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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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Vaivoothpinyo S, Sathitakorn O, Jantarathaneewat K, Weber DJ, Apisarnthanarak P, Rutjanawech S, Tantiyavarong P, Apisarnthanarak A. The impact of environmental cleaning protocol featuring PX-UV in reducing the incidence of multidrug-resistant gram-negative healthcare-associated infection and colonization in intensive care units in Thailand. Infect Control Hosp Epidemiol 2024; 45:684-687. [PMID: 38088177 DOI: 10.1017/ice.2023.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
In this quasi-experimental study, implementing PX-UV to the standard environmental cleaning protocol was associated with a reduction in the overall incidence of multidrug-resistant (MDR) gram-negative organisms (P = .01) and MDR Acinetobacter baumannii (P = .001) in intervention intensive care units. However, the intervention did not reduce patient length of stay and 30-day mortality.
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Affiliation(s)
- Supavit Vaivoothpinyo
- Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Ornnicha Sathitakorn
- Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Kittiya Jantarathaneewat
- Department of Pharmaceutical Care, Faculty of Pharmacy, Thammasat University, Pathum Thani, Thailand
- Research Group in Infectious Diseases Epidemiology and Prevention, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - David J Weber
- University of North Carolina, Gillings School of Global Public Health, Chapel Hill, North Carolina, United States
| | - Piyaporn Apisarnthanarak
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sasinuch Rutjanawech
- Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
- Research Group in Infectious Diseases Epidemiology and Prevention, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Pichaya Tantiyavarong
- Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Anucha Apisarnthanarak
- Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
- Research Group in Infectious Diseases Epidemiology and Prevention, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
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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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4
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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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Pandya VS, Morsy MS, Hassan AAHAA, Alshawkani HA, Sindi AS, Mattoo KA, Mehta V, Mathur A, Meto A. Ultraviolet disinfection (UV-D) robots: bridging the gaps in dentistry. FRONTIERS IN ORAL HEALTH 2023; 4:1270959. [PMID: 38024151 PMCID: PMC10646406 DOI: 10.3389/froh.2023.1270959] [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: 08/01/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Maintaining a microbe-free environment in healthcare facilities has become increasingly crucial for minimizing virus transmission, especially in the wake of recent epidemics like COVID-19. To meet the urgent need for ongoing sterilization, autonomous ultraviolet disinfection (UV-D) robots have emerged as vital tools. These robots are gaining popularity due to their automated nature, cost advantages, and ability to instantly disinfect rooms and workspaces without relying on human labor. Integrating disinfection robots into medical facilities reduces infection risk, lowers conventional cleaning costs, and instills greater confidence in patient safety. However, UV-D robots should complement rather than replace routine manual cleaning. To optimize the functionality of UV-D robots in medical settings, additional hospital and device design modifications are necessary to address visibility challenges. Achieving seamless integration requires more technical advancements and clinical investigations across various institutions. This mini-review presents an overview of advanced applications that demand disinfection, highlighting their limitations and challenges. Despite their potential, little comprehensive research has been conducted on the sterilizing impact of disinfection robots in the dental industry. By serving as a starting point for future research, this review aims to bridge the gaps in knowledge and identify unresolved issues. Our objective is to provide an extensive guide to UV-D robots, encompassing design requirements, technological breakthroughs, and in-depth use in healthcare and dentistry facilities. Understanding the capabilities and limitations of UV-D robots will aid in harnessing their potential to revolutionize infection control practices in the medical and dental fields.
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Affiliation(s)
- Visha Shailesh Pandya
- Department of Public Health Dentistry, Vaidik Dental College & Research Centre, Dadra and Nagar Haveli and Daman and Diu, India
| | - Mohamed S.M. Morsy
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | - Hamed A. Alshawkani
- Department of Restorative Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Abdulelah Sameer Sindi
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Khurshid A. Mattoo
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Vini Mehta
- Department of Dental Research Cell, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Ankita Mathur
- Department of Dental Research Cell, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Aida Meto
- Department of Dental Research Cell, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, India
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, Tirana, Albania
- Clinical Microbiology, School of Dentistry, University of Modena and Reggio Emilia, Modena, Italy
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Cobrado L, Ricardo E, Ramalho P, Fernandes AR, Rodrigues AG. Does repeated exposure to hydrogen peroxide induce Candida auris resistance? Antimicrob Resist Infect Control 2023; 12:92. [PMID: 37674229 PMCID: PMC10483791 DOI: 10.1186/s13756-023-01281-5] [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: 12/19/2022] [Accepted: 07/27/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND To minimize environmental colonization by microorganisms that may persist and thrive in healthcare settings, thus reducing healthcare-associated infections (HAIs), new insights over already known biocides are certainly of relevance. Although the efficacy of hydrogen peroxide (H2O2) against the emergent yeast Candida auris is moderately documented, concerns over the potential induction of resistance after repeated exposure do persist. The main objective of the present study was to evaluate the hypothetical induction of Candida auris resistance following 30 days of consecutive exposure to lethal and sublethal concentrations of H2O2. Furthermore, the authors aimed to elucidate about the rank of efficacy of H2O2 against C. auris comparing to other Candida species and whether different strains of C. auris may display different susceptibilities to H2O2. METHODS During the induction of resistance assays, both type strains and clinical isolates of Candida auris, Candida albicans and Candida parapsilosis were exposed repeatedly to defined concentrations of H2O2, for 30 days. RESULTS After that period, no significant differences were found when comparing the minimal inhibitory concentration values of H2O2 in case of the induced strains versus each respective positive control. Moreover, H2O2 displayed similar effectiveness against all the tested Candida species and no differences were demonstrated among the distinct strains of C. auris. CONCLUSIONS The adoption of H2O2 solutions in routine protocols in order to promote disinfection standards against Candida auris, improving patient safety and reducing healthcare costs, is certainly welcomed.
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Affiliation(s)
- Luis Cobrado
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, Porto, 4200 - 319, Portugal.
- Center for Health Technology and Services Research / Rede de Investigação em Saúde, CINTESIS / RISE, University of Porto, Porto, Portugal.
- Burn Unit, Department of Plastic and Reconstructive Surgery, University Hospital Center of São João, Porto, Portugal.
| | - Elisabete Ricardo
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, Porto, 4200 - 319, Portugal
- Center for Health Technology and Services Research / Rede de Investigação em Saúde, CINTESIS / RISE, University of Porto, Porto, Portugal
| | - Patricia Ramalho
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, Porto, 4200 - 319, Portugal
- Center for Health Technology and Services Research / Rede de Investigação em Saúde, CINTESIS / RISE, University of Porto, Porto, Portugal
| | - Angela Rita Fernandes
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, Porto, 4200 - 319, Portugal
| | - Acacio Goncalves Rodrigues
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, Porto, 4200 - 319, Portugal
- Center for Health Technology and Services Research / Rede de Investigação em Saúde, CINTESIS / RISE, University of Porto, Porto, Portugal
- Burn Unit, Department of Plastic and Reconstructive Surgery, University Hospital Center of São João, Porto, Portugal
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Dancer SJ. Hospital cleaning: past, present, and future. Antimicrob Resist Infect Control 2023; 12:80. [PMID: 37608396 PMCID: PMC10464435 DOI: 10.1186/s13756-023-01275-3] [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: 05/08/2023] [Accepted: 07/10/2023] [Indexed: 08/24/2023] Open
Abstract
INTRODUCTION The importance of hospital cleaning for controlling healthcare-associated infection (HAI) has taken years to acknowledge. This is mainly because the removal of dirt is inextricably entwined with gender and social status, along with lack of evidence and confusion over HAI definitions. Reducing so-called endogenous infection due to human carriage entails patient screening, decolonisation and/or prophylaxis, whereas adequate ventilation, plumbing and cleaning are needed to reduce exogenous infection. These infection types remain difficult to separate and quantitate. Patients themselves demonstrate wide-ranging vulnerability to infection, which further complicates attempted ranking of control interventions, including cleaning. There has been disproportionate attention towards endogenous infection with less interest in managing environmental reservoirs. QUANTIFYING CLEANING AND CLEANLINESS Finding evidence for cleaning is compromised by the fact that modelling HAI rates against arbitrary measurements of cleaning/cleanliness requires universal standards and these are not yet established. Furthermore, the distinction between cleaning (soil removal) and cleanliness (soil remaining) is usually overlooked. Tangible bench marking for both cleaning methods and all surface types within different units, with modification according to patient status, would be invaluable for domestic planning, monitoring and specification. AIMS AND OBJECTIVES This narrative review will focus on recent history and current status of cleaning in hospitals. While its importance is now generally accepted, cleaning practices still need attention in order to determine how, when and where to clean. Renewed interest in removal and monitoring of surface bioburden would help to embed risk-based practice in hospitals across the world.
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Affiliation(s)
- Stephanie J Dancer
- Department of Microbiology, NHS Lanarkshire & School of Applied Sciences, Edinburgh Napier University, Scotland, UK.
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Mehta I, Hsueh HY, Taghipour S, Li W, Saeedi S. UV Disinfection Robots: A Review. ROBOTICS AND AUTONOMOUS SYSTEMS 2023; 161:104332. [PMID: 36514383 PMCID: PMC9731820 DOI: 10.1016/j.robot.2022.104332] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The novel coronavirus (COVID-19) pandemic has completely changed our lives and how we interact with the world. The pandemic has brought about a pressing need to have effective disinfection practices that can be incorporated into daily life. They are needed to limit the spread of infections through surfaces and air, particularly in public settings. Most of the current methods utilize chemical disinfectants, which can be laborious and time-consuming. Ultraviolet (UV) irradiation is a proven and powerful means of disinfection. There has been a rising interest in the implementation of UV disinfection robots by various public institutions, such as hospitals, long-term care homes, airports, and shopping malls. The use of UV-based disinfection robots could make the disinfection process faster and more efficient. The objective of this review is to equip readers with the necessary background on UV disinfection and provide relevant discussion on various aspects of UV robots.
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Evaluation of the microbial reduction efficacy and perception of use of an ozonized water spray disinfection technology. Sci Rep 2022; 12:13019. [PMID: 35906472 PMCID: PMC9335460 DOI: 10.1038/s41598-022-16953-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022] Open
Abstract
The development of new approaches for the decontamination of surfaces is important to deal with the processes related to exposure to contaminated surfaces. Therefore, was evaluated the efficacy of a disinfection technology using ozonized water (0.7–0.9 ppm of O3) on the surfaces of garments and accessories of volunteers, aiming to reduce the spread of microbial pathogens in the workplace and community. A Log10 microbial reduction of 1.72–2.40 was observed between the surfaces tested. The microbial reductions remained above 60% on most surfaces, and this indicated that the disinfection technology was effective in microbial log reduction regardless of the type of transport used by the volunteers and/or their respective work activities. In association with the evaluation of efficacy, the analysis of the perception of use (approval percentage of 92.45%) was fundamental to consider this technology as an alternative for use as a protective barrier, in conjunction with other preventive measures against microbiological infections, allowing us to contribute to the availability of proven effective devices against the spread of infectious agents in the environment.
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10
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Is It Possible to Eradicate Carbapenem-Resistant Acinetobacter baumannii (CRAB) from Endemic Hospitals? Antibiotics (Basel) 2022; 11:antibiotics11081015. [PMID: 36009885 PMCID: PMC9405503 DOI: 10.3390/antibiotics11081015] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Despite the global efforts to antagonize carbapenem-resistant Acinetobacter baumannii (CRAB) spreading, it remains an emerging threat with a related mortality exceeding 40% among critically ill patients. The purpose of this review is to provide evidence concerning the best infection prevention and control (IPC) strategies to fight CRAB spreading in endemic hospitals. Methods: The study was a critical review of the literature aiming to evaluate all available studies reporting IPC measures to control CRAB in ICU and outside ICU in both epidemic and endemic settings in the past 10 years. Results: Among the 12 included studies, the majority consisted of research reports of outbreaks mostly occurred in ICUs. The reported mortality reached 50%. Wide variability was observed related to the frequency of application of recommended CRAB IPC measures among the studies: environmental disinfection (100%); contact precautions (83%); cohorting staff and patients (75%); genotyping (66%); daily chlorhexidine baths (58%); active rectal screening (50%); closing or stopping admissions to the ward (33%). Conclusions: Despite effective control of CRAB spreading during the outbreaks, the IPC measures reported were heterogeneous and highly dependent on the different setting as well as on the structural characteristics of the wards. Reinforced ‘search and destroy’ strategies both on the environment and on the patient, proved to be the most effective measures for permanently eliminating CRAB spreading.
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Jabłońska-Trypuć A, Makuła M, Włodarczyk-Makuła M, Wołejko E, Wydro U, Serra-Majem L, Wiater J. Inanimate Surfaces as a Source of Hospital Infections Caused by Fungi, Bacteria and Viruses with Particular Emphasis on SARS-CoV-2. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138121. [PMID: 35805776 PMCID: PMC9265696 DOI: 10.3390/ijerph19138121] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 02/01/2023]
Abstract
The carriers of nosocomial infections are the hands of medical personnel and inanimate surfaces. Both hands and surfaces may be contaminated as a result of contact with the patient, their body fluids, and touching contaminated surfaces in the patient’s surroundings. Visually clean inanimate surfaces are an important source of pathogens. Microorganisms have properties thanks to which they can survive in unfavorable conditions, from a few days to several months. Bacteria, viruses and fungi are able to transmit from inanimate surfaces to the skin of the patient and the medical staff. These pathogens include SARS-CoV-2, which can survive on various types of inanimate surfaces, being a potential source of infection. By following the recommendations related to washing and disinfecting hands and surfaces, and using appropriate washing and disinfecting agents with a broad biocidal spectrum, high material compatibility and the shortest duration of action, we contribute to breaking the chain of nosocomial infections.
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Affiliation(s)
- Agata Jabłońska-Trypuć
- Department of Chemistry, Biology and Biotechnology, Faculty of Civil Engineering and Environmental Sciences, Bialystok University of Technology, Wiejska 45E Street, 15-351 Białystok, Poland; (E.W.); (U.W.)
- Correspondence:
| | - Marcin Makuła
- Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Traugutta sq.2, 41-800 Zabrze, Poland;
| | - Maria Włodarczyk-Makuła
- Faculty of Infrastructure and Environment, Częstochowa University of Technology, 69 Dabrowskiego Str., 42-201 Częstochowa, Poland;
| | - Elżbieta Wołejko
- Department of Chemistry, Biology and Biotechnology, Faculty of Civil Engineering and Environmental Sciences, Bialystok University of Technology, Wiejska 45E Street, 15-351 Białystok, Poland; (E.W.); (U.W.)
| | - Urszula Wydro
- Department of Chemistry, Biology and Biotechnology, Faculty of Civil Engineering and Environmental Sciences, Bialystok University of Technology, Wiejska 45E Street, 15-351 Białystok, Poland; (E.W.); (U.W.)
| | - Lluis Serra-Majem
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain;
| | - Józefa Wiater
- Department of Agri-Food Engineering and Environmental Management, Faculty of Civil Engineering and Environmental Sciences, Bialystok University of Technology, Wiejska 45E Street, 15-351 Białystok, Poland;
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12
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Smith M. Ultraviolet-C radiation: A supplemental tool for disinfection. Nursing 2022; 52:35-39. [PMID: 35609075 DOI: 10.1097/01.nurse.0000829900.60122.4c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT In response to the COVID-19 pandemic, healthcare facilities have purchased more ultraviolet-C (UVC) disinfection devices than in previous years. This article discusses the safety and efficacy of UVC disinfection in healthcare settings.
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Affiliation(s)
- Mairead Smith
- Mairead Smith is a senior project engineer at ECRI in Pennsylvania
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Cobrado L, Ramalho P, Ricardo E, Fernandes ÂR, Azevedo MM, Rodrigues AG. Efficacy assessment of different time-cycles of nebulized hydrogen peroxide against bacterial and yeast biofilm. J Hosp Infect 2022; 127:7-14. [PMID: 35594987 DOI: 10.1016/j.jhin.2022.05.010] [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: 03/20/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The prevention of healthcare-associated infections requires a continuous effort. In order to achieve better practical results, the control of environmental microbial biofilms with effective disinfection strategies should be addressed. AIM This study aims to test the efficacy of different time-cycles of nebulized H2O2 against bacterial and yeast dry biofilm. METHODS The efficacy of a standard cycle (SC) and of a fast cycle (FC) of nebulized H2O2 was compared. Microbial biofilms were previously grown on different material coupons. The biofilm metabolic activity was determined by XTT assay and the biofilm total biomass by crystal violet assay. FINDINGS Regarding the efficacy of nebulized H2O2 against biofilms, the mean reduction of metabolic activity of the SC was 55.2% (±19.4%), comparing to a reduction of 50.4% (±17.7%) of the FC. The mean reduction of total biomass of the SC was 45.5% (±22.7%), versus 46.7% (±21.7%) of the FC. No statistical significant differences were found when comparing the tested cycles and distinct materials. CONCLUSION H2O2 nebulization was found to exhibit a good efficacy against healthcare-associated microbial dry biofilms. Moreover, similar efficacies were found between the tested cycles.
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Affiliation(s)
- Luís Cobrado
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal; CINTESIS, Center for Health Technology and Services Research, Portugal; Burn Unit and Department of Plastic and Reconstructive Surgery, University Hospital Center of São João, Porto, Portugal.
| | - Patrícia Ramalho
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal; CINTESIS, Center for Health Technology and Services Research, Portugal
| | - Elisabete Ricardo
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal; CINTESIS, Center for Health Technology and Services Research, Portugal
| | - Ângela Rita Fernandes
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
| | - Maria-Manuel Azevedo
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal; CINTESIS, Center for Health Technology and Services Research, Portugal
| | - Acácio Gonçalves Rodrigues
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal; CINTESIS, Center for Health Technology and Services Research, Portugal; Burn Unit and Department of Plastic and Reconstructive Surgery, University Hospital Center of São João, Porto, Portugal
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Dancer SJ, Inkster T. One size does NOT fit all: why infection prevention is difficult to randomise or control. J Hosp Infect 2022; 123:182-183. [DOI: 10.1016/j.jhin.2022.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 01/16/2023]
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Automated room decontamination: report of a Healthcare Infection Society Working Party. J Hosp Infect 2022; 124:97-120. [DOI: 10.1016/j.jhin.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/07/2022] [Indexed: 01/24/2023]
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A systematic review and meta-analysis of decontamination methods to prevent hospital environmental contamination and transmission of Clostridioidesdifficile. Anaerobe 2021; 73:102478. [PMID: 34808391 DOI: 10.1016/j.anaerobe.2021.102478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 02/08/2023]
Abstract
The current guidelines suggest that hospital rooms previously occupied with Clostridioides difficile infection (CDI) patients should be decontaminated with recommended decontamination methods because C. difficile can persist on surfaces despite adherence to the recommended procedures. Recently, ultraviolet (UV) light and hydrogen peroxide have increasingly been used as innovative decontamination methods. Hence, we conducted a systematic review and meta-analysis to investigate which decontamination methods are effective in reducing environmental C. difficile contamination. We systematically searched the EMBASE, PubMed, CINAHL, Scopus, and Ichushi until March 11, 2021. We evaluated the efficacy of decontamination methods in terms of the frequency of C. difficile contamination on high-touch surfaces in hospital rooms and the incidence of hospital-acquired C. difficile infection. Among the 15 studies retrieved in our meta-analysis, eight evaluated decontamination methods with the frequency of C. difficile detection among samples after disinfection procedures, and eight reported the number of hospital-acquired CDI cases. Pooled analysis indicated that hydrogen peroxide significantly reduced the frequency of environmental C. difficile contamination, compared with hypochlorite (odds ratios [OR]: 0.12; 95% confidence interval [CI]: 0.07-0.23). Additionally, hydrogen peroxide reduced the incidence of hospital-acquired CDI compared to other methods (OR: 0.52; 95% CI: 0.28-0.96). Decontamination with UV significantly reduced the incidence of hospital-acquired CDI compared to hypochlorite (OR 0.52, 95% CI 0.28-0.96). The use of hydrogen peroxide and UV can help prevent environmental C. difficile contamination and transmission in healthcare facilities.
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