Quantitative studies on fabrics as disseminators of viruses. II. Persistence of poliomyelitis virus on cotton and wool fabrics

The impact of bioactive textiles on human skin microbiota

In order to support the elevated market demand for the development of textiles with specific benefits for a healthy and safe lifestyle, several bioactive textiles with defined properties, including antimicrobial, antioxidant, anti-inflammatory, anti-odor, and anti-repellent, anti-ultraviolet (UV) radiation, have been proposed. Antimicrobial textiles, particularly, have received special interest considering the search for smart, protective textiles that also impact health and well-being. Although the incorporation of antimicrobials into textile material has been well succeeded, the addition of such components in textile clothing can influence the balance of the skin microbiota of the wearer. While most antimicrobial textiles have demonstrated good biocompatibility and antimicrobial performance against bacteria, fungi, and viruses, some problems such as textile biodegradation, odor, and dissemination of unwanted microorganisms might arise. However, little is known about the impact of such antimicrobial textile-products on human skin microbiota. To address this issue, the present review, for the first time, gives an overview about the main effects of antimicrobial textiles, i.e., antibacterial, antifungal, and antiviral, on skin microbiota while driving future investigation to elucidate their putative clinical relevance and possible applications according to their impact on skin microbiota. This knowledge may open doors for the development of more microbiota friendly textiles or antimicrobial textile-products able to target specific populations of the skin microbiota aiming to alleviate skin disorders, malodor, and allergies by avoiding the growth and spread of pathogenic microorganisms.

Antimicrobial and Antiviral Properties of Triclosan-Containing Polymer Composite: Aging Effects of pH, UV, and Sunlight Exposure

The present study deals with the synthesis and characterization of a polymer composite based on an unsaturated ester loaded with 5 wt.% triclosan, produced by co-mixing on an automated hardware system. The polymer composite's non-porous structure and chemical composition make it an ideal material for surface disinfection and antimicrobial protection. According to the findings, the polymer composite effectively inhibited (100%) the growth of Staphylococcus aureus 6538-P under exposure to physicochemical factors, including pH, UV, and sunlight, over a 2-month period. In addition, the polymer composite demonstrated potent antiviral activity against human influenza virus strain A and the avian coronavirus infectious bronchitis virus (IBV), with infectious activities of 99.99% and 90%, respectively. Thus, the resulting triclosan-loaded polymer composite is revealed to have a high potential as a surface-coating non-porous material with antimicrobial properties.

Highly stable, antiviral, antibacterial cotton textiles via molecular engineering

Cotton textiles are ubiquitous in daily life and are also one of the primary mediums for transmitting viruses and bacteria. Conventional approaches to fabricating antiviral and antibacterial textiles generally load functional additives onto the surface of the fabric and/or their microfibres. However, such modifications are susceptible to deterioration after long-term use due to leaching of the additives. Here we show a different method to impregnate copper ions into the cellulose matrix to form a copper ion-textile (Cu-IT), in which the copper ions strongly coordinate with the oxygen-containing polar functional groups (for example, hydroxyl) of the cellulose chains. The Cu-IT displays high antiviral and antibacterial performance against tobacco mosaic virus and influenza A virus, and Escherichia coli, Salmonella typhimurium, Pseudomonas aeruginosa and Bacillus subtilis bacteria due to the antimicrobial properties of copper. Furthermore, the strong coordination bonding of copper ions with the hydroxyl functionalities endows the Cu-IT with excellent air/water retainability and superior mechanical stability, which can meet daily use and resist repeated washing. This method to fabricate Cu-IT is cost-effective, ecofriendly and highly scalable, and this textile appears very promising for use in household products, public facilities and medical settings.

Violacein-embedded nanofiber filters with antiviral and antibacterial activities

Most respiratory masks are made of fabrics, which only capture the infectious virus carriers into the matrix. However, these contagious viruses stay active for a long duration (∼7 days) within the fabric matrix possibly inducing post-contact transmissions. Moreover, conventional masks are vulnerable to bacterial growth with prolonged exposure to exhaled breaths. Herein, we combined violacein, a naturally-occurring antimicrobial agent, with porous nanofiber membranes to develop a series of functional filters that autonomously sterilizes viruses and bacteria. The violacein-embedded membrane inactivates viruses within 4 h (99.532 % reduction for influenza and 99.999 % for human coronavirus) and bacteria within 2 h (75.5 % reduction). Besides, its nanofiber structure physically filters out the nanoscale (<0.8 μm) and micron-scale (0.8 μm - 3 μm) particulates, providing high filtration efficiencies (99.7 % and 100 % for PM 1.0 and PM 10, respectively) with long-term stability (for 25 days). In addition, violacein provides additional UV-resistant property, which protects the skin from sunlight. The violacein-embedded membrane not only proved the sterile efficacy of microbe extracted pigments for biomedical products but also provided insights to advance the personal protective equipment (PPE) to fight against contagious pathogens.

A New Method for Testing Filtration Efficiency of Mask Materials Under Sneeze-like Pressure

BACKGROUND

Sneezes produce many pathogen-containing micro-droplets with high velocities of 4.5-50.0 m/s. Face masks are believed to protect people from infection by blocking those droplets. However, current filtration efficiency tests can't evaluate masks under sneeze-like pressure. The goal of this study was to establish a method to evaluate the filtration efficiency of mask materials under extreme conditions.

MATERIALS AND METHODS

Efficiency of surgical masks, gauze masks, gauze, cotton, silk, linen and tissue paper on blocking micro-droplet sized starch particles (average 8.2 μm) and latex microspheres (0.75 μm) with a velocity of 44.4 m/s created by centrifugation was qualitatively analyzed by using imaging-based analysis.

RESULTS

The 4 layers of silk could block 93.8% of microspheres and 88.9% of starch particles, followed by the gauze mask (78.5% of microspheres and 90.4% of starch particles) and the 2 layers of cotton (74.6% of microspheres and 87.5-89.0% of particles). Other materials also blocked 53.2-66.5% of microspheres and 76.4%-87.9% of particles except the 8 layers of gauze which only blocked 36.7% of particles. The filtration efficiency was improved by the increased layers of materials.

CONCLUSION

Centrifugation-based filtration efficiency test not only compensates shortcomings of current tests for masks, but also offers a simple way to explore new mask materials during pandemics. Common mask materials can potentially provide protection against respiratory droplet transmission.

How long can nosocomial pathogens survive on textiles? A systematic review

Aims: Healthcare-associated infections linked to contaminated textiles are rare but underline their potential role as a source for transmission. The aim of the review was to summarize the experimental evidence on the survival and persistence of the different types of nosocomial pathogens on textiles.

Methods: A literature search was performed on MedLine. Original data on the survival of bacteria, mycobacteria, and fungi and persistence of viruses on textiles were evaluated.

Results: The survival of bacteria at room temperature was the longest on polyester (up to 206 days), whereas it was up to 90 days for some species on cotton and mixed fibers. Only low inocula of 100 CFU were found on all types of textiles with a short survival time of ≤3 days. Most bacterial species survived better at elevated air humidity. The infectivity of viruses on textiles is lost much faster at room temperature, typically within 2–4 weeks.

Conclusions: Contaminated textiles or fabrics may be a source of transmission for weeks. The presence of pathogens on the coats of healthcare workers is associated with the presence of pathogens on their hands, demonstrating the relevance of textile contamination in patient care.

Recovery Optimization and Survival of the Human Norovirus Surrogates Feline Calicivirus and Murine Norovirus on Carpet

Carpets have been implicated in prolonged and reoccurring outbreaks of human noroviruses (HuNoV), the leading cause of acute gastroenteritis worldwide. Viral recovery from environmental surfaces, such as carpet, remains undeveloped. Our aim was to determine survival of HuNoV surrogates on an understudied environmental surface, carpet. First, we measured the zeta potential and absorption capacity of wool and nylon carpet fibers, we then developed a minispin column elution (MSC) method, and lastly we characterized the survival of HuNoV surrogates, feline calicivirus (FCV) and murine norovirus (MNV), over 60 days under 30 and 70% relative humidity (RH) on two types of carpet and one glass surface. Carpet surface charge was negative between relevant pH values (i.e., pH 7 to 9). In addition, wool could absorb approximately two times more liquid than nylon. The percent recovery efficiency obtained by the MSC method ranged from 4.34 to 20.89% and from 30.71 to 54.14% for FCV and MNV on carpet fibers, respectively, after desiccation. Overall, elution buffer type did not significantly affect recovery. Infectious FCV or MNV survived between <1 and 15 or between 3 and 15 days, respectively. However, MNV survived longer under some conditions and at significantly (P < 0.05) higher titers compared to FCV. Albeit, surrogates followed similar survival trends, i.e., both survived longest on wool then nylon and glass, while 30% RH provided a more hospitable environment compared to 70% RH. Reverse transcription-quantitative PCR signals for both surrogates were detectable for the entire study, but FCV genomic copies experienced significantly higher reductions (<3.80 log₁₀ copies) on all surfaces compared to MNV (<1.10 log₁₀ copies).IMPORTANCE Human noroviruses (HuNoV) are the leading cause of acute gastroenteritis worldwide. Classical symptoms of illness include vomiting and diarrhea which could lead to severe dehydration and death. HuNoV are transmitted by the fecal-oral or vomitus-oral route via person-to-person contact, food, water, and/or environmental surfaces. Published laboratory-controlled studies have documented the environmental stability of HuNoV on hard surfaces, but there is limited laboratory-based evidence available about survival on soft surfaces, e.g., carpet and upholstered furniture. Several epidemiological reports have suggested soft surfaces may be HuNoV fomites illustrating the importance of conducting a survival study. The three objectives of our research were to demonstrate techniques to characterize soft surfaces, develop a viral elution method for carpet, and characterize the survival of HuNoV surrogates on carpet. These results can be used to improve microbial risk assessments, the development of much-needed soft surface disinfectant, and standardizing protocols for future soft surface studies.

Developing Novel Antimicrobial and Antiviral Textile Products

In conjunction with an increasing public awareness of infectious diseases, the textile industry and scientists are developing hygienic fabrics by the addition of various antimicrobial and antiviral compounds. In the current study, sodium pentaborate pentahydrate and triclosan are applied to cotton fabrics in order to gain antimicrobial and antiviral properties for the first time. The antimicrobial activity of textiles treated with 3 % sodium pentaborate pentahydrate, 0.03 % triclosan, and 7 % Glucapon has been investigated against a broad range of microorganisms including bacteria, yeast, and fungi. Moreover, modified cotton fabrics were tested against adenovirus type 5 and poliovirus type 1. According to the test results, the modified textile goods attained very good antimicrobial and antiviral properties. Thus, the results of the present study clearly suggest that sodium pentaborate pentahydrate and triclosan solution-treated textiles can be considered in the development of antimicrobial and antiviral textile finishes.

Isolation gowns in health care settings: Laboratory studies, regulations and standards, and potential barriers of gown selection and use

Although they play an important role in infection prevention and control, textile materials and personal protective equipment (PPE) used in health care settings are known to be one of the sources of cross-infection. Gowns are recommended to prevent transmission of infectious diseases in certain settings; however, laboratory and field studies have produced mixed results of their efficacy. PPE used in health care is regulated as either class I (low risk) or class II (intermediate risk) devices in the United States. Many organizations have published guidelines for the use of PPE, including isolation gowns, in health care settings. In addition, the Association for the Advancement of Medical Instrumentation published a guidance document on the selection of gowns and a classification standard on liquid barrier performance for both surgical and isolation gowns. However, there is currently no existing standard specific to isolation gowns that considers not only the barrier resistance but also a wide array of end user desired attributes. As a result, infection preventionists and purchasing agents face several difficulties in the selection process, and end users have limited or no information on the levels of protection provided by isolation gowns. Lack of knowledge about the performance of protective clothing used in health care became more apparent during the 2014 Ebola epidemic. This article reviews laboratory studies, regulations, guidelines and standards pertaining to isolation gowns, characterization problems, and other potential barriers of isolation gown selection and use.

A Review of Isolation Gowns in Healthcare: Fabric and Gown Properties

The threat of emerging infectious diseases including Ebola hemorrhagic fever, pandemic influenza, avian influenza, Hepatitis B, Hepatitis C, and SARS has highlighted the need for effective personal protective equipment (PPE) to protect healthcare workers (HCWs), patients, and visitors. PPE is a critical component in the hierarchy of controls used to protect HCWs from infectious hazards. HCW PPE may include gowns, respirators, face masks, gloves, eye protection, face shields, and head and shoe coverings. Important research has been conducted in certain areas, such as respirators and protective masks, but studies in other areas, particularly gowns, are scarce. Gowns are identified as the second-most-used piece of PPE, following gloves, in the healthcare setting. According to the Centers for Disease Control and Prevention's Guideline for Isolation Precautions, isolation gowns should be worn to protect HCWs' arms and exposed body areas during procedures and patient-care activities when anticipating contact with clothing, blood, bodily fluids, secretions and excretions. Isolation gowns currently available on the marketplace offer varying resistance to blood and other bodily fluids depending on the type of the material, its impermeability, and wear and tear. While some studies show no benefit of the routine use of isolation gowns, others demonstrate that its use is associated with a reduced infection rate. This paper reviews isolation gowns in healthcare settings, including the fabrics used, gown design and interfaces, as well as critical parameters that affect microorganism and liquid transmission through fabrics.

Enteric virus survival during household laundering and impact of disinfection with sodium hypochlorite

This study was conducted to determine whether enteric viruses (adenovirus, rotavirus, and hepatitis A virus) added to cotton cloth swatches survive the wash cycle, the rinse cycle, and a 28-min permanent press drying cycle as commonly practiced in households in the United States. Detergent with and without bleach (sodium hypochlorite) was added to washing machines containing sterile and virus-inoculated 58-cm2 swatches, 3.2 kg of cotton T-shirts and underwear, and a soiled pillowcase designed to simulate the conditions (pH, organic load, etc.) encountered in soiled laundry. The most important factors for the reduction of virus in laundry were passage through the drying cycle and the addition of sodium hypochlorite. Washing with detergent alone was not found to be effective for the removal or inactivation of enteric viruses, as significant concentrations of virus were found on the swatches (reductions of 92 to 99%). It was also demonstrated that viruses are readily transferred from contaminated cloths to uncontaminated clothes. The use of sodium hypochlorite reduced the number of infectious viruses on the swatches after washing and drying by at least 99.99%. Laundering practices in common use in the United States do not eliminate enteric and respiratory viruses from clothes. The use of bleach can further reduce the numbers of enteric viruses in laundry.

Impact of detergent systems on bacterial survival on laundered fabrics

The survival of Staphylococcus aureus was determined from inoculated swatches laundered in either a phosphate or a phosphate-substitute detergent. In a Plackett-Burman design study, the independent variables of detergent type, concentration, and variation, wash water temperature, soil load, cycle time, and water hardness were assigned high and low values. Wash water temperatures of 27, 38, 49, and 60 degrees C were employed. Viable bacteria were recovered from macerated swatches. Statistical analysis disclosed that there was no practical difference in the ability of phosphate or phosphate-substitute detergents to reduce the level of S. aureus on the laundered swatches in this controlled design. Analysis did reveal that water temperature was the most significant independent variables. The remaining variables did not appear to have any practical significance upon bacterial reduction. This bacteriological study did not evaluate other essential detergent properties.

Survival of coxsackievirus B3 under diverse environmental conditions

The survival of coxsackievirus B3 was studied under various conditions of incubation. The comparative study demonstrated that coxsackievirus B3 was stable for 24h (less than 0.4-log decrease in titer) when suspended at neutral pH (6 or 23 degrees C) in the presence of 0.25% bovine serum albumin in saline regardless of whether the preparations were subjected to evaporation. Bovine serum albumin provided increased stability to the virus for each of the conditions tested. At 37 degrees C, evaporation greatly reduced the virus infectivity between 6 and 20 h of incubation. Nevertheless, coxsackievirus B3 was found to be stable for at least 24 h under conditions similar to those of a household environment, and its presence represents a potential biohazard to nonimmune persons. These data provide a rationale for using coxsackievirus B3 as a model for investigating the role of environmental surfaces in the transmission of enteroviral diseases.

Inactivation of enteric viruses in wastewater sludge through dewatering by evaporation

The effect of dewatering on the inactivation rates of enteric viruses in sludge was determined. For this study, water was evaporated from seeded raw sludge at 21 degrees C, and the loss of viral plaque-forming units was measured. Initial results with poliovirus showed that recoverable infectivity gradually decreased with the loss of water until the solids content reached about 65%. When the solids content was increased from 65 to 83%, a further, more dramatic decrease in virus titer of greater than three orders of magnitude was observed. This loss of infectivity was due to irreversible inactivation of poliovirus because viral particles were found to have released their RNA molecules which were extensively degraded. Viral inactivation in these experiments may have been at least partially caused by the evaporation process itself because similar effects on poliovirus particles were observed in distilled water after only partial loss of water by evaporation. Coxsackievirus and reovirus were also found to be inactivated in sludge under comparable conditions, which suggests that dewatering by evaporation may be a feasible method of inactivating all enteric viruses in sludge.

Potentially infectious agents associated with shearling bedpads: effect of laundering with detergent-disinfectant combinations on Staphylococcus aureus and Pseudomonas aeruginosa

Glutaraldehyde-tanned woolskins which are used as bedpads to prevent decubitus ulcers were contaminated with Staphylococcus aureus (ATCC 6538) and Pseudomonas aeruginosa (ATCC 15442). Two methods of exposure, direct contact and aerosol, were used in separate experiments. Attempts were made to decrease the bacterial population placed on the woolskins by laundering them in a quaternary ammonium disinfectant, a phenolic disinfectant, or alkalinized glutaraldehyde, in combination with an anionic or nonionic detergent. The effect of a commercial detergent-sanitizer was also studied. Bacterial populations were significantly reduced in all experiments, but only laundering in glutaraldehyde in combination with either detergent resulted in maximum removal of bacteria. Viable bacteria were usually not detected in the rinse water (<1 viable organism/5 ml of rinse water).

Quantitative studies on fabrics as disseminators of viruses. V. Effect of laundering on poliovirus-contaminated fabrics

The effects of laundering with both anionic and nonionic detergents in cold, warm, and hot water on poliovirus-contaminated cotton sheeting, cotton terry cloth, washable wool shirting, wool blanketing, dull nylon jersey, and dacron/cotton shirting were determined. The fabrics were exposed to virus by aerosolization and direct contact (pipette) in separate studies. Although the results varied with each factor used in the study, virus titers on all the fabrics were generally reduced considerably by the laundering process. When the fabrics were dried for 20 hr after laundering, an additional decline in virus titers was seen, often to below detectable levels. The type of detergent used made little difference in effect on virus titer reduction, but the hot wash water markedly reduced the detectable virus. Fabric type was not a major factor in the majority of the experiments, although virus tended to be eliminated more readily from the nylon jersey, and in warm water the virus persisted longer on wool blanketing material laundered in anionic detergent. Sterile fabrics of each type laundered with similar fabrics which contained virus often became contaminated by the virus during the laundering process. Virus titers ranging from undetectable to 10(3.9) cell culture 50% infectious doses/ml were obtained from samples of the rinse water after warm- and cold-water laundering.

Quantitative studies on fabrics as disseminators of viruses. IV. Virus transmission by dry contact of fabrics

Cotton and woolen fabrics and fabrics of synthetic fibers were exposed by direct contact (pipette) and by aerosolization to poliovirus and to vaccinia virus in separate experiments, allowed to dry for 16 hr at 25 C in 35% relative humidity, and randomly tumbled with sterile swatches of the same fabrics for 30 min. By use of a HEp-2 cell assay system, up to 10(3.5) CCID(50) of poliovirus per ml and 10(4.4) CCID(50) of vaccinia virus per ml were recovered from the originally sterile fabrics as early as 1 to 10 min after contact. Maximum transfer of both viruses was achieved with wool blanket material, although high titers of vaccinia virus were recovered from all fabrics tested. Poliovirus placed on the fabrics in an aerosol tended to be transferred to the sterile fabrics at a greater rate than when it was placed on the fabrics by direct contact. The method of exposure had essentially no effect on the rate of transfer of vaccinia virus.

Potentially infectious agents associated with shearling bedpads. I. Effect of laundering with detergent-disinfectant combinations on polio and vaccinia viruses

Glutaraldehyde-tanned woolskin pads which are used for the prevention of decubitus ulcers in bed patients were experimentally contaminated with polio or vaccinia viruses. Two methods of exposure, direct contact and aerosol, were used in separate experiments. Attempts were made to remove or inactivate these virus contaminants by laundering the woolskins in a quaternary ammonium disinfectant, a phenolic disinfectant, or alkalinized glutaraldehyde, in combination with an anionic detergent or a nonionic detergent. The effect of a commercial detergent-sanitizer was also studied. The virus titers were significantly reduced in all experiments, but only laundering in glutaraldehyde in combination with either detergent lowered the vaccinia virus titers to below detectable limits. High concentrations of glutaraldehyde altered the texture of the wool and leather apparently by precipitating a component of the detergent onto the fibers. In all the poliovirus experiments, the virus was still detectable on either or both the wool and the leather of the pads after laundering. The rinse water from each experiment was tested for the presence of virus. No vaccinia virus was recovered, but poliovirus was demonstrated in titers up to 10(3) cell culture 50% infectious doses.

Procedure for the evaluation of the virucidal effectiveness of an ethylene oxide gas sterilizer

A quantitative, reproducible method was developed for the evaluation of the virucidal activity of test gases. Using this method, we determined the virucidal effectiveness of a Steri-Vac ethylene oxide gas sterilizer. Wool gabardine material was exposed to high concentrations of herpes simplex, vaccinia, parainfluenza, or polio viruses and was processed through the sterilizer. Two time-temperature cycles of the machine, 29 C for 180 min and 60 C for 48 min, were used in separate experiments. The viruses were exposed to the gas when freshly pipetted onto the fabric or when pipetted on the material and allowed to dry 16 to 24 hr. In two experiments carried out under each condition, the virus titers were reduced by the sterilization process to less than detectable limits. These titer reductions were for the herpes virus >/= 2.7 to 5.0 log, for vaccinia virus >/= 4.0 to 6.1 log, for parainfluenza virus >/= 1.8 to 4.9 log, and for poliovirus >/= 4.9 to 7.7 log. The observed reductions in virus titers were the same whether the virus-contaminated fabrics were sealed in polyethylene packages or held in open petri dishes during exposure to ethylene oxide.

Quantitative studies on fabrics as disseminators of viruses. 3. Persistence of vaccinia virus on fabrics impregnated with a virucidal agent

Eight compounds were tested in vitro for virucidal and antiviral activity against poliovirus and vaccinia virus. These compounds included five quaternary ammonium salts, two bromosalicylanilides, and neomycin sulfate, an antibiotic. None of the compounds was active against poliovirus, but virucidal activity was demonstrated against vaccinia virus with three of the quarternary ammonium compounds: n-alkyl (C14, C12, C16) dimethyl benzyl ammonium chloride, di-isobutyl cresoxy ethoxy ethyl dimethyl benzyl ammonium chloride monohydrate, and n-alkyl (60% C14, 30% C16, 5% C12, 5% C18) dimethyl benzyl ammonium chlorides plus n-alkyl (50% C12, 30% C14, 17% C16, 3% C18) dimethyl ethylbenzyl ammonium chlorides. Wool blanketing, wool gabardine, and cotton sheeting materials were impregnated with the first of the above virucidal compounds, and the persistence of vaccinia virus on these fabrics was compared with the persistence of the agent on nonimpregnated fabrics of the same type held at 25 C in 35 and 78% relative humidity. No virus could be recovered from the chemically treated fabrics at any time after virus exposure, whereas the virus persisted as long as 4 weeks on nonimpregnated materials. Viable vaccinia virus was also found to persist less than 1 day on a cotton fabric finished with a wash-and-wear modified triazone resin. Poliovirus persisted less than 5 days on this wash-and-wear fabric.