights the enhanced effectiveness of UV-C surface disinfection over standard protocols across various study designs and surfaces. However, surface and room characteristics do appear to play a role in the level of bacterial reduction.
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Affiliation(s)
- Marisol Resendiz
- Center for Nursing Science & Clinical Inquiry, Tripler Army Medical Center, Honolulu, HI, USA
| | - Dawn Blanchard
- Center for Nursing Science & Clinical Inquiry, Tripler Army Medical Center, Honolulu, HI, USA
| | - Gordon F West
- Center for Nursing Science & Clinical Inquiry, Madigan Army Medical Center, Tacoma, WA, USA
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Popovich KJ, Aureden K, Ham DC, Harris AD, Hessels AJ, Huang SS, Maragakis LL, Milstone AM, Moody J, Yokoe D, Calfee DP. SHEA/IDSA/APIC Practice Recommendation: Strategies to prevent methicillin-resistant Staphylococcus aureus transmission and infection in acute-care hospitals: 2022 Update. Infect Control Hosp Epidemiol 2023; 44:1039-1067. [PMID: 37381690 PMCID: PMC10369222 DOI: 10.1017/ice.2023.102] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 05/03/2023] [Indexed: 06/29/2023]
Abstract
Previously published guidelines have provided comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute-care hospitals in implementing and prioritizing efforts to prevent methicillin-resistant Staphylococcus aureus (MRSA) transmission and infection. This document updates the "Strategies to Prevent Methicillin-Resistant Staphylococcus aureus Transmission and Infection in Acute Care Hospitals" published in 2014.1 This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA). It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise.
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Affiliation(s)
- Kyle J. Popovich
- Department of Internal Medicine, RUSH Medical College, Chicago, Illinois
| | - Kathy Aureden
- Infection Prevention, Advocate Aurora Health, Downers Grove, Illinois
| | - D. Cal Ham
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anthony D. Harris
- Health Care Outcomes Research, University of Maryland School of Medicine, Baltimore, Maryland
| | - Amanda J. Hessels
- Columbia School of Nursing, New York, New York
- Hackensack Meridian Health, Edison, New Jersey
| | - Susan S. Huang
- Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California
| | - Lisa L. Maragakis
- Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Aaron M. Milstone
- Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Julia Moody
- Infection Prevention, HCA Healthcare, Nashville, Tennessee
| | - Deborah Yokoe
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California
- Transplant Infectious Diseases, UCSF Medical Center, San Francisco, California
| | - David P. Calfee
- Department of Medicine, Weill Cornell Medicine, New York, New York
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
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Anforderungen an die Hygiene bei der Reinigung und Desinfektion von Flächen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:1074-1115. [PMID: 36173419 PMCID: PMC9521013 DOI: 10.1007/s00103-022-03576-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Boucherabine S, Nassar R, Mohamed L, Olsen M, Alqutami F, Zaher S, Hachim M, Alkhajeh A, McKirdy S, Alghafri R, Tajouri L, Senok A. Healthcare Derived Smart Watches and Mobile Phones are Contaminated Niches to Multidrug Resistant and Highly Virulent Microbes. Infect Drug Resist 2022; 15:5289-5299. [PMID: 36106052 PMCID: PMC9464629 DOI: 10.2147/idr.s378524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/17/2022] [Indexed: 11/24/2022] Open
Abstract
Background As high touch wearable devices, the potential for microbial contamination of smart watches is high. In this study, microbial contamination of smart watches of healthcare workers (HCWs) was assessed and compared to the individual’s mobile phone and hands. Methods This study was part of a larger point prevalence survey of microbial contamination of mobile phones of HCWs at the emergency unit of a tertiary care facility. Swabs from smart watches, mobile phones and hands were obtained from four HCWs with dual ownership of these digital devices. Bacterial culture was carried out for all samples and those from smart watches and mobile phones were further assessed using shotgun metagenomic sequencing. Results Majority of the participants were females (n/N = 3/4; 75%). Although they all use their digital devices at work and believe that these devices could harbour microbes, cleaning in the preceding 24 hours was reported by one individual. Predominant organisms identified on bacterial culture were multidrug resistant Staphylococcus hominis and Staphylococcus epidermidis. At least one organism identified from the hands was also detected on all mobile phones and two smart watches. Shotgun metagenomics analysis demonstrated greater microbial number and diversity on mobile phones compared to smart watches. All devices had high signatures of Pseudomonas aeruginosa and associated bacteriophages and antibiotic resistance genes. Almost half of the antibiotic resistance genes (n/N = 35/75;46.6%) were present on all devices and majority were related to efflux pumps. Of the 201 virulence factor genes (VFG) identified, majority (n/N = 148/201;73%) were associated with P. aeruginosa with 96% (n/N = 142/148) present on smart watches and mobile phones. Conclusion This first report on microbial contamination of smart watches using metagenomics next generation sequencing showed similar pattern of contamination with microbes, VFG and antibiotic resistance genes across digital devices. Further studies on microbial contamination of wearable digital devices are urgently needed.
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Affiliation(s)
- Syrine Boucherabine
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Rania Nassar
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.,Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Lobna Mohamed
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Matthew Olsen
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - Fatma Alqutami
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Shroque Zaher
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Mahmood Hachim
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | | | - Simon McKirdy
- Harry Butler Institute, Murdoch University, Murdoch, WA, Australia
| | - Rashed Alghafri
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia.,Harry Butler Institute, Murdoch University, Murdoch, WA, Australia.,General Department of Forensic Sciences and Criminology, Dubai Police, Dubai, United Arab Emirates.,Dubai Police Scientists Council, Dubai, United Arab Emirates
| | - Lotti Tajouri
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia.,Harry Butler Institute, Murdoch University, Murdoch, WA, Australia.,Dubai Police Scientists Council, Dubai, United Arab Emirates
| | - Abiola Senok
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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12
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Yimer RM, Alemu MK. Bacterial Contamination Level of Indoor Air and Surface of Equipment in the Operation Room in Dil-Chora Referral Hospital, Dire Dawa, Eastern Ethiopia. Infect Drug Resist 2022; 15:5085-5097. [PMID: 36071817 PMCID: PMC9442909 DOI: 10.2147/idr.s380774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/20/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study investigated the bacterial contamination level of the indoor air and surface of the operation room, surgical, and gynecology wards of Dilchora Referral hospitals between January and August 2020. Methods A laboratory based cross-sectional study was carried out on the OR and wards of Dilchora referral hospital in Eastern Ethiopia. A passive air sampling method was used to collect 128 indoor air samples; the bacterial load was enumerated and the result was expressed as colony forming units (CFU/m3). Additional qualitative analysis was carried out to identify particular bacterial species that were isolated from the indoor air and swabs taken from the surface of the equipment using conventional techniques. All laboratory data were entered and analyzed using MS Excel 2007 and SPSS version 20. Results The mean bacterial counts of 94.63 CFU/dm/hr in major OR during active time as well as 509.75 and 509.38 CFU/dm/hr in male and female clothing rooms during the afternoon were unacceptable (>450 CFU/dm2). Similarly, 43.75% of the bacterial counts found in the afternoon samples fell short of Fisher's criterion. The difference between the bacterial counts recorded in the morning and afternoon was significant (p=0.000). A total of 54 (42.2%) indoor air samples and 28 (93.3%) cotton swabs were positive for bacterial growth, with S. aureus (51.04%) and Bacillus sp (55%) being the dominant bacteria isolated from indoor air and the surface of equipment, respectively. Conclusion The bacterial load of investigated wards is considerably "high" to "very high", which implies a significant risk of hospital acquired infections. Therefore, devising effective control strategies targeted on surface cleansing and sterilizing of the air environment and practicing periodic microbial surveillance of the hospital environment is a paramant.
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Affiliation(s)
- Robel Mekonnen Yimer
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Mesfin Kebede Alemu
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
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13
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Tembo GM, Chaggar GK, Li X, Teska PJ, Oliver HF. Evaluation of automated floor cleaning, disinfection, and application methods against Staphylococcus aureus. Am J Infect Control 2022; 51:380-387. [PMID: 35868460 DOI: 10.1016/j.ajic.2022.07.011] [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: 06/03/2022] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Optimization of automated floor disinfection practices using different application methods and product types is important to ensure that pathogens such as Staphylococcus aureus do not transfer from contaminated floors to other high contact areas resulting in healthcare-associated infections (HAIs). We hypothesized that there would be significant differences among disinfectants and a cleaner under different application methods. Also, performance of application methods would be dependent upon type of product used. METHODS We tested and compared efficacies of five EPA registered disinfectants and one cleaner using an automated Taski 455B floor cleaner against S. aureus ATCC 6538 on two meters of contaminated vinyl flooring using three application methods. RESULTS Hydrogen peroxide and quaternary ammonium compounds were more efficacious against S. aureus than the neutral cleaner. There were no significant differences among the sampling areas tested and application methods regardless of product type. Mean log10 densities recovered from different machine parts and wastewater collected were statistically higher for the cleaner than disinfectants. CONCLUSIONS All disinfectants had more bactericidal efficacy than the cleaner for all sampling zones on the tested floor. Overall, performance of the floor machine is dependent upon the type of product used.
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Affiliation(s)
- Geraldine M Tembo
- Department of Food Science, 745 Agriculture Mall Drive, Purdue University, West Lafayette, IN, 47907, USA
| | - Gurpreet K Chaggar
- Department of Food Science, 745 Agriculture Mall Drive, Purdue University, West Lafayette, IN, 47907, USA
| | - Xiaobao Li
- Diversey Inc., Charlotte, NC, 28273, USA
| | | | - Haley F Oliver
- Department of Food Science, 745 Agriculture Mall Drive, Purdue University, West Lafayette, IN, 47907, USA.
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14
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Al Banna MH, Khan MSI, Rezyona H, Seidu AA, Abid MT, Ara T, Kundu S, Ahinkorah BO, Hagan, Jr. JE, Tareq MA, Begum MR, Chowdhury MFT, Schack T. Assessment of Food Safety Knowledge, Attitudes and Practices of Food Service Staff in Bangladeshi Hospitals: A Cross-Sectional Study. Nutrients 2022; 14:nu14122540. [PMID: 35745271 PMCID: PMC9227153 DOI: 10.3390/nu14122540] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 12/04/2022] Open
Abstract
Food safety knowledge, attitudes and practices among hospital food service staff are crucial in the prevention of foodborne disease outbreaks, as hospitalized patients are more vulnerable to potential hazards. This study, therefore, sought to assess the food safety knowledge, attitudes and practices of food service staff in Bangladeshi hospitals. A cross-sectional study was conducted among 191 food service staff from seven different hospitals in Dhaka and Chattogram from October 2021 to March 2022 using pretested questionnaires. Multiple linear regression was used to identify the factors associated with the food safety knowledge, attitudes and practices. The findings showed moderate knowledge but high levels of attitudes and practices of food safety among hospital food handlers. Food safety knowledge was significantly higher among males, participants from private hospitals and participants working in a hospital that had a food service supervisor and dietitian in charge of food service operations. Moreover, participants from private hospitals and participants working in a hospital that had a food service supervisor and dietitian in charge of food service operations had more positive attitudes and better practices regarding food safety. Hospital management should consider these factors for enhancing food handlers’ knowledge and increase training and supervision on food safety practices to reduce foodborne diseases and outbreaks.
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Affiliation(s)
- Md. Hasan Al Banna
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali 8602, Bangladesh; (M.H.A.B.); (M.S.I.K.); (M.A.T.)
| | - Md Shafiqul Islam Khan
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali 8602, Bangladesh; (M.H.A.B.); (M.S.I.K.); (M.A.T.)
| | - Humayra Rezyona
- Department of Food and Nutrition, College of Home Economics, Azimpur, Dhaka 1205, Bangladesh; (H.R.); (T.A.)
| | - Abdul-Aziz Seidu
- Department of Real Estate Management, Takoradi Technical University, Takoradi P.O. Box 256, Ghana;
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi P.O. Box 256, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Australia
| | - Mohammad Tazrian Abid
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali 8602, Bangladesh; (M.T.A.); or (S.K.)
| | - Tasnu Ara
- Department of Food and Nutrition, College of Home Economics, Azimpur, Dhaka 1205, Bangladesh; (H.R.); (T.A.)
| | - Satyajit Kundu
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali 8602, Bangladesh; (M.T.A.); or (S.K.)
- School of Public Health, Southeast University, Nanjing 210009, China
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney 2007, Australia;
| | - John Elvis Hagan, Jr.
- Department of Health, Physical Education & Recreation, College of Education Studies, University of Cape Coast, Cape Coast PMB TF0494, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sports Science, Bielefeld University, Postfach 10 01 31, 33501 Bielefeld, Germany;
- Correspondence:
| | - Md. Abu Tareq
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali 8602, Bangladesh; (M.H.A.B.); (M.S.I.K.); (M.A.T.)
| | - Musammet Rasheda Begum
- Department of Agricultural Economics and Social Sciences, Chattogram Veterinary and Animal Sciences University, Chattogram 4225, Bangladesh;
| | | | - Thomas Schack
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sports Science, Bielefeld University, Postfach 10 01 31, 33501 Bielefeld, Germany;
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15
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Abstract
The recent COVID-19 pandemic requires long-term and real-life applicable antimicrobial skin protection. However, there has been no practical solution to prevent cross-infection while preserving intrinsic skin naturalness. Conventional blocking-based approaches such as gloves cannot preserve the skin sterility and modify the morphology, temperature change rate, and humidity affecting our sensation and comfort. Here, we propose a skin-attachable protection platform copper nanomesh, which prevents cross-infection while maintaining skin naturalness. Copper nanomesh composed of copper coating and interconnected polymer nanofibers kills 99.99% of bacteria and viruses within 1 and 10 min and prevents bacterial cross-infection. The thin and porous structure of the nanomesh enables natural skin-environment interaction in terms of the morphology, temperature change rate, and humidity compared to films or gloves. The functional support and advancement of our body while preserving inherent naturalness is one of the ultimate goals of bioengineering. Skin protection against infectious pathogens is an application that requires common and long-term wear without discomfort or distortion of the skin functions. However, no antimicrobial method has been introduced to prevent cross-infection while preserving intrinsic skin conditions. Here, we propose an antimicrobial skin protection platform copper nanomesh, which prevents cross-infectionmorphology, temperature change rate, and skin humidity. Copper nanomesh exhibited an inactivation rate of 99.99% for Escherichia coli bacteria and influenza virus A within 1 and 10 min, respectively. The thin and porous nanomesh allows for conformal coating on the fingertips, without significant interference with the rate of skin temperature change and humidity. Efficient cross-infection prevention and thermal transfer of copper nanomesh were demonstrated using direct on-hand experiments.
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16
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Methicillin-Resistant Staphylococcus aureus Contamination of Frequently Touched Objects in Intensive Care Units: Potential Threat of Nosocomial Infections. CANADIAN JOURNAL OF INFECTIOUS DISEASES AND MEDICAL MICROBIOLOGY 2022; 2022:1023241. [PMID: 35637744 PMCID: PMC9148222 DOI: 10.1155/2022/1023241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/05/2022] [Indexed: 11/17/2022]
Abstract
Background Bacterial contamination in intensive care units is an important risk factor associated with increasing incidences of nosocomial infections. This study was conducted to study the bacterial colonization on commonly touched objects of intensive care units and antibiotic resistance pattern of bacterial isolates. Methods This study was conducted in different intensive care units of Manipal Teaching Hospital, Pokhara, Nepal. A total of 235 swabs were collected from surfaces of bed rails, monitors, door handles, IV stands, telephone sets, nursing stations, medicine trolleys, sphygmomanometers, wash basin taps, dressing drums, stethoscopes, pulse oximeters, ventilators, defibrillators, and stretchers. Isolation, identification, and antibiotic susceptibility tests of the bacteria were performed following standard microbiological techniques. Results Of 235 samples, bacterial growth was observed in 152 samples. A total of 90 samples of Staphylococcus aureus were isolated from 235 samples. Most of the sampling sites included in this study were found contaminated with S. aureus. The highest number of S. aureus was cultured from the surface of bed rails. Of the total S. aureus isolates, 54.4% (49/90) were methicillin-resistant Staphylococcus aureus (MRSA). Vancomycin resistance was detected among 8.1% MRSA isolates (4/49). Acinetobacter species were the commonest Gram-negative bacterial isolate. Conclusion Bacterial contamination of the objects/instruments of the ICU was recorded to be high. The most common contaminating bacteria were S. aureus with a high percentage of MRSA and emergence of VRSA. Periodic microbiological surveillance, detection of contaminated sites, and effective decontamination methods would minimize the colonization by potential pathogens and their transmission.
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17
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Boucherabine S, Nassar R, Zaher S, Mohamed L, Olsen M, Alqutami F, Hachim M, Alkhaja A, Campos M, Jones P, McKirdy S, Alghafri R, Tajouri L, Senok A. Metagenomic Sequencing and Reverse Transcriptase PCR Reveal That Mobile Phones and Environmental Surfaces Are Reservoirs of Multidrug-Resistant Superbugs and SARS-CoV-2. Front Cell Infect Microbiol 2022; 12:806077. [PMID: 35372113 PMCID: PMC8964345 DOI: 10.3389/fcimb.2022.806077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/24/2022] [Indexed: 11/28/2022] Open
Abstract
Background Mobile phones of healthcare workers (HCWs) can act as fomites in the dissemination of microbes. This study was carried out to investigate microbial contamination of mobile phones of HCWs and environmental samples from the hospital unit using a combination of phenotypic and molecular methods. Methods This point prevalence survey was carried out at the Emergency unit of a tertiary care facility. The emergency unit has two zones, a general zone for non-COVID-19 patients and a dedicated COVID-19 zone for confirmed or suspected COVID-19 patients. Swabs were obtained from the mobile phones of HCWs in both zones for bacterial culture and shotgun metagenomic analysis. Metagenomic sequencing of pooled environmental swabs was conducted. RT-PCR for SARS-CoV-2 detection was carried out. Results Bacteria contamination on culture was detected from 33 (94.2%) mobile phones with a preponderance of Staphylococcus epidermidis (n/N = 18/35), Staphylococcus hominis (n/N = 13/35), and Staphylococcus haemolyticus (n/N = 7/35). Two methicillin-sensitive and three methicillin-resistant Staphylococcus aureus, and one pan-drug-resistant carbapenemase producer Acinetobacter baumannii were detected. Shotgun metagenomic analysis showed high signature of Pseudomonas aeruginosa in mobile phone and environmental samples with preponderance of P. aeruginosa bacteriophages. Malassezia and Aspergillus spp. were the predominant fungi detected. Fourteen mobile phones and one environmental sample harbored protists. P. aeruginosa antimicrobial resistance genes mostly encoding for efflux pump systems were detected. The P. aeruginosa virulent factor genes detected were related to motility, adherence, aggregation, and biofilms. One mobile phone from the COVID-19 zone (n/N = 1/5; 20%) had positive SARS-CoV-2 detection while all other phone and environmental samples were negative. Conclusion The findings demonstrate that mobile phones of HCWs are fomites for potentially pathogenic and highly drug-resistant microbes. The presence of these microbes on the mobile phones and hospital environmental surfaces is a concern as it poses a risk of pathogen transfer to patients and dissemination into the community.
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Affiliation(s)
- Syrine Boucherabine
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Rania Nassar
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.,Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Shroque Zaher
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Lobna Mohamed
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Matthew Olsen
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - Fatma Alqutami
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Mahmood Hachim
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Abdulmajeed Alkhaja
- Medical Education & Research Department, Dubai Health Authority, Dubai, United Arab Emirates
| | - Mariana Campos
- CSIRO Land and Water, CSIRO Health and Biosecurity, Floreat, WA, Australia
| | - Peter Jones
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - Simon McKirdy
- Harry Butler Institute, Murdoch University, Murdoch, WA, Australia
| | - Rashed Alghafri
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia.,Harry Butler Institute, Murdoch University, Murdoch, WA, Australia.,General Department of Forensic Sciences and Criminology, Dubai Police, Dubai, United Arab Emirates.,Dubai Future Council on Community Security and Dubai Police Scientists Council, Duba, United Arab Emirates
| | - Lotti Tajouri
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia.,General Department of Forensic Sciences and Criminology, Dubai Police, Dubai, United Arab Emirates.,Dubai Future Council on Community Security and Dubai Police Scientists Council, Duba, United Arab Emirates
| | - Abiola Senok
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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18
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Hosseini M, Chin AWH, Williams MD, Behzadinasab S, Falkinham JO, Poon LLM, Ducker WA. Transparent Anti-SARS-CoV-2 and Antibacterial Silver Oxide Coatings. ACS APPLIED MATERIALS & INTERFACES 2022; 14:8718-8727. [PMID: 35138100 PMCID: PMC8848512 DOI: 10.1021/acsami.1c20872] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/14/2022] [Indexed: 05/17/2023]
Abstract
Transparent antimicrobial coatings can maintain the aesthetic appeal of surfaces and the functionality of a touch-screen while adding the benefit of reducing disease transmission. We fabricated an antimicrobial coating of silver oxide particles in a silicate matrix on glass. The matrix was grown by a modified Stöber sol-gel process with vapor-phase water and ammonia. A coating on glass with 2.4 mg of Ag2O per mm2 caused a reduction of 99.3% of SARS-CoV-2 and >99.5% of Pseudomonas aeruginosa, Staphylococcus aureus, and methicillin-resistant Staphylococcus aureus compared to the uncoated glass after 1 h. We envisage that screen protectors with transparent antimicrobial coatings will find particular application to communal touch-screens, such as in supermarkets and other check-out or check-in facilities where a number of individuals utilize the same touch-screen in a short interval.
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Affiliation(s)
- Mohsen Hosseini
- Dept. of Chemical Engineering and Center for Soft Matter and Biological Physics, Virginia Tech, Blacksburg, Virginia, 24061, USA
| | - Alex W. H. Chin
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
- Centre for Immunity and Infection, Hong Kong Science Park, Hong Kong, Hong Kong, China
| | - Myra D. Williams
- Department of Biological Sciences, Virginia Tech, Blacksburg, Virginia, 24061, USA
| | - Saeed Behzadinasab
- Dept. of Chemical Engineering and Center for Soft Matter and Biological Physics, Virginia Tech, Blacksburg, Virginia, 24061, USA
| | - Joseph O. Falkinham
- Department of Biological Sciences, Virginia Tech, Blacksburg, Virginia, 24061, USA
| | - Leo L. M. Poon
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
- Centre for Immunity and Infection, Hong Kong Science Park, Hong Kong, Hong Kong, China
- HKU-Pasteur Research Pole, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - William A. Ducker
- Dept. of Chemical Engineering and Center for Soft Matter and Biological Physics, Virginia Tech, Blacksburg, Virginia, 24061, USA
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19
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Kim HJ, Na SW, Alodaini HA, Al-Dosary MA, Nandhakumari P, Dyona L. Prevalence of multidrug-resistant bacteria associated with polymicrobial infections. J Infect Public Health 2021; 14:1864-1869. [PMID: 34801434 DOI: 10.1016/j.jiph.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/03/2021] [Accepted: 11/07/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Wounds remain the most important cause of postoperative mortality and morbidity and generate considerable additional social and healthcare costs. Most wounds are caused by various coliforms, Enterococcus fecalis, Proteus sp., and multidrug resistant Staphylococcus aureus. Wound is one of the leading cause of infections in the under developed and developing countries than developed nations. METHODS A total of 43 samples associated with bacteremia and wound infection were collected. Biochemical characterization and culture characteristics of the drug resistant isolates were studied using MacConkey agar, blood agar and mannitol-salt agar. Antibiotic susceptibility analysis of the isolated strains was performed by disc diffusion method using various antibiotics. Prevalence of dug resistance among bacteria isolated from the wound was studied. The ability of Beta lactamase antibiotic producing bacterial strains were analyzed. RESULTS A total of 168 bacterial strains were isolated showed high resistant towards ampicillin (89%), ciprofloxacin (90.8), cefepine (90.5), piperacillin (91.8), oxacillin (92.5), and imipenem (96.5). The isolated bacterial strains showed monobacterial as well as polybacterial growth on the surface of the wound. The isolated bacterial strains revealed 89% sensitivity against norfloxacin and 94.9 sensitivity against vancomycin. About 26% of bacterial strains degraded quinolones, whereas only 14% clinical isolates showed their ability to degrade aminoglycosides. A total of 27% bacteria degraded tetracycline and 51% of isolates degraded carbapenems compounds. Interestingly, E. faecalis was resistant against antibiotics such as, Oxacillin, Nalidic acid, Ofloxacin, Erythromycin, Norfloxacin, Ciprofloxacin, Ampicillin, Tetracycline, Cefepine, Amikacin, Cefurooxime, Vancomycin, Piperacillin, Imipenem and Gentamycin. Moreover, Proteus species was resistant against certain numbers of antibiotics namely, Ampicillin, Piperacillin, Oxacillin, Nalidic acid, Tetracycline, Erythromycin, Cefurooxime, Nitrofurantoin, Vancomycin and Imipenem. CONCLUSIONS The isolated bacterial strains were resistant against various drugs including vancomycin. Staphylococci, and E. faecalisis strains showed resistance against various classes of antibiotics.
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Affiliation(s)
- Hak-Jae Kim
- Department of Clinical Pharmacology, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Sae Won Na
- The Comfort Animal Hospital, Sungbuk-gu, Soonginro-50, Seoul, Republic of Korea
| | - Hissah Abdulrahman Alodaini
- Department of Botany and Microbiology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
| | - Munirah Abdullah Al-Dosary
- Department of Botany and Microbiology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
| | - P Nandhakumari
- Department of Zoology, Lekshmipuram College of Arts and Science, Kanykakumari District, Tamil Nadu, India.
| | - L Dyona
- Department of Botany, Holycross College, Nagercoil, Tamil Nadu, India
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20
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Hosseini M, Behzadinasab S, Chin AWH, Poon LLM, Ducker WA. Reduction of Infectivity of SARS-CoV-2 by Zinc Oxide Coatings. ACS Biomater Sci Eng 2021; 7:5022-5027. [PMID: 34613703 DOI: 10.1021/acsbiomaterials.1c01076] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We developed antimicrobial coatings from ZnO particles that reduce the infectivity of SARS-CoV-2 suspensions by >99.9% in 1 h. The advantage of a coating is that it can be applied to a variety of objects, e.g., hand rails and door knobs, to hinder the spread of disease. Two porous coatings were prepared: one from submicrometer zinc oxide particles bound with silica menisci and the other from zinc oxide tetrapods bound with polyurethane. Experiments on glass coatings show that infectivity depends on porosity for hydrophilic materials, wherein aqueous droplets are imbibed into the pores.
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Affiliation(s)
- Mohsen Hosseini
- Department of Chemical Engineering and Center for Soft Matter and Biological Physics, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Saeed Behzadinasab
- Department of Chemical Engineering and Center for Soft Matter and Biological Physics, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Alex W H Chin
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Centre for Immunity and Infection, Hong Kong Science Park, Hong Kong, China
| | - Leo L M Poon
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Centre for Immunity and Infection, Hong Kong Science Park, Hong Kong, China.,HKU-Pasteur Research Pole, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - William A Ducker
- Department of Chemical Engineering and Center for Soft Matter and Biological Physics, Virginia Tech, Blacksburg, Virginia 24061, United States
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21
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Huriez P, Lourtet-Hascoet J, Zahar JR, Le Monnier A, Pilmis B. Frequency of surface bacterial contamination in family physicians' offices. Infect Dis Now 2021; 51:603-606. [PMID: 34118487 DOI: 10.1016/j.idnow.2021.06.001] [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: 04/13/2021] [Revised: 05/08/2021] [Accepted: 06/07/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The environment is perceived as a potential source of healthcare-associated infections. While this infection source has been well studied in hospital settings, little data on the risk of contamination in general medical practice is available. We aimed to assess the frequency of environmental contamination in family practice (FP), and to describe pathogens isolated, at-risk surfaces, and factors associated with this contamination. PATIENTS AND METHODS We conducted a cross-sectional point prevalence study over six months in 51 FP offices. In each office, six environmental samples were collected after and before consultations on high-touch surfaces (stethoscope, examination table, physician's desktop, blood pressure cuff, medical equipment tray, computer keyboard and mouse). RESULTS A total of 580 samples were obtained. All offices were contaminated at any time with at least 2.5 colony forming units. The median rate of examination room bio-cleaning was twice a week. For all equipment and surfaces, a lower bacterial load was found before consultations when the last cleaning had occurred less than 24hours prior to testing. CONCLUSION High environmental contamination was observed in FP offices. Less than one practice in five used an effective cleaning agent; family physicians' awareness of practice hygiene is an important step for prevention.
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Affiliation(s)
- Pauline Huriez
- Équipe Mobile de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, Paris 75014, France.
| | - Julie Lourtet-Hascoet
- Service de microbiologie clinique et plateforme de dosage des anti-infectieux, Groupe Hospitalier Paris Saint-Joseph, Paris 75014, France
| | - Jean-Ralph Zahar
- Service de Microbiologie Clinique et Unité de Contrôle et de Prévention du risque infectieux, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France; IAME, UMR 1137, Université Paris 13, Sorbonne Paris Cité, France
| | - Alban Le Monnier
- Service de microbiologie clinique et plateforme de dosage des anti-infectieux, Groupe Hospitalier Paris Saint-Joseph, Paris 75014, France
| | - Benoît Pilmis
- Équipe Mobile de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, Paris 75014, France; Service de maladies infectieuses et tropicales, Hôpital Necker Enfants-Malades, Centre médicale de l'institut Pasteur, Université de Paris, Paris, France; Institut Micalis, UMR1319, Université Paris-Saclay, INRAe, AgroParisTech, Bactéries Pathogènes et Santé, Chatenay-Malabry, France
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Noh EY, Lee MH, Yi YM, Park YH. Implementation of a multimodal infection control strategy in the nursing home. Geriatr Nurs 2021; 42:767-771. [PMID: 33895498 DOI: 10.1016/j.gerinurse.2021.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Abstract
The main cause of morbidity and mortality among residents of nursing homes (NHs) is healthcare-associated infections (HAIs). We conducted infection control intervention by applying the WHO multimodal strategy for one year from January to December 2018 in the one NH in South Korea. Healthcare workers (HCWs) in NH were observed by infection control nurse from February to December 2018. Hand hygiene (HH) compliance according WHO 5 moments and type of HH, glove use were measured as main outcomes. During the intervention period, a total of 1,461 cases were observed. HH compliance among HCWs increased from 12.6% to 55.2% after the intervention. According to WHO 5 moments, HH before touching a patient and after touching a patient saw significant improvements. Further, glove misuse decreased significantly from 45.9% to 25.4%. The multifaceted infection control program in the NH group significantly improved the HH compliance of HCWs.
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Affiliation(s)
- Eun-Young Noh
- The Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul, Republic of Korea 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Min Hye Lee
- College of Nursing, Dong-A University, Busan, Republic of Korea 32, Daesingongwon-ro, Seo-gu, Busan, 49201, Republic of Korea.
| | - Yu Mi Yi
- College of Nursing, Kyungnam College of Information and Technology, Busan, Republic of Korea 45, Jurye-ro, Sasang-gu, Busan, 47011, Republic of Korea.
| | - Yeon-Hwan Park
- The Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul, Republic of Korea 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Existence of Multiple ESBL Genes among Phenotypically Confirmed ESBL Producing Klebsiella pneumoniae and Escherichia coli Concurrently Isolated from Clinical, Colonization and Contamination Samples from Neonatal Units at Bugando Medical Center, Mwanza, Tanzania. Antibiotics (Basel) 2021; 10:antibiotics10050476. [PMID: 33919117 PMCID: PMC8143173 DOI: 10.3390/antibiotics10050476] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022] Open
Abstract
The proportions and similarities of extended-spectrum β-lactamase (ESBL) producing K. pneumoniae (ESBL-KP) and E. coli (ESBL-EC) carrying multiple ESBL genes is poorly known at our setting. This study investigated the existence of multiple ESBL genes (blaCTX-M, blaTEM, and blaSHV) among ESBL-KP and ESBL-EC concurrently isolated from clinical, colonization, and contamination samples from neonatology units in Mwanza-Tanzania. Twenty and 55 presumptive ESBL-EC and ESBL-KP, respectively, from a previous study archived at −80 °C were successfully recovered for this study. Isolates were screened and confirmed for production of ESBLs by phenotypic methods followed by multiplex PCR assay to determine ESBL genes. All (100%) and 97.3% of presumptive ESBL isolates were phenotypically confirmed by Clinical and Laboratory Standards Institute (CLSI) and modified double-disc synergy methods, respectively. About 93.3% (70/75) of phenotypically confirmed ESBL isolates had at least one ESBL gene, whereby for 62.9% (44/70), all ESBL genes (blaCTX-M, blaTEM, and blaSHV) were detected. Eight pairs of ESBL bacteria show similar patterns of antibiotics susceptibility and ESBL genes. ESBL-KP and ESBL-EC, concurrently isolated from clinical, colonization and contamination samples, harbored multiple ESBL genes. Further, eight pairs of ESBL isolates had similar patterns of antibiotics susceptibility and ESBL genes, suggesting transmission of and/or sharing of mobile genetic elements (MGEs) among ESBL-KP and ESBL-EC.
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From the hospital toilet to the ward: A pilot study on microbe dispersal to multiple hospital surfaces following hand drying using a jet air dryer versus paper towels. Infect Control Hosp Epidemiol 2021; 43:241-244. [PMID: 33726871 DOI: 10.1017/ice.2021.43] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Using a bacteriophage to represent microbial contamination, we investigated virus transmission to the hospital environment following hand drying. The use of paper towels resulted in lower rates of virus contamination on hands and clothing compared with a jet air dryer and, consequently, lower contamination of multiple hospital surfaces.
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25
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Bhatta DR, Hosuru Subramanya S, Hamal D, Shrestha R, Gauchan E, Basnet S, Nayak N, Gokhale S. Bacterial contamination of neonatal intensive care units: How safe are the neonates? Antimicrob Resist Infect Control 2021; 10:26. [PMID: 33516271 PMCID: PMC7847238 DOI: 10.1186/s13756-021-00901-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 01/21/2021] [Indexed: 11/25/2022] Open
Abstract
Background Intensive care units (ICU) are essential healthcare facility for life threatening conditions. Bacterial contamination of objects/instruments in ICU is an important source of nosocomial infections. This study is aimed to determine the level of bacterial contamination of instruments/objects which are commonly touched by healthcare workers and frequently come in contact with the neonates.
Methods This hospital based prospective study was conducted in neonatal intensive care unit (NICU) of Manipal Teaching Hospital, Pokhara, Nepal. A total of 146 samples collected from surfaces of incubators, radiant warmers, suction tips, ventilators, stethoscopes, door handles, weighing machines, mothers’ beds, phototherapy beds, laryngoscope, telephone sets, blood pressure machine, etc. formed the material of the study. Isolation, identification and antibiotic susceptibility of the bacterial isolates was performed by standard techniques. Blood culture isolates from NICU patients during the study period were compared with the environmental isolates. Results Out of 146 samples, bacterial growth was observed in 109. A total of 119 bacterial isolates were retrieved from 109 samples. Three common potential pathogens isolated were Escherichia coli (n = 27), Klebsiella species (n = 21) and Staphylococcus aureus (n = 18). Majority of E. coli and Klebsiella isolates were from incubators, suction tips and mothers’ beds. Majority of S. aureus isolates were cultured from radiant warmers. Among S. aureus isolates, 33.3% (6/18) were methicillin resistant. Majority of the bacterial isolates were susceptible to gentamicin and amikacin. Common potential pathogens isolated from blood culture of NICU patients were S. aureus and Klebsiella species. Conclusion High degree of bacterial contamination of objects/instruments in NICU was recorded. Isolation of potential pathogens like E. coli, Klebsiella species and S. aureus is a major threat of nosocomial infections. Blood culture data of NICU reflects possibility of nosocomial infections from contaminated sites. Gentamicin and amikacin may be used for empirical therapy in suspected cases of nosocomial infections in NICU.
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Affiliation(s)
- Dharm Raj Bhatta
- Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal.
| | | | - Deependra Hamal
- Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal
| | - Rajani Shrestha
- Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal
| | - Eva Gauchan
- Department of Pediatrics and Neonatology, Manipal College of Medical Sciences, Pokhara, Nepal
| | - Sahisnuta Basnet
- Department of Pediatrics and Neonatology, Manipal College of Medical Sciences, Pokhara, Nepal
| | - Niranjan Nayak
- Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal
| | - Shishir Gokhale
- Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal
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Guidelines for infection control and prevention in anaesthesia in South Africa. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2021. [DOI: 10.36303/sajaa.2021.27.4.s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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27
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Foong YC, Green M, Zargari A, Siddique R, Tan V, Brain T, Ogden K. Los teléfonos móviles como potencial vehículo de infección en un entorno hospitalario. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2021; 18:S70-S74. [PMID: 33822689 DOI: 10.1080/15459624.2021.1877061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
ResumenEl objetivo de este artículo es investigar el posible papel desempeñado por los teléfonos móviles como depósitos de colonización bacteriana y los factores de riesgo que ésta conlleva en un ambiente hospitalario. Entre enero de 2013 y marzo de 2014 examinamos a 226 miembros del personal de un hospital regional de Australia (146 médicos y 80 estudiantes de medicina). Los principales resultados de interés se relacionaron con los tipos de microorganismos y la cantidad de contaminación encontrados en los teléfonos móviles. Este estudio mostró la existencia de un alto nivel de contaminación bacteriana (n = 168/226, 74%) en los teléfonos móviles de los funcionarios de un hospital de atención terciaria, aislándose organismos similares en la mano dominante del personal y en sus teléfonos móviles. Mientras que la mayoría de los organismos aislados pertenecía a la flora cutánea normal, un pequeño porcentaje era potencialmente patógeno (n = 12/226, 5%). Además, se encontró que ser miembro subalterno del personal médico constituía un factor de riesgo para un importante crecimiento microbiano (OR 4.00, 95% CI 1.54, 10.37). Sólo 31% (70/226) de los participantes en el estudio informó que limpiaba sus teléfonos regularmente y sólo 21% (47/226) reportó que usa toallitas con alcohol para la limpieza de su teléfono. Este estudio demuestra que los teléfonos móviles son potenciales vehículos de bacterias patógenas en un ambiente hospitalario. Sólo una minoría de participantes informó que limpia su teléfono regularmente. Deberían elaborarse y aplicarse directrices de desinfección utilizando toallitas con alcohol.
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Affiliation(s)
- Yi Chao Foong
- Launceston Clinical School, University of Tasmania, Tasmania, Australia
- Menzies Research Institute, University of Tasmania, Tasmania, Hobart, Tasmania, Australia
| | - Mark Green
- Launceston General Hospital, University of Tasmania, Launceston, Tasmania, Australia
| | | | - Romana Siddique
- Launceston Clinical School, University of Tasmania, Tasmania, Australia
| | - Vanessa Tan
- Launceston Clinical School, University of Tasmania, Tasmania, Australia
| | - Terry Brain
- Launceston General Hospital, University of Tasmania, Launceston, Tasmania, Australia
| | - Kathryn Ogden
- Launceston Clinical School, University of Tasmania, Tasmania, Australia
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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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29
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Browne K, Wood D, Clezy K, Lehm J, Walsh WR. Reduction of bacterial load with the addition of ultraviolet-C disinfection inside the hyperbaric chamber. Diving Hyperb Med 2020; 50:332-337. [PMID: 33325012 DOI: 10.28920/dhm50.4.332-337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/09/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Healthcare acquired infections (HAIs) are associated with increased mortality, morbidity and prolonged hospital stays. Microbiological contamination of the hospital environment directly contributes to HAIs. Optimising environmental cleaning reduces transmission of HAIs. The hyperbaric chamber poses a specific challenge for infection control as certain disinfectants and alcohol-based hand sanitisers are prohibited due to fire risk. Patients often possess multiple risk factors for HAIs. This study compared the bacteria remaining on a surface (bioburden) after a standard clean and after adjunctive disinfection with an ultraviolet-C (UV-C) robot. METHODS Internal hyperbaric chamber surfaces were first manually cleaned with Clinell® universal wipes and the floor was mopped with Whiteley neutral detergent. Allocated surfaces were swabbed using sterile cotton swabs and processed using a standard microbial culture and a bacteria-specific rapid metabolic assay. Bacterial contamination was also measured by direct contact plating on flat surfaces. The plexiglass ports were covered to protect from potential UV-C mediated damage and used as a negative control. A UV-C disinfection robot was then used to disinfect the chamber for 30 min, whereafter surfaces were swabbed again. RESULTS There was a significantly greater mean reduction in bioburden following adjunctive UV-C disinfection than with standard cleaning alone. The surfaces not routinely manually cleaned (e.g., bench, phone) showed greatest reduction in bacterial load following UV-C cleaning. CONCLUSIONS There was a significant reduction in the bacterial load in the chamber following an adjunctive UV-C clean compared with that of a standard clean. Adjunctive cleaning of the hyperbaric chamber environment with a non-touch UV-C device shows promise as a method to reduce HAIs.
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Affiliation(s)
- Katrina Browne
- Surgical and Orthopaedic Research Laboratory, University of New South Wales, Prince of Wales Hospital, Sydney, Australia
| | - Danielle Wood
- Hyperbaric Medicine Unit, Prince of Wales Hospital, Sydney, Australia.,Corresponding author: Dr Danielle Wood, Hyperbaric Medicine Unit, Prince of Wales Hospital, Nurses Dr, Randwick, NSW 2031, Australia,
| | - Kate Clezy
- Infectious Diseases Department, Prince of Wales Hospital, Sydney Australia
| | - Jan Lehm
- Hyperbaric Medicine Unit, Prince of Wales Hospital, Sydney, Australia
| | - William R Walsh
- Surgical and Orthopaedic Research Laboratory, University of New South Wales, Prince of Wales Hospital, Sydney, Australia
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30
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Lu MC, Chen PL, Huang DJ, Liang CK, Hsu CS, Liu WT. Disinfection efficiency of hospital infectious disease wards with chlorine dioxide and hypochlorous acid. AEROBIOLOGIA 2020; 37:29-38. [PMID: 33169045 PMCID: PMC7642575 DOI: 10.1007/s10453-020-09670-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 10/22/2020] [Indexed: 06/11/2023]
Abstract
The disinfection efficiencies of two chemical disinfectants, chlorine dioxide and weak acid hypochlorous water (WAHW), were examined in the soiled room and dishwashing room of a hospital infectious disease ward in Taiwan. The investigations were conducted in two seasons, namely winter and summer, in order to examine the correlation between the bioaerosol concentration and the environmental factors. In addition, a single-daily disinfection mode (SM) and a twice-daily disinfection mode (TM) were applied in this study. The results showed that the bacteria and fungi colony counts were strongly correlated with the temperature. Both disinfectants reduced the bacteria and fungi concentrations in the considered rooms. However, of the two disinfectants, the ClO2 showed a stronger disinfection effect than the WAHW. It means that when using ClO2 as the disinfectant, the disinfection efficiency of the TM treatment mode is significantly better than that of the SM treatment mode. But, when using WAHW as the disinfectant, no significant difference is found between the disinfection efficiencies of the two methods. Overall, the results showed that the application of ClO2 twice daily provided the most effective means of satisfying the Taiwan EPA guidelines for the indoor air quality of hospital medical wards.
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Affiliation(s)
- Ming-Chun Lu
- Department of Environmental Resources Management, Chia-Nan University of Pharmacy and Science, Tainan, 71710 Taiwan
| | - Po-Lin Chen
- Center for Infection Control and Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 70101 Taiwan
| | - Da-Ji Huang
- Department of Environmental Resources Management, Chia-Nan University of Pharmacy and Science, Tainan, 71710 Taiwan
| | - Chih-Kuo Liang
- Department of Electrical Engineering, National Taitung Junior College, Taitung, 95045 Taiwan
| | - Ching-Shan Hsu
- Department of Environmental Resources Management, Chia-Nan University of Pharmacy and Science, Tainan, 71710 Taiwan
| | - Wei-Ting Liu
- Department of Environmental Resources Management, Chia-Nan University of Pharmacy and Science, Tainan, 71710 Taiwan
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31
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Cruz-López F, Villarreal-Treviño L, Morfin-Otero R, Martínez-Meléndez A, Camacho-Ortiz A, Rodríguez-Noriega E, Garza-González E. Dynamics of colonization in patients with health care-associated infections at step-down care units from a tertiary care hospital in Mexico. Am J Infect Control 2020; 48:1329-1335. [PMID: 32360458 DOI: 10.1016/j.ajic.2020.04.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Patient colonization has been suggested as a risk factor in hospital-associated infections (HAI) development, which are of the most frequent complications in hospitals. OBJECTIVE To examine the colonization process and possible transmission routes of HAI-causative agents in step-down care unit (SDCU) patients. METHODS Patients admitted to SDCU within 48 hours of admission that had no evidence of infection present, nurse health care workers (HCWs), and relatives of infected patients were included. Participants were sampled and cultured at different times in different body surfaces. Environmental surfaces and medical devices were also sampled. Antimicrobial susceptibility and clonal relatedness were determined in selected HAI-causative agents, environmental, nurse HCWs, and patient isolates. RESULTS A total of 2,735 isolates corresponding to 126 species were identified. Of the 11 patients included, 8 developed 1-3 HAIs (14 isolates recovered as HAI-causative agents). Acinetobacter baumannii (36% of infections) was distributed in clone A (n = 1), B (n = 3), and F (n = 1); Klebsiella pneumoniae (29%) in clones A (n = 2) and B (n = 1) and Enterobacter cloacae (7%) in one clone A. Causative agents were progressively recovered from environmental surfaces and medical devices before and after HAI onset. CONCLUSIONS Highly related strains were recovered from environmental surfaces, patients, and nurse HCWs before and after HAI outcome. This is a first step to examine colonization process in SDCU settings and provides a base for further studies to understand colonization dynamics and the role of patients' relatives and nurse HCWs in organism transmission in the SDCU.
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32
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Wang Z, Kowal SF, Carslaw N, Kahan TF. Photolysis-driven indoor air chemistry following cleaning of hospital wards. INDOOR AIR 2020; 30:1241-1255. [PMID: 32485006 DOI: 10.1111/ina.12702] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 04/17/2020] [Accepted: 05/19/2020] [Indexed: 05/25/2023]
Abstract
Effective cleaning techniques are essential for the sterilization of rooms in hospitals and industry. No-touch devices (NTDs) that use fumigants such as hydrogen peroxide (H2 O2 ), formaldehyde (HCHO), ozone (O3 ), and chlorine dioxide (OClO) are a recent innovation. This paper reports a previously unconsidered potential consequence of such cleaning technologies: the photochemical formation of high concentrations of hydroxyl radicals (OH), hydroperoxy radicals (HO2 ), organic peroxy radicals (RO2 ), and chlorine radicals (Cl) which can form harmful reaction products when exposed to chemicals commonly found in indoor air. This risk was evaluated by calculating radical production rates and concentrations based on measured indoor photon fluxes and typical fumigant concentrations during and after cleaning events. Sunlight and fluorescent tubes without covers initiated photolysis of all fumigants, and plastic-covered fluorescent tubes initiated photolysis of only some fumigants. Radical formation was often dominated by photolysis of fumigants during and after decontamination processes. Radical concentrations were predicted to be orders of magnitude greater than background levels during and immediately following cleaning events with each fumigant under one or more illumination condition. Maximum predicted radical concentrations (1.3 × 107 molecule cm-3 OH, 2.4 ppb HO2 , 6.8 ppb RO2 and 2.2 × 108 molecule cm-3 Cl) were much higher than baseline concentrations. Maximum OH concentrations occurred with O3 photolysis, HO2 with HCHO photolysis, and RO2 and Cl with OClO photolysis. Elevated concentrations may persist for hours after NTD use, depending on the air change rate and air composition. Products from reactions involving radicals could significantly decrease air quality when disinfectants are used, leading to adverse health effects for occupants.
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Affiliation(s)
- Zixu Wang
- Department of Environment and Geography, University of York, York, UK
| | - Shawn F Kowal
- Department of Chemistry, Syracuse University, Syracuse, NY, USA
| | - Nicola Carslaw
- Department of Environment and Geography, University of York, York, UK
| | - Tara F Kahan
- Department of Chemistry, Syracuse University, Syracuse, NY, USA
- Department of Chemistry, University of Saskatchewan, Saskatoon, SK, Canada
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33
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Wang X, Du Z, Huang W, Zhang X, Zhou Y. Outbreak of Multidrug-Resistant Acinetobacter baumannii ST208 Producing OXA-23-Like Carbapenemase in a Children's Hospital in Shanghai, China. Microb Drug Resist 2020; 27:816-822. [PMID: 33185494 DOI: 10.1089/mdr.2019.0232] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Aims: Acinetobacter baumannii is notorious for acquiring antibiotic resistance and causing nosocomial infections worldwide. This study aimed to investigate the prevalence and molecular characteristics of A. baumannii isolates obtained from inpatients and the intensive care unit (ICU) environment of a pediatric hospital in Shanghai, China. Methods: Between July 2017 and January 2018, a total of 88 A. baumannii isolates, including three obtained from ICU environmental specimens, were characterized by antibiotic susceptibility, multilocus sequence typing, and resistance genes. Results: Carbapenem-resistant A. baumannii (CRAB) isolates, which were resistant to all the antibiotics tested except colistin, accounted for 69.3% (61/88) of all isolates. Three sequence types (STs) were identified among the CRAB isolates, and the predominant clone was ST208 (93.4%, 57/61), which included three environmental isolates and 54 clinical isolates collected from ICU patients. Carbapenem-susceptible isolates, none of which was multidrug resistant (MDR), showed a more diverse genetic background with three known STs and 21 novel STs identified. Intrinsic blaOXA-51-like and blaAmpC were detected in all isolates, while blaOXA-23-like was only detected in all CRAB isolates. ISAba1-blaOXA-23-like, ISAba1-blaOXA-51-like, and ISAba1-blaAmpC were identified in 69.3% (all CRAB isolates), 0%, and 65.9% (58 CRAB isolates) of all isolates, respectively. Conclusions: A nosocomial outbreak of MDR A. baumannii ST208 producing OXA-23-like carbapenemase occurred, highlighting the necessity for strict infection control interventions in the ICU.
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Affiliation(s)
- Xing Wang
- Department of Laboratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China
| | - Zhuoying Du
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, P.R. China.,Neurosurgical Institute of Fudan University.,Shanghai Clinical Medical Center of Neurosurgery.,Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration
| | - Weichun Huang
- Department of Laboratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China
| | - Xingyu Zhang
- Department of Laboratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China
| | - Yun Zhou
- Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai, P.R. China
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Wang T, Chen W, Dong T, Lv Z, Zheng S, Cao X, Wei Q, Ghiladi RA, Wang Q. Color-Variable Photodynamic Antimicrobial Wool/Acrylic Blended Fabrics. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E4141. [PMID: 32957677 PMCID: PMC7560281 DOI: 10.3390/ma13184141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 01/23/2023]
Abstract
Towards the goal of developing scalable, economical and effective antimicrobial textiles to reduce infection transmission, here we prepared color-variable photodynamic materials comprised of photosensitizer (PS)-loaded wool/acrylic (W/A) blends. Wool fibers in the W/A blended fabrics were loaded with the photosensitizer rose bengal (RB), and the acrylic fibers were dyed with a variety of traditional cationic dyes (cationic yellow, cationic blue and cationic red) to broaden their color range. Investigations on the colorimetric and photodynamic properties of a series of these materials were implemented through CIELab evaluation, as well as photooxidation and antibacterial studies. Generally, the photodynamic efficacy of these dual-dyed fabrics was impacted by both the choice, and how much of the traditional cationic dye was employed in the dyeing of the W/A fabrics. When compared with the PS-only singly-dyed material, RB-W/A, that showed a 99.97% (3.5 log units; p = 0.02) reduction of Staphylococcus aureus under visible light illumination (λ ≥ 420 nm, 60 min), the addition of cationic dyes led to a slight decrease in the photoinactivation ability of the dual-dyed fabrics, but was still able to achieve a 99.3% inactivation of S. aureus. Overall, our findings demonstrate the feasibility and potential applications of low cost and color variable RB-loaded W/A blended fabrics as effective self-disinfecting textiles against pathogen transmission.
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Affiliation(s)
- Tingting Wang
- Key Laboratory of Eco-Textiles, Ministry of Education, Jiangnan University, Wuxi 214122, China; (T.W.); (W.C.); (T.D.); (Z.L.); (S.Z.); (Q.W.)
| | - Wangbingfei Chen
- Key Laboratory of Eco-Textiles, Ministry of Education, Jiangnan University, Wuxi 214122, China; (T.W.); (W.C.); (T.D.); (Z.L.); (S.Z.); (Q.W.)
| | - Tingting Dong
- Key Laboratory of Eco-Textiles, Ministry of Education, Jiangnan University, Wuxi 214122, China; (T.W.); (W.C.); (T.D.); (Z.L.); (S.Z.); (Q.W.)
| | - Zihao Lv
- Key Laboratory of Eco-Textiles, Ministry of Education, Jiangnan University, Wuxi 214122, China; (T.W.); (W.C.); (T.D.); (Z.L.); (S.Z.); (Q.W.)
| | - Siming Zheng
- Key Laboratory of Eco-Textiles, Ministry of Education, Jiangnan University, Wuxi 214122, China; (T.W.); (W.C.); (T.D.); (Z.L.); (S.Z.); (Q.W.)
| | - Xiuming Cao
- Jiangsu Sunshine Group Co., Ltd., Jiangyin 214122, China;
| | - Qufu Wei
- Key Laboratory of Eco-Textiles, Ministry of Education, Jiangnan University, Wuxi 214122, China; (T.W.); (W.C.); (T.D.); (Z.L.); (S.Z.); (Q.W.)
| | - Reza A. Ghiladi
- Key Laboratory of Eco-Textiles, Ministry of Education, Jiangnan University, Wuxi 214122, China; (T.W.); (W.C.); (T.D.); (Z.L.); (S.Z.); (Q.W.)
- Department of Chemistry, North Carolina State University, Raleigh, NC 27695, USA
| | - Qingqing Wang
- Key Laboratory of Eco-Textiles, Ministry of Education, Jiangnan University, Wuxi 214122, China; (T.W.); (W.C.); (T.D.); (Z.L.); (S.Z.); (Q.W.)
- Jiangsu Sunshine Group Co., Ltd., Jiangyin 214122, China;
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King MF, López-García M, Atedoghu KP, Zhang N, Wilson AM, Weterings M, Hiwar W, Dancer SJ, Noakes CJ, Fletcher LA. Bacterial transfer to fingertips during sequential surface contacts with and without gloves. INDOOR AIR 2020; 30:993-1004. [PMID: 32329918 DOI: 10.1111/ina.12682] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/26/2020] [Accepted: 04/14/2020] [Indexed: 05/05/2023]
Abstract
Bacterial transmission from contaminated surfaces via hand contact plays a critical role in disease spread. However, the fomite-to-finger transfer efficiency of microorganisms during multiple sequential surface contacts with and without gloves has not been formerly investigated. We measured the quantity of Escherichia coli on fingertips of participants after 1-8 sequential contacts with inoculated plastic coupons with and without nitrile gloves. A Bayesian approach was used to develop a mechanistic model of pathogen accretion to examine finger loading as a function of the difference between E coli on surfaces and fingers. We used the model to determine the coefficient of transfer efficiency (λ), and influence of swabbing efficiency and finger area. Results showed that λ for bare skin was higher (49%, 95% CI = 32%-72%) than for gloved hands (30%, CI = 17%-49%). Microbial load tended toward a dynamic equilibrium after four and six contacts for gloved hands and bare skin, respectively. Individual differences between volunteers' hands had a negligible effect compared with use of gloves (P < .01). Gloves reduced loading by 4.7% (CI = -12%-21%) over bare skin contacts, while 20% of participants accrued more microorganisms on gloved hands. This was due to poor fitting, which created a larger finger surface area than bare hands.
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Affiliation(s)
| | | | | | - Nan Zhang
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China, SAR
| | - Amanda M Wilson
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Martijn Weterings
- Institute of Life Technologies, University of Applied Sciences and Arts Western, Sion, Valais-Wallis, Switzerland
| | - Waseem Hiwar
- School of Civil Engineering, University of Leeds, Leeds, UK
| | - Stephanie J Dancer
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
- Department of Microbiology, Hairmyres Hospital, NHS Lanarkshire, Glasgow, UK
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Acquired Genetic Elements that Contribute to Antimicrobial Resistance in Frequent Gram-Negative Causative Agents of Healthcare-Associated Infections. Am J Med Sci 2020; 360:631-640. [PMID: 32747008 DOI: 10.1016/j.amjms.2020.06.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/26/2020] [Accepted: 06/29/2020] [Indexed: 12/12/2022]
Abstract
Antimicrobial resistance (AMR) is a worldwide public health problem that reduces therapeutic options and increases the risk of death. The causative agents of healthcare-associated infections (HAIs) are drug-resistant microorganisms of the nosocomial environment, which have developed different mechanisms of AMR. The hospital-associated microbiota has been proposed to be a reservoir of genes associated with AMR and an environment where the transfer of genetic material among organisms may occur. The ESKAPE group (Enterococcus faecalis and Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter aerogenes and Escherichia coli) is a frequent causative agents of HAIs. In this review, we address the issue of acquired genetic elements that contribute to AMR in the most frequent Gram-negative of ESKAPE, with a focus on last resort antimicrobial agents and the role of transference of genetic elements for the development of AMR.
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McAleese T, Broderick JM, Stanley E, Curran R. Thyroid radiation shields: A potential source of intraoperative infection. J Orthop 2020; 22:300-303. [PMID: 32616992 PMCID: PMC7322090 DOI: 10.1016/j.jor.2020.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/06/2020] [Indexed: 11/15/2022] Open
Abstract
Introduction Thyroid radiation shields are often uncovered by the surgical gown and may represent a preventable source of wound contamination. The aims of this study are to define the common pathogens found on thyroid radiation shields and evaluate the effectiveness of a simple cleaning method. Methods Samples were obtained from 29 community thyroid shields collected from the operating theatres of 3 teaching hospitals. Each shield was swabbed under strict sterile technique using a separate swab for each of 4 designated zones. After sampling, shields were cleaned with a readily available disinfectant and sampling was repeated after 5 min. All swabs were cultured in ambient air at 37 °C on 5% sheeps blood agar for 48 hrs and subsequent growth was identified by a MALDI-TOF Walkaway mass spectrometer. Results Before cleaning, 100% of thyroid shields (29/29) and 68% of shield zones (79/116) grew at least 1 type of bacteria. Coagulase negative staphylococci, including S. epidermidis, S. capitis, S. cohnii, S. haemolyticus and S. hominis, were most commonly isolated. Enterobacteriaceae and S. aureus were also cultured. After cleaning, culturable contamination was reduced by 86.3% and 64.5%, respectively (p < 0.001). Conclusion The most common pathogens associated with SSIs can be isolated on thyroid radiation shields. Appropriate cleaning of thyroid shields with readily available disinfectant can significantly reduce the bacterial burden as detectable by culture. Hospitals should facilitate staff education and reinforce their policies on cleaning these shields which may often be overlooked.
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Affiliation(s)
| | - J M Broderick
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - E Stanley
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - R Curran
- Our Lady of Lourdes Hospital, Drogheda, Ireland
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Bizzoca ME, Campisi G, Lo Muzio L. Covid-19 Pandemic: What Changes for Dentists and Oral Medicine Experts? A Narrative Review and Novel Approaches to Infection Containment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3793. [PMID: 32471083 PMCID: PMC7312076 DOI: 10.3390/ijerph17113793] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/20/2020] [Accepted: 05/23/2020] [Indexed: 12/22/2022]
Abstract
The authors performed a narrative review on Severe Acute Respiratory Syndrome- CoronaVirus-2 ( SARS-CoV-2) and all infectious agents with the primary endpoints to illustrate the most accepted models of safety protocols in dentistry and oral medicine, and to propose an easy view of the problem and a comparison (pre- vs post-COVID19) for the most common dental procedures. The outcome is forecast to help dentists to individuate for a given procedure the differences in terms of safety protocols to avoid infectious contagion (by SARS-CoV-2 and others dangerous agents). An investigation was performed on the online databases Pubmed and Scopus using a combination of free words and Medical Subject Headings (MESH) terms: "dentist" OR "oral health" AND "COVID-19" OR "SARS-CoV-2" OR "coronavirus-19". After a brief excursus on all infectious agents transmittable at the dental chair, the authors described all the personal protective equipment (PPE) actually on the market and their indications, and on the basis of the literature, they compared (before and after COVID-19 onset) the correct safety procedures for each dental practice studied, underlining the danger of underestimating, in general, dental cross-infections. The authors have highlighted the importance of knowing exactly the risk of infections in the dental practice, and to modulate correctly the use of PPE, in order to invest adequate financial resources and to avoid exposing both the dental team and patients to preventable risks.
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Affiliation(s)
- Maria Eleonora Bizzoca
- Department of Clinical and Experimental Medicine, University of Foggia, 71121 Foggia, Italy;
| | - Giuseppina Campisi
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, 90121 Palermo, Italy;
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, 71121 Foggia, Italy;
- C.I.N.B.O. (Consorzio Interuniversitario Nazionale per la Bio-Oncologia), 66100 Chieti, Italy
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Role of Hydrogen Peroxide Vapor (HPV) for the Disinfection of Hospital Surfaces Contaminated by Multiresistant Bacteria. Pathogens 2020; 9:pathogens9050408. [PMID: 32456303 PMCID: PMC7281489 DOI: 10.3390/pathogens9050408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 12/14/2022] Open
Abstract
The emergence of multiresistant bacterial strains as agents of healthcare-related infection in hospitals has prompted a review of the control techniques, with an added emphasis on preventive measures, namely good clinical practices, antimicrobial stewardship, and appropriate environmental cleaning. The latter item is about the choice of an appropriate disinfectant as a critical role due to the difficulties often encountered in obtaining a complete eradication of environmental contaminations and reservoirs of pathogens. The present review is focused on the effectiveness of hydrogen peroxide vapor, among the new environmental disinfectants that have been adopted. The method is based on a critical review of the available literature on this topic.
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Sustainable practice of ophthalmology during COVID-19: challenges and solutions. Graefes Arch Clin Exp Ophthalmol 2020; 258:1427-1436. [PMID: 32314034 PMCID: PMC7170732 DOI: 10.1007/s00417-020-04682-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 03/27/2020] [Accepted: 04/01/2020] [Indexed: 01/05/2023] Open
Abstract
Purpose The Coronavirus (COVID-19) outbreak is rapidly emerging as a global health threat. With no proven vaccination or treatment, infection control measures are paramount. In this article, we aim to describe the impact of COVID-19 on our practice and share our strategies and guidelines to maintain a sustainable ophthalmology practice. Methods Tan Tock Seng Hospital (TTSH) Eye Centre is the only ophthalmology department supporting the National Centre for Infectious Diseases (NCID), which is the national screening center and the main center for management of COVID-19 patients in Singapore. Our guidelines during this outbreak are discussed. Results Challenges in different care settings in our ophthalmology practice have been identified and analyzed with practical solutions and guidelines implemented in anticipation of these challenges. First, to minimize cross-infection of COVID-19, stringent infection control measures were set up. These include personal protective equipment (PPE) for healthcare workers and routine cleaning of “high-touch” surfaces. Second, for outpatient care, a stringent dual screening and triaging process were carried out to identify high-risk patients, with proper isolation for such patients. Administrative measures to lower patient attendance and reschedule appointments were carried out. Third, inpatient and outpatient care were separated to minimize interactions. Last but not least, logistics and manpower plans were drawn up in anticipation of resource demands and measures to improve the mental well-being of staff were implemented. Conclusion We hope our measures during this COVID-19 pandemic can help ophthalmologists globally and serve to guide and maintain safe access in ophthalmology clinics when faced with similar disease outbreaks.
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Arjyal C, KC J, Neupane S. Prevalence of Methicillin-Resistant Staphylococcus aureus in Shrines. Int J Microbiol 2020; 2020:7981648. [PMID: 32190054 PMCID: PMC7068152 DOI: 10.1155/2020/7981648] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/30/2020] [Indexed: 12/27/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) infection in human beings and animals is concerning; it stands out as one of the leading agents causing nosocomial and community infections. Also, marginally increasing drug resistance in MRSA has limited therapeutic options. This study focuses on estimating the prevalence of MRSA in shrines, a place where human and animal interaction is frequent, sharing antibiotic-resistant bacteria, antibiotic-resistant genes, and diseases. A total of 120 environmental swabs were collected from targeted areas during the study period, March 2018 to May 2018. Staphylococcus aureus was identified by growth on mannitol salt agar (MSA), and MRSA by growth on mannitol salt agar containing 4 μg Oxacillin, Gram staining, and conventional biochemical test. Isolates of S. aureus were characterized by antibiotic susceptibility testing using the disc diffusion method. MRSA and methicillin-sensitive S. aureus (MSSA) proportion were 19% and 81%, respectively; a high rate of MRSA was observed in isolates from Thapathali (28.6%). MSSA isolates showed a high rate of resistance to erythromycin (64.7%). MRSA isolates were resistant to gentamicin (50%), cotrimoxazole (25%), erythromycin (50%), and ciprofloxacin (25%). The isolates were susceptible to linezolid (100%), clindamycin (100%), ciprofloxacin (75%), erythromycin (50%), tetracycline (100%), and cotrimoxazole (75%). Intermediate resistance was also found in gentamicin (50%). Of the 11 MSSA isolates that were erythromycin resistant and clindamycin sensitive, 6 (54.5%) showed the inducible clindamycin resistance (ICR) pattern and 2 MRSA isolates that were erythromycin resistant and clindamycin sensitive showed ICR pattern. Fifteen MSSA isolates were β-lactamase positive, whereas only two MRSA isolates showed β-lactamase production. There exists a minimal research work on infectious diseases that are shared between primates and animals. This study suggests the pervasiveness of MRSA/MSSA in the shrines, which may be a primary place for pathogen exchange between humans and primates.
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Affiliation(s)
- Charu Arjyal
- Tri-Chandra Multiple Campus, Tribhuvan University, Kathmandu, Nepal
| | - Jyoti KC
- Tri-Chandra Multiple Campus, Tribhuvan University, Kathmandu, Nepal
| | - Shreya Neupane
- Tri-Chandra Multiple Campus, Tribhuvan University, Kathmandu, Nepal
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Systematic Analysis of Efflux Pump-Mediated Antiseptic Resistance in Staphylococcus aureus Suggests a Need for Greater Antiseptic Stewardship. mSphere 2020; 5:5/1/e00959-19. [PMID: 31941819 PMCID: PMC6968660 DOI: 10.1128/msphere.00959-19] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
S. aureus remains a significant cause of disease within hospitals and communities. To reduce the burden of S. aureus infections, antiseptics are ubiquitously used in our daily lives. Furthermore, many antiseptic compounds are dual purpose and are found in household products. The increased abundance of antiseptic compounds has selected for S. aureus strains that carry efflux pumps that increase resistance to antiseptic compounds; however, the effect of carrying multiple pumps within S. aureus is unclear. We demonstrated that an isogenic strain carrying multiple efflux pumps had an additive resistance phenotype to cetrimide. Moreover, in a strain carrying qacA and norA, increased chlorhexidine tolerance was observed after the strain was preexposed to subinhibitory concentrations of a different common-use antiseptic. Taken together, our findings demonstrate cooperation between antiseptic resistance efflux pumps and suggest that their protective phenotype may be exacerbated by priming with subinhibitory concentrations of household antiseptics. Staphylococcus aureus-associated infections can be difficult to treat due to multidrug resistance. Thus, infection prevention is critical. Cationic antiseptics, such as chlorhexidine (CHX) and benzalkonium chloride (BKC), are liberally used in health care and community settings to prevent infection. However, increased administration of antiseptics has selected for S. aureus strains that show reduced susceptibilities to cationic antiseptics. This increased resistance has been associated with carriage of specific efflux pumps (QacA, QacC, and NorA). Since prior published studies focused on different strains and on strains carrying only a single efflux gene, the relative importance of these various systems to antiseptic resistance is difficult to ascertain. To overcome this, we engineered a collection of isogenic S. aureus strains that harbored norA, qacA, and qacC, individually or in combination. MIC assays showed that qacA was associated with increased resistance to CHX, cetrimide (CT), and BKC, qacC was associated with resistance to CT and BKC, and norA was necessary for basal-level resistance to the majority of tested antiseptics. When all three pumps were present in a single strain, an additive effect was observed in the MIC for CT. Transcriptional analysis revealed that expression of qacA and norA was significantly induced following exposure to BKC. Alarmingly, in a strain carrying qacA and norA, preexposure to BKC increased CHX tolerance. Overall, our results reveal increased antiseptic resistance in strains carrying multiple efflux pumps and indicate that preexposure to BKC, which is found in numerous daily-use products, can increase CHX tolerance. IMPORTANCES. aureus remains a significant cause of disease within hospitals and communities. To reduce the burden of S. aureus infections, antiseptics are ubiquitously used in our daily lives. Furthermore, many antiseptic compounds are dual purpose and are found in household products. The increased abundance of antiseptic compounds has selected for S. aureus strains that carry efflux pumps that increase resistance to antiseptic compounds; however, the effect of carrying multiple pumps within S. aureus is unclear. We demonstrated that an isogenic strain carrying multiple efflux pumps had an additive resistance phenotype to cetrimide. Moreover, in a strain carrying qacA and norA, increased chlorhexidine tolerance was observed after the strain was preexposed to subinhibitory concentrations of a different common-use antiseptic. Taken together, our findings demonstrate cooperation between antiseptic resistance efflux pumps and suggest that their protective phenotype may be exacerbated by priming with subinhibitory concentrations of household antiseptics.
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Lei H, Jones RM, Li Y. Quantifying the relative impact of contact heterogeneity on MRSA transmission in ICUs - a modelling study. BMC Infect Dis 2020; 20:6. [PMID: 31900118 PMCID: PMC6942315 DOI: 10.1186/s12879-019-4738-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/24/2019] [Indexed: 12/17/2022] Open
Abstract
Background An efficient surface cleaning strategy would first target cleaning to surfaces that make large contributions to the risk of infections. Methods In this study, we used data from the literature about methicillin-resistant Staphylococcus aureus (MRSA) and developed an ordinary differential equations based mathematical model to quantify the impact of contact heterogeneity on MRSA transmission in a hypothetical 6-bed intensive care unit (ICU). The susceptible patients are divided into two types, these who are cared by the same nurse as the MRSA infected patient (Type 1) and these who are not (Type 2). Results The results showed that the mean MRSA concentration on three kinds of susceptible patient nearby surfaces was significantly linearly associated with the hand-touch frequency (p < 0.05). The noncompliance of daily cleaning on patient nearby high-touch surfaces (HTSs) had the most impact on MRSA transmission. If the HTSs were not cleaned, the MRSA exposure to Type 1 and 2 susceptible patients would increase 118.4% (standard deviation (SD): 33.0%) and 115.4% (SD: 30.5%) respectively. The communal surfaces (CSs) had the least impact, if CSs were not cleaned, the MRSA exposure to Type 1 susceptible patient would only increase 1.7% (SD: 1.3). The impact of clinical equipment (CE) differed largely for two types of susceptible patients. If the CE was not cleaned, the exposure to Type 1 patients would only increase 8.4% (SD: 3.0%), while for Type 2 patients, it can increase 70.4% (SD: 25.4%). Conclusions This study provided a framework to study the pathogen concentration dynamics on environmental surfaces and quantitatively showed the importance of cleaning patient nearby HTSs on controlling the nosocomial infection transmission via contact route.
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Affiliation(s)
- Hao Lei
- School of Public Health, Zhejiang University, Hangzhou, People's Republic of China. .,Zhejiang Institute of Research and Innovation, The University of Hong Kong, Lin An, Zhejiang, People's Republic of China.
| | - Rachael M Jones
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Yuguo Li
- Zhejiang Institute of Research and Innovation, The University of Hong Kong, Lin An, Zhejiang, People's Republic of China.,Department of Mechanical Engineering, The University of Hong Kong, Pokfulam, Hong Kong, SAR, People's Republic of China
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The Environmental Exposures and Inner- and Intercity Traffic Flows of the Metro System May Contribute to the Skin Microbiome and Resistome. Cell Rep 2019; 24:1190-1202.e5. [PMID: 30067975 DOI: 10.1016/j.celrep.2018.06.109] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/25/2018] [Accepted: 06/27/2018] [Indexed: 12/21/2022] Open
Abstract
The skin functions as the primary interface between the human body and the external environment. To understand how the microbiome varies within urban mass transit and influences the skin microbiota, we profiled the human palm microbiome after contact with handrails within the Hong Kong Mass Transit Railway (MTR) system. Intraday sampling time was identified as the primary determinant of the variation and recurrence of the community composition, whereas human-associated species and clinically important antibiotic resistance genes (ARGs) were captured as p.m. signatures. Line-specific signatures were notably correlated with line-specific environmental exposures and city characteristics. The sole cross-border line appeared as an outlier in most analyses and showed high relative abundance and a significant intraday increment of clinically important ARGs (24.1%), suggesting potential cross-border ARG transmission, especially for tetracycline and vancomycin resistance. Our study provides an important reference for future public health strategies to mitigate intracity and cross-border pathogen and ARG transmission.
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Chaoui L, Mhand R, Mellouki F, Rhallabi N. Contamination of the Surfaces of a Health Care Environment by Multidrug-Resistant (MDR) Bacteria. Int J Microbiol 2019; 2019:3236526. [PMID: 31871459 PMCID: PMC6906863 DOI: 10.1155/2019/3236526] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/20/2019] [Accepted: 10/31/2019] [Indexed: 11/18/2022] Open
Abstract
Nosocomial infections (NIs) are known worldwide and remain a major problem despite scientific and technical advances in the field of health. The severity of the infection depends on the characteristics of the microorganisms involved and the high frequency of resistant pathogens in the hospital environment. The aim of this study is to determine the distribution of pathogenic bacteria (and their resistance to antibiotics) that spread on hospital surfaces, more specifically, on those of various departments in the Provincial Hospital Center (PHC) of Mohammedia, Morocco. A cross-sectional study was conducted from March 2017 to April 2018. Samples were collected by swabbing the hospital surfaces, and the isolated bacteria were checked for their susceptibility to antibiotics by the Kirby-Bauer disk diffusion method following the standards of the Clinical and Laboratory Standards Institute (CLSI). Among 200 swab samples, 176 (88%) showed bacterial growth. Gram-negative isolates were predominant at 51.5% (101/196), while the Gram-positives were at 48.5% (95/196). The main isolates are Enterobacteria weighted at 31.6% (62/196), Staphylococcus aureus reaching 24% (47/196), Pseudomonas aeruginosa at 9.2% (18/196), and Acinetobacter spp. with 3.3% (6/196). Moreover, the antimicrobial susceptibility profile of the isolates showed that about 31.7% (32/101) of the Gram-negative isolates were found to be MDR. This resistance is also high among isolates of S. aureus of which 44.7% (20/47) were methicillin-resistant Staphylococcus aureus (MRSA). Contamination of hospital surfaces by MDR bacteria is a real danger to public health. The concept of environmental bacterial reservoir is a reality that requires strict compliance with current guidelines and recommendations for hand hygiene, cleaning, and disinfection of surfaces in hospitals.
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Affiliation(s)
- Laila Chaoui
- Provincial Diagnostic Laboratory Epidemiological and Environmental Health, Provincial Health Delegation, Mohammedia, Morocco
- Research Unit Microbiology Hygiene Bioactives Molecules Laboratory Virology Microbiology Quality and Biotechnology/Ecotoxicology Biodiversity, University Hassan II Casablanca, FSTM, Mohammedia, Morocco
| | - RajaaAit Mhand
- Research Unit Microbiology Hygiene Bioactives Molecules Laboratory Virology Microbiology Quality and Biotechnology/Ecotoxicology Biodiversity, University Hassan II Casablanca, FSTM, Mohammedia, Morocco
| | - Fouad Mellouki
- Research Unit Microbiology Hygiene Bioactives Molecules Laboratory Virology Microbiology Quality and Biotechnology/Ecotoxicology Biodiversity, University Hassan II Casablanca, FSTM, Mohammedia, Morocco
| | - Naima Rhallabi
- Research Unit Microbiology Hygiene Bioactives Molecules Laboratory Virology Microbiology Quality and Biotechnology/Ecotoxicology Biodiversity, University Hassan II Casablanca, FSTM, Mohammedia, Morocco
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Comparative evaluation of a novel fluorescent marker and environmental surface cultures to assess the efficacy of environmental cleaning practices at a tertiary care hospital. J Hosp Infect 2019; 104:261-268. [PMID: 31760128 DOI: 10.1016/j.jhin.2019.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/25/2019] [Accepted: 11/13/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Cleaning high-touch surfaces serves as a crucial step towards controlling the transmission of multidrug-resistant pathogens in hospital environments. The process can be made most effective if scientifically monitored using a simple, feasible and reliable technique, especially in resource-poor settings. AIM To identify a novel florescent marker (FM) comparable to the already existing commercial FM systems and to assess its efficacy in evaluating cleaning of high-touch surfaces in a hospital environment. METHODS A liquid detergent used for washing purposes was identified as a novel FM. Pre- and post-cleaning sampling were performed from 250 high-touch surfaces in different patient-care areas using this marker and aerobic colony counts. Concordance between the two methods was assessed and compared by Cohen's kappa coefficient. The sensitivity, specificity, positive predictive and negative predictive values for the new FM method were calculated against the microbiological method. FINDINGS A good correlation (κ = 0.60) with overall concordance of 79.6% was observed between the two methods. The sensitivity, specificity, positive predictive value and negative predictive value of the FM were 79.58% (95% confidence interval (CI): 72-85.85%), 79.63% (95% CI: 70.79-86.78), 83.70% (95% CI: 76.38-89.50) and 74.78% (95% CI: 65.83-82.38), respectively. CONCLUSIONS The FM used in the present study proved to be a simple and cost-effective alternative to commercially available FMs for assessing environmental cleaning practices on a daily basis in resource-poor settings. Additional studies making direct comparisons of the FM used here with the established FMs are warranted before it can be generalized for use.
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Oztoprak N, Kizilates F, Percin D. Comparison of steam technology and a two-step cleaning (water/detergent) and disinfecting (1,000 resp. 5,000 ppm hypochlorite) method using microfiber cloth for environmental control of multidrug-resistant organisms in an intensive care unit. GMS HYGIENE AND INFECTION CONTROL 2019; 14:Doc15. [PMID: 31728268 PMCID: PMC6838735 DOI: 10.3205/dgkh000330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Aim: The aim of this prospective observational study was to evaluate the impact of two cleaning and disinfecting methods and the use of steam against methicillin-resistant Staphyl ococcus aureus, vancomycin-resistant Enterococcus faecalis, carbapenem-resistant Pseudomonas aeruginosa and multidrug-resistant (MDR) Acinetobacter baumannii in a tertiary referral hospital. Methods: McFarland 0.5 suspensions (content 1.5 x 108 cfu/ml) of four challenge bacterial species were prepared and used to inoculate different sites in three ICU rooms. One of the following methods was used in each room: steam technology (Tecnovap Evo 304) resp. cleaning with microfiber cloths, soaked with detergent and water, thereafter disinfection with 1,000 ppm hypochlorite or the same procedure with 5,000 ppm hypochlorite. Qualitative microbiology and ATP bioluminescence were performed before and after cleaning with each method. The Wilcoxon test was used for paired samples to check for ordinal variables. The cost of each cleaning method was analyzed. Results: Environmental cleaning with steam technology was found to be as effective against MDR microorganisms as a two-step cleaning process (water/detergent and disinfecting with 1,000 resp. 5,000 ppm hypochlorite) in ICUs. No bacterial growth was detected after any of the three cleaning methods. Steam technology was 76% and 91% cheaper than using 5,000 ppm and 1,000 ppm hypochlorite, respectively. Conclusions: When compared to, steam technology was found to have an advantage over the 2-step procedure with cleaning and disinfection, because it avoids the use of chemicals, reduces water consumption, labor time and costs for cleaning.
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Affiliation(s)
- Nefise Oztoprak
- Antalya Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - Filiz Kizilates
- Antalya Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - Duygu Percin
- Kutahya Health Sciences University Medical Faculty, Department of Medical Microbiology, Kutahya, Turkey
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Hilt N, Hulscher MEJL, Antonise-Kamp L, OldeLoohuis A, Voss A. Current practice of infection control in Dutch primary care: Results of an online survey. Am J Infect Control 2019; 47:643-647. [PMID: 30616933 DOI: 10.1016/j.ajic.2018.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 11/08/2018] [Accepted: 11/08/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Good infection prevention is an important aspect of quality of medical care. The aim was to evaluate infection prevention and control (IPC) performance among Dutch general practitioners (GPs). METHODS Based on the current national IPC guidelines for GPs, a self-administered anonymous online questionnaire was developed and sent to GPs in the Nijmegen region of the Netherlands. Thirty-two questions were constructed to survey characteristics of GPs' offices and assess current performance of IPC measures. RESULTS One hundred questionnaires were included in our analysis. The preferred method of hand hygiene was soap and water (56%) versus alcohol-based handrub (44%). The cleaning of nondisposable, noncritical, semicritical, and critical instruments was consistent with national guideline recommendations or superior to them in 100%, 49%, and 97% of cases, respectively. An average of 57% of GPs reported environmental cleaning frequencies that were compliant with the national guidelines or superior to them. Personal protective equipment was available in 62% of GPs' practices but used in only 25% of home visits to patients. CONCLUSIONS Not all national IPC guidelines seem to be followed to the fullest extent. The current situation indicates there is room for potential improvement regarding implementation of IPC measures in GPs' offices. Area-specific guidelines and continuous medical education regarding IPC may help improve the situation.
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Affiliation(s)
- Nataliya Hilt
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, Groningen, The Netherlands.
| | - Marlies E J L Hulscher
- Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Laura Antonise-Kamp
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Alfons OldeLoohuis
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Andreas Voss
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Clinical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands; REshape Center for Innovation, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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49
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Munoz-Gutierrez K, Canales R, Reynolds K, Verhougstraete M. Floor and environmental contamination during glove disposal. J Hosp Infect 2019; 101:347-353. [DOI: 10.1016/j.jhin.2018.10.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 10/15/2018] [Indexed: 11/30/2022]
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50
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Bowe E, Srivastava T, Masroor N, Cooper K, Fleming M, Knowlson S, Doll M, Stevens MP, Bearman G. Disinfection of noncritical equipment on units with high hospital-onset Clostridium difficile infections. Am J Infect Control 2019; 47:220-221. [PMID: 30262259 DOI: 10.1016/j.ajic.2018.07.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/29/2018] [Accepted: 07/30/2018] [Indexed: 10/28/2022]
Abstract
We assessed barriers and knowledge of disinfection of noncritical items (NCIs) between intensive care unit (ICU) and non-ICU staff members. General understanding of cleaning NCIs was low across all staff. Non-ICU staff had a better understanding of who is responsible for disinfecting and where to access information on storing cleaned NCIs. Opportunities exist for heightened disinfection of NCIs through improved point-of-care instructional information, improved cleaning supply access, and increased instrument storage space.
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