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Herrera S, Roca I, Del Río A, Fernández J, Pitart C, Fortes I, Torralbo B, Santana G, Parejo-González R, Veà-Baró A, Campistol JM, Aguilar M, Degea S, Casals-Pascual C, Soriano A, Martínez JA. Performance of an Autonomous Sanitary Sterilisation Ultraviolet Machine (ASSUM) on terminal disinfection of surgical theaters and rooms of an intensive-intermediate care unit. Infect Prev Pract 2024; 6:100396. [PMID: 39308772 PMCID: PMC11415570 DOI: 10.1016/j.infpip.2024.100396] [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] [Received: 05/08/2024] [Accepted: 08/13/2024] [Indexed: 09/25/2024] Open
Abstract
Background Ultraviolet- C (UV-C) light is effective for reducing environmental bioburden in hospitals, and the use of robots to deliver it may be advantageous. Aim To evaluate the feasibility and clinical efficacy of an autonomous programmable UV-C robot in surgical and intensive care unit (ICU) rooms of a tertiary hospital. Method During ten consecutive months, the device was used in six theatres where cardiac, colorectal and orthopaedic surgeries were performed, and in the rooms previously occupied by patients subjected to contact precautions of a 14-bed ICU. Surgical site infection (SSI) rates of procedures performed in the UV-cleaned theatres were compared with those of the previous year. Incidence in clinical samples of ICU-acquired multiple-drug resistant (MDR) microorganisms was compared with that of the same period of the previous year. An UV-C exposure study done by semi-quantitative dosimeters and a survey of the bioburden on surfaces were carried out. Findings SSI rates in the pre- and post-intervention periods were 8.67% (80/922) and 7.5% (61/813), respectively (p=0.37). Incidence of target microorganisms in clinical samples remained unchanged (38.4 vs. 39.4 per 10,000 patient-days, p=0.94). All the dosimeters exposed to ≤1 meter received ≥500 mJ/cm2. The bacterial load on surfaces decreased after the intervention, particularly in ICU rooms (from 4.57±7.4 CFU to 0.27±0.8 CFU, p<0.0001). Conclusion Deployment of an UV-C robot in surgical and ICU rooms is feasible, ensures adequate delivery of germicidal UV-C light and reduces the environmental bacterial burden. Rates of surgical site infections or acquisition of MDR in clinical samples of critically-ill patients remained unchanged.
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Affiliation(s)
- Sabina Herrera
- Infectious Disease Service, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Ignasi Roca
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Department of Microbiology, Biomedical Diagnostic Center (CDB) and ISGlobal, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Ana Del Río
- Infectious Disease Service, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Fernández
- Liver ICU, Liver Unit, Hospital Clinic, University of Barcelona, IDIBAPS and CIBERehd, Spain
- EF Clif, EASL-CLIF Consortium, Barcelona, Spain
- CovidWarriors, Barcelona, Spain
| | - Cristina Pitart
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Department of Microbiology, Biomedical Diagnostic Center (CDB) and ISGlobal, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Isabel Fortes
- Preventive Medicine Service, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Blanca Torralbo
- Preventive Medicine Service, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Gemina Santana
- Preventive Medicine Service, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Romina Parejo-González
- Preventive Medicine Service, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Andreu Veà-Baró
- Andreu Veà, Ph.D. advisor to the CEO (on Digital-Transformation & Optimization) Hospital Clinic Barcelona CovidWarrior, Barcelona, Spain
| | - Josep Maria Campistol
- Hospital Clínic, University of Barcelona, August Pi i Sunyer Biomedical Research Institute Barcelona, Spain
| | - Mireia Aguilar
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Department of Microbiology, Biomedical Diagnostic Center (CDB) and ISGlobal, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Sergi Degea
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Department of Microbiology, Biomedical Diagnostic Center (CDB) and ISGlobal, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Climent Casals-Pascual
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Department of Microbiology, Biomedical Diagnostic Center (CDB) and ISGlobal, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Alex Soriano
- Infectious Disease Service, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - José A. Martínez
- Infectious Disease Service, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Lee J, Kim EJ, Lim YJ, Kim EO, Bae S, Jung J, Kim SH. Effectiveness of ceiling-mounted ultraviolet-C lamps: An experimental study in a biocontainment unit of a tertiary care hospital. Am J Infect Control 2024:S0196-6553(24)00581-9. [PMID: 38945300 DOI: 10.1016/j.ajic.2024.06.020] [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: 03/11/2024] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND We aimed to evaluate the performance of ceiling-mounted UV-C lamps. METHODS This study was conducted in an empty room with UV-C lamps in the biocontainment unit of a tertiary care hospital in South Korea. Each pathogen (Staphylococcus aureus, Escherichia coli, Candida krusei, Bacillus cereus, and Mycobacterium peregrinum) was inoculated on blood agar plates and placed in 20 selected places from the UV-C lamp, and irradiation was applied for 15 min. As a control group, the bacterial solution was diluted 10,000 times and UV was not applied. RESULTS A mean ± SD of 5.95 ± 0.91 log reduction was observed with UV irradiation compared with the control. The log reduction was greatest for S. aureus [median, 7.05 (IQR, 6.49-7.26)] and least for M. peregrinum [median, 4.88 (IQR, 4.58-5.24)]. The degree of log reduction was inversely proportional to the square of the distance from the UV-C lamp (R2 = -0.12, P < .001). CONCLUSIONS In this study, ceiling-mounted UV-C demonstrated effective disinfection of at least 4-log reduction of the test organisms within a 4-m distance. Mounted UV-C lighting is a considerable option for improving surface disinfection.
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Affiliation(s)
- Jeongyoung Lee
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea
| | - Eun Ju Kim
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea
| | - Young-Ju Lim
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea
| | - Eun Ok Kim
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jiwon Jung
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea; Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Sung-Han Kim
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea; Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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3
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Dhar S, Jinadatha C, Kilgore PE, Henig O, Divine GW, Todter EN, Coppin JD, Carter MJ, Chopra T, Egbert S, Carling PC, Kaye KS. Lowering the Acquisition of Multi-drug Resistant Organism (MDROs) with Pulsed-xenon (LAMP) Study: a cluster randomized controlled, double-blinded, interventional crossover trial. Clin Infect Dis 2024:ciae240. [PMID: 38743564 DOI: 10.1093/cid/ciae240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/11/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Environmental disinfection is essential for reducing spread of healthcare associated infections (HAIs). Previous studies report conflicting results regarding the effects of ultraviolet light (UV) in reducing infections. This trial evaluated the impact of adding pulsed xenon UV (PX-UV) to standard terminal cleaning in reducing environmentally-implicated HAIs (eiHAIs). METHODS The LAMP trial was conducted in 2 hospitals (15 inpatient wards) utilizing a cluster randomized controlled, double-blinded, interventional crossover trial comparing standard terminal cleaning followed by either pulsed xenon ultraviolet (PX-UV) disinfection (intervention arm) or sham disinfection (control arm). The primary outcome was incidence of eiHAIs from clinical microbiology tests on the 4th day of stay or later or within 3 days after discharge from the study unit. EiHAIs included clinical cultures positive for vancomycin-resistant enterococci (VRE), extended spectrum beta-lactamase-producing Escherichia coli or Klebsiella pneumonia, methicillin-resistant Staphylococcus aureus (MRSA), and Acinetobacter baumannii, and stool PCR positive for Clostridiodes difficile. FINDINGS Between May 18, 2017 to Jan 7, 2020, 25,732 patients were included, with an incidence of 601 eiHAI and 180,954 patient days. There was no difference in the rate of eiHAIs in the intervention and sham arms (3.49 vs 3.17 infections/1000 patient days respectively, RR 1.10 CI (0.94, 1.29, p= 0.23)). Study results were similar when stratified by eiHAI type, hospital, and unit type. CONCLUSION The LAMP study failed to demonstrate an effect of the addition of UV light disinfection following terminal cleaning on reductions in rates of eiHAIs. Further investigations targeting hospital environmental surfaces and the role of no touch technology to reduce HAIs are needed.
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Affiliation(s)
- Sorabh Dhar
- Professor of Medicine, Division of Infectious Diseases, Wayne State University, John D. Dingell Veterans Affairs Medical Center, Harper University Hospital - 5 Hudson, 3990 John R St, Detroit, MI 48201
| | - Chetan Jinadatha
- Central Texas Veterans Health Care System, School of Medicine, Texas A&M University, 8447 Riverside Pkwy, Bryan, TX 77807
| | - Paul E Kilgore
- Professor, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, Michigan, 259 Mack Ave., Room 2156, Detroit, Michigan 48201
| | - Oryan Henig
- Tel Aviv Sourasky Medical Center, Weizmann 7, Tel Aviv, Israel
| | - George W Divine
- Michigan State University, Department of Epidemiology and Biostatistics, Henry Ford Health, 1 Ford Place, 3C16, Detroit, MI 48202
| | - Erika N Todter
- Henry Ford Health, Department of Public Health Sciences, 1 Ford Place, Detroit, MI 48202
| | - John D Coppin
- Central Texas Veterans Health Care System, 1901 South 1st Street, Temple, TX 76504
| | - Marissa J Carter
- Strategic Solutions, Inc., 37 Voyager Lane, Bozeman, MT 59718, USA
| | - Teena Chopra
- Professor of Medicine, Division of Infectious Diseases, Wayne State University, Harper University Hospital - 5 Hudson, 3990 John R St, Detroit, MI 48201
| | - Steve Egbert
- XENDELLA Facilities Management, 6 Shearwater Ct, Hawthorn Woods, IL 60047
| | - Philip C Carling
- Clinical Professor of Medicine, Department of Infectious Diseases, Boston University School of Medicine, 72 E Concord Street, Boston, MA 02118
| | - Keith S Kaye
- Professor of Medicine, Division of Allergy, Immunology and Infectious Diseases, Robert Wood Johnson Medical School, 125 Paterson Street, CAB 7136, New Brunswick, NJ 08901
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Smith M, Crnich C, Donskey C, Evans CT, Evans M, Goto M, Guerrero B, Gupta K, Harris A, Hicks N, Khader K, Kralovic S, McKinley L, Rubin M, Safdar N, Schweizer ML, Tovar S, Wilson G, Zabarsky T, Perencevich EN. Research agenda for transmission prevention within the Veterans Health Administration, 2024-2028. Infect Control Hosp Epidemiol 2024:1-10. [PMID: 38600795 DOI: 10.1017/ice.2024.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Affiliation(s)
- Matthew Smith
- Center for Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Chris Crnich
- William. S. Middleton Memorial VA Hospital, Madison, WI, USA
| | - Curtis Donskey
- Geriatric Research, Education and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
| | - Charlesnika T Evans
- Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, Hines, IL, USA
- Department of Preventive Medicine and Center for Health Services and Outcomes Research, Northwestern University of Feinberg School of Medicine, Chicago, IL, USA
| | - Martin Evans
- MRSA/MDRO Division, VHA National Infectious Diseases Service, Patient Care Services, VA Central Office and the Lexington VA Health Care System, Lexington, KY, USA
| | - Michihiko Goto
- Center for Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Bernardino Guerrero
- Environmental Programs Service (EPS), Veterans Affairs Central Office, Washington, DC, USA
| | - Kalpana Gupta
- VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, USA
| | - Anthony Harris
- Department of Epidemiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Natalie Hicks
- National Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC, USA
| | - Karim Khader
- DEAS Center of Innovation, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah
- Division of Epidemiology, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Stephen Kralovic
- Veterans Health Administration National Infectious Diseases Service, Washington, DC, USA
- Cincinnati VA Medical Center and University of Cincinnati, Cincinnati, OH, USA
| | - Linda McKinley
- William. S. Middleton Memorial VA Hospital, Madison, WI, USA
| | - Michael Rubin
- DEAS Center of Innovation, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah
- Division of Epidemiology, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Nasia Safdar
- William. S. Middleton Memorial VA Hospital, Madison, WI, USA
| | - Marin L Schweizer
- William. S. Middleton Memorial VA Hospital, Madison, WI, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, and William S. Middleton Hospital, Madison, WI, USA
| | - Suzanne Tovar
- National Infectious Diseases Service (NIDS), Veterans Affairs Central Office, Washington, DC, USA
| | - Geneva Wilson
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines Jr. Veterans Affairs Hospital, Hines, IL, USA
- Department of Preventive Medicine, Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Trina Zabarsky
- Environmental Programs Service (EPS), Veterans Affairs Central Office, Washington, DC, USA
| | - Eli N Perencevich
- Center for Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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5
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Chen Z, Yang Y, Li G, Huang Y, Luo Y, Le S. Effective elimination of bacteria on hard surfaces by the combined use of bacteriophages and chemical disinfectants. Microbiol Spectr 2024; 12:e0379723. [PMID: 38483478 PMCID: PMC10986474 DOI: 10.1128/spectrum.03797-23] [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: 12/13/2023] [Accepted: 02/27/2024] [Indexed: 04/06/2024] Open
Abstract
Hospital-acquired infections (HAIs) represent one of the significant causes of morbidity and mortality worldwide, and controlling pathogens in the hospital environment is of great importance. Currently, the standard disinfection method in the hospital environment is chemical disinfection. However, disinfectants are usually not used strictly according to the label, making them less effective in disinfection. Therefore, there is an emergent need to find a better approach that can be used in hospitals to control pathogenic bacteria in the clinical environment. Bacteriophages (phages) are effective in killing bacteria and have been applied in the treatment of bacterial infections but have not received enough attention regarding the control of contamination in the clinical environment. In this study, we found that various phages remain active in the presence of chemical disinfectants. Moreover, the combined use of specific phages and chemical disinfectants is more effective in removing bacterial biofilms and eliminating bacteria on hard surfaces. Thus, this proof-of-concept study indicates that adding phages directly to chemical disinfectants might be an effective and economical approach to enhance clinical environment disinfection. IMPORTANCE In this study, we investigated whether the combination of bacteriophages and chemical disinfectants can enhance the efficacy of reducing bacterial contamination on hard surfaces in the clinical setting. We found that specific phages are active in chemical disinfectants and that the combined use of phages and chemical disinfectants was highly effective in reducing bacterial presence on hard surfaces. As a proof-of-concept, we demonstrated that adding specific phages directly to chemical disinfectants is an effective and cost-efficient strategy for clinical environment disinfection.
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Affiliation(s)
- Zongyue Chen
- School of Nursing, Army Medical University, Chongqing, China
| | - Yuhui Yang
- School of Nursing, Army Medical University, Chongqing, China
| | - Gaoming Li
- Disease Surveillance Division, Center for Disease Control and Prevention of Central Theater Command, Shijingshan, Beijing, China
| | - Youying Huang
- Biomedical Analysis Center, College of Basic Medical Sciences, Army Medical University, Chongqing, China
| | - Yu Luo
- School of Nursing, Army Medical University, Chongqing, China
| | - Shuai Le
- Department of Microbiology, College of Basic Medical Sciences, Key Laboratory of Microbial Engineering Under the Educational Committee in Chongqing, Army Medical University, Chongqing, China
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Padte S, Samala Venkata V, Mehta P, Tawfeeq S, Kashyap R, Surani S. 21st century critical care medicine: An overview. World J Crit Care Med 2024; 13:90176. [PMID: 38633477 PMCID: PMC11019625 DOI: 10.5492/wjccm.v13.i1.90176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/28/2023] [Accepted: 01/24/2024] [Indexed: 03/05/2024] Open
Abstract
Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units (ICUs). This abstract provides a concise summary of the latest developments in critical care, highlighting key areas of innovation. Recent advancements in critical care include Precision Medicine: Tailoring treatments based on individual patient characteristics, genomics, and biomarkers to enhance the effectiveness of therapies. The objective is to describe the recent advancements in Critical Care Medicine. Telemedicine: The integration of telehealth technologies for remote patient monitoring and consultation, facilitating timely interventions. Artificial intelligence (AI): AI-driven tools for early disease detection, predictive analytics, and treatment optimization, enhancing clinical decision-making. Organ Support: Advanced life support systems, such as Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy provide better organ support. Infection Control: Innovative infection control measures to combat emerging pathogens and reduce healthcare-associated infections. Ventilation Strategies: Precision ventilation modes and lung-protective strategies to minimize ventilator-induced lung injury. Sepsis Management: Early recognition and aggressive management of sepsis with tailored interventions. Patient-Centered Care: A shift towards patient-centered care focusing on psychological and emotional well-being in addition to medical needs. We conducted a thorough literature search on PubMed, EMBASE, and Scopus using our tailored strategy, incorporating keywords such as critical care, telemedicine, and sepsis management. A total of 125 articles meeting our criteria were included for qualitative synthesis. To ensure reliability, we focused only on articles published in the English language within the last two decades, excluding animal studies, in vitro/molecular studies, and non-original data like editorials, letters, protocols, and conference abstracts. These advancements reflect a dynamic landscape in critical care medicine, where technology, research, and patient-centered approaches converge to improve the quality of care and save lives in ICUs. The future of critical care promises even more innovative solutions to meet the evolving challenges of modern medicine.
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Affiliation(s)
- Smitesh Padte
- Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States
| | | | - Priyal Mehta
- Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States
| | - Sawsan Tawfeeq
- Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States
| | - Rahul Kashyap
- Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States
- Department of Research, WellSpan Health, York, PA 17403, United States
- Department of Pulmonary & Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Salim Surani
- Department of Pulmonary & Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
- Department of Medicine & Pharmacology, Texas A&M University, College Station, TX 77843, United States
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7
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Watkin S, Yongblah F, Burton J, Hartley JC, Cloutman-Green E. Clostridioides difficile detection and infection in children: are they just small adults? J Med Microbiol 2024; 73. [PMID: 38526913 DOI: 10.1099/jmm.0.001816] [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] [Indexed: 03/27/2024] Open
Abstract
Clostridioides difficile is a well-recognized healthcare-associated pathogen, with its significance widely recognized in adult populations. Despite this, there is limited data on the significance of detection within paediatric populations, both for individual patient management and wider transmission risk-based considerations. High rates of colonization are understood to occur in infants, with increasing levels up to 11 months, and colonization rates similar to adults by 8 years old. Sources of C. difficile are ubiquitous, with detection in companion animals and food sources, as well as within the clinical and wider environment. Due to the close interactions that occur between children and the environment, it is understandable that increasing recognition is afforded to the community acquisition of C. difficile in children. Other risk factors for the detection of C. difficile in children are similar to those observed in adults, including prior hospitalization and underlying conditions affecting gut health and motility. Recent studies have shown rising awareness of the role of asymptomatic carriage of C. difficile in healthcare transmission. Prior to this, paediatric patient populations were less likely to be screened due to uncertainty regarding the significance of detection; however, this increased awareness has led to a review of possible carriage testing pathways. Despite this increased attention, C. difficile infection remains poorly defined in paediatric populations, with limited dedicated paediatric data sets making comparison challenging. This is further complicated by the fact that infection in children frequently self resolves without additional therapies. Due to this, C. difficile remains a management challenge in paediatric settings.
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Affiliation(s)
- Sam Watkin
- Department of Civil Environmental and Geomatic Engineering, Healthy Infrastructure Research Group, University College London, Chadwick Building, London, UK
| | - Francis Yongblah
- Great Ormond Street Hospital NHS Foundation Trust, Camelia Botnar Laboratories, Department of Microbiology, London, UK
| | - James Burton
- Great Ormond Street Hospital NHS Foundation Trust, Camelia Botnar Laboratories, Department of Microbiology, London, UK
| | - John C Hartley
- Great Ormond Street Hospital NHS Foundation Trust, Camelia Botnar Laboratories, Department of Microbiology, London, UK
| | - Elaine Cloutman-Green
- Department of Civil Environmental and Geomatic Engineering, Healthy Infrastructure Research Group, University College London, Chadwick Building, London, UK
- Great Ormond Street Hospital NHS Foundation Trust, Camelia Botnar Laboratories, Department of Microbiology, London, UK
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8
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Crall VD, Lewis CL, Dickman DJ, Grinage DW, George T, Ayres AM, Ciccone C, Snyder GM. Strategies for deployment of ultraviolet disinfection in an acute care facility: A quality improvement initiative. Am J Infect Control 2023; 51:1230-1236. [PMID: 37116712 DOI: 10.1016/j.ajic.2023.04.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/16/2023] [Accepted: 04/17/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND Mobile ultraviolet (UV) disinfection uses UV-C light to render microorganisms nonviable and reduce environmental transmission of pathogens in hospital settings. Optimal strategies for deployment must consider the cost, physical layout, and staffing resources. The aim of this quality improvement study was to increase UV disinfection utilization by developing novel deployment strategies without adding resources. METHODS A novel deployment strategy and tools were developed by a multidisciplinary group that included infection prevention, environmental services, and nursing unit staff. Utilization was tracked via a manufacturer-supported database. The infection prevention team analyzed the weekly UV disinfection minutes, cycles, and proportions of cycles completed in defined areas across 4 periods: baseline, pilot, baseline 2, and intervention. RESULTS The median (range) disinfection cycle times per week during a geographically confined pilot (4,985 minutes [3,476-6,551] minutes) and the intervention period (1,454 [512-3,085] minutes) were lower than either baseline period (5,394 [3,953-6,987] and 6,641 [2,830-7,276] minutes, respectively). Cycles per week were lower in the intervention period than in the preceding 3 periods. CONCLUSIONS Use of UV disinfection in acute care settings should be guided by multidisciplinary groups balancing resources against efficacy and using tailored tools to promote efficiency.
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Affiliation(s)
- Victoria D Crall
- Department of Infection Control and Hospital Epidemiology, UPMC Presbyterian-Shadyside, Pittsburgh, PA
| | - Casey L Lewis
- Department of Infection Control and Hospital Epidemiology, UPMC Presbyterian-Shadyside, Pittsburgh, PA
| | - Daniel J Dickman
- Department of Environmental Services, UPMC Presbyterian-Shadyside, Pittsburgh, PA
| | - Darnell W Grinage
- Department of Environmental Services, UPMC Presbyterian-Shadyside, Pittsburgh, PA
| | - Trish George
- Department of Patient Safety and Innovation, UPMC Presbyterian-Shadyside, Pittsburgh, PA
| | - Ashley M Ayres
- Department of Infection Control and Hospital Epidemiology, UPMC Presbyterian-Shadyside, Pittsburgh, PA
| | - Carl Ciccone
- Department of Infection Control and Hospital Epidemiology, UPMC Presbyterian-Shadyside, Pittsburgh, PA
| | - Graham M Snyder
- Department of Infection Control and Hospital Epidemiology, UPMC Presbyterian-Shadyside, Pittsburgh, PA; Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
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9
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Rutala WA, Donskey CJ, Weber DJ. Disinfection and sterilization: New technologies. Am J Infect Control 2023; 51:A13-A21. [PMID: 37890943 DOI: 10.1016/j.ajic.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Adherence to professional guidelines and/or manufacturer's instructions for use regarding proper disinfection and sterilization of medical devices is crucial to preventing cross transmission of pathogens between patients. Emerging pathogens (e.g., Candida auris) and complex medical devices provide new challenges. METHODS A search for published English articles on new disinfection and sterilization technologies was conducted by Google, Google scholar and PubMed. RESULTS Several new disinfection methods or products (e.g., electrostatic spraying, new sporicides, colorized disinfectants, "no touch" room decontamination, continuous room decontamination) and sterilization technologies (e.g., new sterilization technology for endoscopes) were identified. CONCLUSIONS These technologies should reduce patient risk.
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Affiliation(s)
- William A Rutala
- Statewide Program for Infection Control and Epidemiology, University of North Carolina (UNC) School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC.
| | - Curtis J Donskey
- Geriatric Research, Education and Clinical Care, Louis Stokes Cleveland VA Medical Center, Cleveland, OH
| | - David J Weber
- Statewide Program for Infection Control and Epidemiology, University of North Carolina (UNC) School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC; Infection Prevention, University of North Carolina Medical Center, Chapel Hill, NC
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10
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Weber DJ, Rutala WA, Anderson DJ, Sickbert-Bennett EE. ..úNo touch..Ñ methods for health care room disinfection: Focus on clinical trials. Am J Infect Control 2023; 51:A134-A143. [PMID: 37890944 DOI: 10.1016/j.ajic.2023.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 04/03/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Hospital patient room surfaces are frequently contaminated with multidrug-resistant organisms. Since studies have demonstrated that inadequate terminal room disinfection commonly occurs, ..úno touch..Ñ methods of terminal room disinfection have been developed such as ultraviolet light (UV) devices and hydrogen peroxide (HP) systems. METHODS This paper reviews published clinical trials of ..úno touch..Ñ methods and ..úself-disinfecting..Ñ surfaces. RESULTS Multiple papers were identified including clinical trials of UV room disinfection devices (N.ß=.ß20), HP room disinfection systems (N.ß=.ß8), handheld UV devices (N.ß=.ß1), and copper-impregnated or coated surfaces (N.ß=.ß5). Most but not all clinical trials of UV devices and HP systems for terminal disinfection demonstrated a reduction of colonization/infection in patients subsequently housed in the room. Copper-coated surfaces were the only ..úself-disinfecting..Ñ technology evaluated by clinical trials. Results of these clinical trials were mixed. DISCUSSION Almost all clinical trials reviewed used a ..úweak..Ñ design (eg, before-after) and failed to assess potential confounders (eg, compliance with hand hygiene and environmental cleaning). CONCLUSIONS The evidence is strong enough to recommend the use of a ..úno-touch..Ñ method as an adjunct for outbreak control, mitigation strategy for high-consequence pathogens (eg, Candida auris or Ebola), or when there are an excessive endemic rates of multidrug-resistant organisms.
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Affiliation(s)
- David J Weber
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC; Department of Infection Prevention, UNC Medical Center, Chapel Hill, NC.
| | - William A Rutala
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Deverick J Anderson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University School of Medicine, Durham, NC
| | - Emily E Sickbert-Bennett
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC; Department of Infection Prevention, UNC Medical Center, Chapel Hill, NC
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11
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Carling PC, Parry MF, Olmstead R. Environmental approaches to controlling Clostridioides difficile infection in healthcare settings. Antimicrob Resist Infect Control 2023; 12:94. [PMID: 37679758 PMCID: PMC10483842 DOI: 10.1186/s13756-023-01295-z] [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: 05/14/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023] Open
Abstract
As today's most prevalent and costly healthcare-associated infection, hospital-onset Clostridioides difficile infection (HO-CDI) represents a major threat to patient safety world-wide. This review will discuss how new insights into the epidemiology of CDI have quantified the prevalence of C. difficile (CD) spore contamination of the patient-zone as well as the role of asymptomatically colonized patients who unavoidable contaminate their near and distant environments with resilient spores. Clarification of the epidemiology of CD in parallel with the development of a new generation of sporicidal agents which can be used on a daily basis without damaging surfaces, equipment, or the environment, led to the research discussed in this review. These advances underscore the potential for significantly mitigating HO-CDI when combined with ongoing programs for optimizing the thoroughness of cleaning as well as disinfection. The consequence of this paradigm-shift in environmental hygiene practice, particularly when combined with advances in hand hygiene practice, has the potential for significantly improving patient safety in hospitals globally by mitigating the acquisition of CD spores and, quite plausibly, other environmentally transmitted healthcare-associated pathogens.
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12
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Sun Y, Wu Q, Liu J, Wang Q. Effectiveness of ultraviolet-C disinfection systems for reduction of multi-drug resistant organism infections in healthcare settings: A systematic review and meta-analysis. Epidemiol Infect 2023; 151:e149. [PMID: 37644902 PMCID: PMC10540170 DOI: 10.1017/s0950268823001371] [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: 04/25/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023] Open
Abstract
This study aimed to summarise the findings of the studies assessing the effectiveness of ultraviolet C (UV-C) room disinfection in reducing the incidence rate of healthcare-associated multi-drug-resistant organism (MDRO) infections. A systematic screening was conducted using PubMed, EMBASE, and Scopus for randomised controlled trials (RCTs), quasi-experimental studies, and before-after studies, which assessed the efficacy of the UV-C disinfectant system in reducing the incidence of MDRO infections. A random-effects model was used for the analysis. Effect sizes were described as incidence rate ratio (IRR) with 95% confidence intervals (CI). Nine studies were included, all of which were conducted in the USA. No statistically significant reduction in Clostridioides difficile (CD) (IRR: 0.90, 95% CI; 0.62-1.32) and vancomycin-resistant enterococcal (VRE) infection rates (IRR 0.72, 95% CI; 0.38-1.37) was observed with the use of UV-C, but the risk of Gram-negative rod infection was reduced (IRR 0.82, 95% CI; 0.68-0.99).
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Affiliation(s)
- YanLin Sun
- Day Surgery Center, The Affiliated Qingdao Central Hospital of Qingdao University, Qingdao, China
| | - Qi Wu
- Department of Infection Management, The Affiliated Qingdao Central Hospital of Qingdao University, Qingdao, China
| | - Jinzhi Liu
- Department of Gastroenterology, The Affiliated Qingdao Central Hospital of Qingdao University, Qingdao, China
| | - Qian Wang
- Department of Infection Management, The Affiliated Qingdao Central Hospital of Qingdao University, Qingdao, China
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13
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Schöbel H, Diem G, Kiechl J, Chistè D, Bertacchi G, Mayr A, Wilflingseder D, Lass-Flörl C, Posch W. Antimicrobial efficacy and inactivation kinetics of a novel LED-based UV-irradiation technology. J Hosp Infect 2023; 135:11-17. [PMID: 36754288 PMCID: PMC10041887 DOI: 10.1016/j.jhin.2022.12.023] [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: 10/03/2022] [Revised: 12/06/2022] [Accepted: 12/15/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND Ultraviolet (UV)-light-emitting diodes (UV-LEDs) are energy efficient and of special interest for the inactivation of micro-organisms. In the context of the coronavirus disease 2019 pandemic, novel UV technologies can offer a powerful alternative for effective infection prevention and control. METHODS This study assessed the antimicrobial efficacy of UV-C LEDs on Escherichia coli, Pseudomonas fluorescens and Listeria innocua, as well as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), human immunodeficiency virus-1 (HIV-1) and murine norovirus (MNV), dried on inanimate surfaces, based on European Standard EN 17272. RESULTS This study found 90% inactivation rates for the tested bacteria at mean UV-C doses, averaged over all three investigated UV-C wavelengths, of 1.7 mJ/cm2 for E. coli, 1.9 mJ/cm2 for P. fluorescens and 1.5 mJ/cm2 for L. innocua. For the tested viruses, UV doses <15 mJ/cm2 resulted in 90% inactivation at wavelengths of 255 and 265 nm. Exposure of viruses to longer UV wavelengths, such as 275 and 285 nm, required much higher doses (up to 120 mJ/cm2) for inactivation. Regarding inactivation, non-enveloped MNV required much higher UV doses for all tested wavelengths compared with SARS-CoV-2 or HIV-1. CONCLUSION Overall, the results support the use of LEDs emitting at shorter wavelengths of the UV-C spectrum to inactivate bacteria as well as enveloped and non-enveloped viruses by exposure to the appropriate UV dose. However, low availability and excessive production costs of shortwave UV-C LEDs restricts implementation at present, and supports the use of longwave UV-C LEDs in combination with higher irradiation doses.
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Affiliation(s)
- H Schöbel
- Department of Biotechnology and Food Engineering, MCI - The Entrepreneurial School, Innsbruck, Austria
| | - G Diem
- Institute of Hygiene and Medical Microbiology, Medical University Innsbruck, Innsbruck, Austria
| | - J Kiechl
- Department of Biotechnology and Food Engineering, MCI - The Entrepreneurial School, Innsbruck, Austria
| | - D Chistè
- Department of Biotechnology and Food Engineering, MCI - The Entrepreneurial School, Innsbruck, Austria
| | - G Bertacchi
- Institute of Hygiene and Medical Microbiology, Medical University Innsbruck, Innsbruck, Austria
| | - A Mayr
- Institute of Hygiene and Medical Microbiology, Medical University Innsbruck, Innsbruck, Austria
| | - D Wilflingseder
- Institute of Hygiene and Medical Microbiology, Medical University Innsbruck, Innsbruck, Austria
| | - C Lass-Flörl
- Institute of Hygiene and Medical Microbiology, Medical University Innsbruck, Innsbruck, Austria
| | - W Posch
- Institute of Hygiene and Medical Microbiology, Medical University Innsbruck, Innsbruck, Austria.
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14
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Song C, Wen R, Zhou J, Zeng X, Kou Z, Li Y, Yun F, Wu R. UV C Light from a Light-Emitting Diode at 275 Nanometers Shortens Wound Healing Time in Bacterium- and Fungus-Infected Skin in Mice. Microbiol Spectr 2022; 10:e0342422. [PMID: 36453911 PMCID: PMC9769979 DOI: 10.1128/spectrum.03424-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/07/2022] [Indexed: 12/05/2022] Open
Abstract
Due to the changes in pathogenic species and the absence of research on topical skin antibiotics, the therapy of skin and soft tissue infections (SSTIs) is facing more and more severe challenges. It is particularly urgent to look for alternative therapies without induction of drug resistance. UV C (UVC) light within the range of 200 to 280 nm is one of the most common techniques used to kill and/or inactivate pathogenic microorganisms. However, the traditional most commonly used wavelength of 254 nm irradiated from a low-pressure mercury lamp is hazardous to human health, being both carcinogenic and damaging to eye tissues, which limits its applications in vivo. This research aimed to investigate the antimicrobial properties and influence of 275-nm UVC light from a light-emitting diode (UVC-LED light) on wound healing time. Five bacteria, three fungi, and scalded-mouse models combined with SSTIs were used to evaluate the antimicrobial effect in vitro and in vivo. 275-nm UVC-LED light inactivated both bacteria and fungi with a very short irradiation time in vitro and induced neither DNA damage nor epidermal lesions in the mice's skin. Furthermore, in mouse models of SSTIs induced by either methicillin-resistant Staphylococcus aureus (MRSA) or Candida albicans, the 275-nm UVC-LED light showed significant antimicrobial effects and shortened the wound healing time compared with that in the no-irradiation group. UVC-LED light at 275 nm has the potential to be a new form of physical therapy for SSTIs. IMPORTANCE As a common clinical problem, the therapy of SSTIs is facing growing challenges due to an increase in the number of drug-resistant bacteria and fungi. UV C (UVC) light sterilization has been widely used in all aspects of daily life, but there are very few reports about in vivo therapy using UVC light. It is well known that prolonged exposure to UVC light increases the possibility of skin cancer. In addition, it is also very harmful for eyes. UV irradiation with 254-nm UVC light can cause corneal damage, like thinning of the corneal epithelial layer, superficial punctate keratitis, corneal erosion, etc. In this study, we focused on looking for a more accessible light source and safer UVC wavelength, and 275-nm UVC LED light was chosen. We investigated its applicability for SSTIs therapy with relative skin safety and expected that it could be used as a new physical therapy method for SSTIs.
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Affiliation(s)
- Chenghua Song
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ruichao Wen
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jiaxuan Zhou
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xiaoyan Zeng
- Department of Laboratory Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Zi Kou
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yufeng Li
- Solid-State Lighting Engineering Research Center, Xi’an Jiaotong University, Xi’an, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, China
| | - Feng Yun
- Solid-State Lighting Engineering Research Center, Xi’an Jiaotong University, Xi’an, China
| | - Rongqian Wu
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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15
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MacIsaac SA, Mullin TJ, Munoz S, Ontiveros CC, Gagnon GA. Immersive ultraviolet disinfection of E. coli and MS2 phage on woven cotton textiles. Sci Rep 2022; 12:13260. [PMID: 35918389 PMCID: PMC9345007 DOI: 10.1038/s41598-022-17663-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/28/2022] [Indexed: 12/01/2022] Open
Abstract
Immersive ultraviolet disinfection provides a chemical-free technology for safer textiles, surfaces, and public spaces by inactivating communicable pathogens. This study examined immersive UV disinfection, using a disinfection cabinet, of E. coli and MS2 that was inoculated on white cotton T-shirts. The impact that porous materials have on UV disinfection is poorly understood with the majority of previous surface disinfection research focusing on hard, smooth surfaces. Several approaches were used in this study to characterize the light dynamics within the disinfection cabinet including colorimetric dosimetry coupons, biodosimetry, and spectroradiometry. Micro and macro geometry of porous surfaces are important factors to consider when using immersive UV technologies. The geometry of the cabinet impacted the distribution of emitted UV light within the disinfection cabinet and the physical properties of a porous material, such as the woven pattern of cotton, both contribute to UV disinfection efficiency. This work identified that light distribution is crucial for immersive UV technologies as the delivered fluence was highly variable within the disinfection cabinet and resulted in a difference of several logs of reduction for adjacent areas of T-shirt samples. Other inoculated areas achieved upwards of 1-log reductions values for MS2 and upwards of 2-log reductions for E. coli.
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Affiliation(s)
- Sean A MacIsaac
- Centre for Water Resources Studies, Department of Civil and Resource Engineering, Dalhousie University, 1360 Barrington St., Halifax, NS, B3H 4R2, Canada
| | - Toni J Mullin
- Centre for Water Resources Studies, Department of Civil and Resource Engineering, Dalhousie University, 1360 Barrington St., Halifax, NS, B3H 4R2, Canada
| | - Sebastian Munoz
- Centre for Water Resources Studies, Department of Civil and Resource Engineering, Dalhousie University, 1360 Barrington St., Halifax, NS, B3H 4R2, Canada
| | - C Carolina Ontiveros
- Centre for Water Resources Studies, Department of Civil and Resource Engineering, Dalhousie University, 1360 Barrington St., Halifax, NS, B3H 4R2, Canada
| | - Graham A Gagnon
- Centre for Water Resources Studies, Department of Civil and Resource Engineering, Dalhousie University, 1360 Barrington St., Halifax, NS, B3H 4R2, Canada.
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16
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Svitková V, Nemčeková K, Vyskočil V. Application of silver solid amalgam electrodes in electrochemical detection of DNA damage. Anal Bioanal Chem 2022; 414:5435-5444. [PMID: 35132476 DOI: 10.1007/s00216-022-03917-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/06/2022] [Accepted: 01/19/2022] [Indexed: 11/24/2022]
Abstract
In this study, a mercury meniscus-modified silver solid amalgam electrode was used for the first time for the detection of UV-induced DNA damage. The integrity of the double-stranded DNA (dsDNA) layer was detected indirectly using the evaluation of the methylene blue reduction within its accumulation into dsDNA after the UV irradiation of the biosensor surface with two different wavelengths (254 nm and 365 nm), monitored by differential pulse voltammetry. Moreover, a simple electrochemical characterization of the biosensor surface was performed using cyclic voltammetry of the redox indicator hexaammineruthenium chloride (RuHex) present in the solution. Electrochemical impedance spectroscopy (EIS) was used in both cases for the verification of results. Individual electrochemical signals depend on the time of biosensor exposure to UV irradiation as well as on the selected wavelengths and are different for both used types of dsDNA (salmon sperm and calf thymus). The highest degradation degree up to 60% was observed using sensitive EIS of methylene blue after 10 min irradiation of the biosensor at 254 nm. The use of RuHex seems to be less sensitive for the detection of dsDNA structural changes, when the degradation degree up to 40% was observed, using EIS at the same conditions.
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Affiliation(s)
- Veronika Svitková
- Institute of Analytical Chemistry, Faculty of Chemical and Food Technology, Slovak University of Technology in Bratislava, 81237, Bratislava, Slovakia.
| | - Katarína Nemčeková
- Institute of Analytical Chemistry, Faculty of Chemical and Food Technology, Slovak University of Technology in Bratislava, 81237, Bratislava, Slovakia
| | - Vlastimil Vyskočil
- UNESCO Laboratory of Environmental Electrochemistry, Department of Analytical Chemistry, Faculty of Science, Charles University, 12843, Prague, Czech Republic
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17
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Hodges JC, Bilderback AL, Bridge CM, Wagester S, Colaianne BV, Babiker A, Minnier T, Zapf RL, Kip PL, Snyder GM. Assessment of the effectiveness of ultraviolet-C disinfection on transmission of hospital-acquired pathogens from prior room occupants. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e110. [PMID: 36483381 PMCID: PMC9726560 DOI: 10.1017/ash.2022.254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/02/2022] [Accepted: 06/02/2022] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of ultraviolet-C (UV-C) disinfection as an adjunct to standard chlorine-based disinfectant terminal room cleaning in reducing transmission of hospital-acquired multidrug-resistant organisms (MDROs) from a prior room occupant. DESIGN A retrospective cohort study was conducted to compare rates of MDRO transmission by UV-C status from January 1, 2016, through December 31, 2018. SETTING Acute-care, single-patient hospital rooms at 6 hospitals within an academic healthcare system in Pennsylvania. METHODS Transmission of hospital-acquired MDRO infection was assessed in patients subsequently assigned to a single-patient room of a source occupant with carriage of 1 or more MDROs on or during admission. Acquisition of 5 pathogens was compared between exposed patients in rooms with standard-of-care chlorine-based disinfectant terminal cleaning with or without adjunct UV-C disinfection. Logistic regression analysis was used to estimate the adjusted risk of pathogen transfer with adjunctive use of UV-C disinfection. RESULTS In total, 33,771 exposed patient admissions were evaluated; the source occupants carried 46,688 unique pathogens. Prior to the 33,771 patient admissions, 5,802 rooms (17.2%) were treated with adjunct UV-C disinfection. After adjustment for covariates, exposed patients in rooms treated with adjunct UV-C were at comparable risk of transfer of any pathogen (odds ratio, 1.06; 95% CI, 0.84-1.32; P = .64). CONCLUSION Our analysis does not support the use of UV-C in addition to post-discharge cleaning with chlorine-based disinfectant to lower the risk of prior room occupant pathogen transfer.
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Affiliation(s)
- Jacob C. Hodges
- Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Christine M. Bridge
- Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Suzanne Wagester
- Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Bonnie V. Colaianne
- Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Ahmed Babiker
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Tami Minnier
- Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Rachel L. Zapf
- Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Paula L. Kip
- Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Graham M. Snyder
- Department of Infection Prevention and Control, UPMC Presbyterian Hospital, Pittsburgh, Pennsylvania
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Author for correspondence: Graham M. Snyder, MD, MS, Falk Medical Building, 3601 Fifth Avenue, Suite 150, Pittsburgh, PA15213. E-mail:
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