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Mlynarczyk-Bonikowska B, Rudnicka L. HPV Infections-Classification, Pathogenesis, and Potential New Therapies. Int J Mol Sci 2024; 25:7616. [PMID: 39062859 PMCID: PMC11277246 DOI: 10.3390/ijms25147616] [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: 05/10/2024] [Revised: 07/02/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
To date, more than 400 types of human papillomavirus (HPV) have been identified. Despite the creation of effective prophylactic vaccines against the most common genital HPVs, the viruses remain among the most prevalent pathogens found in humans. According to WHO data, they are the cause of 5% of all cancers. Even more frequent are persistent and recurrent benign lesions such as genital and common warts. HPVs are resistant to many disinfectants and relatively unsusceptible to external conditions. There is still no drug available to inhibit viral replication, and treatment is based on removing lesions or stimulating the host immune system. This paper presents the systematics of HPV and the differences in HPV structure between different genetic types, lineages, and sublineages, based on the literature and GenBank data. We also present the pathogenesis of diseases caused by HPV, with a special focus on the role played by E6, E7, and other viral proteins in the development of benign and cancerous lesions. We discuss further prospects for the treatment of HPV infections, including, among others, substances that block the entry of HPV into cells, inhibitors of viral early proteins, and some substances of plant origin that inhibit viral replication, as well as new possibilities for therapeutic vaccines.
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Arkusz K, Pasik K, Jędrzejewska A, Klekiel T, Woźniak W, Nycz M, Stryjski R. Shedding light on the problem: Influence of the radiator power, source-sample distance, and exposure time on the performance of UV-C lamps in laboratory and real-world conditions. PLoS One 2024; 19:e0302258. [PMID: 38626152 PMCID: PMC11020484 DOI: 10.1371/journal.pone.0302258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/31/2024] [Indexed: 04/18/2024] Open
Abstract
Effective surface disinfection is crucial for preventing the spread of pathogens in hospitals. Standard UltraViolet-C (UV-C) lamps have been widely used for this purpose, but their disinfection efficiency under real-world conditions is not well understood. To fill this gap, the influence of the power of the ultraviolet radiator, source-sample distance, and exposure time on the performance of UV-C lamps against Escherichia coli and Staphylococcus epidermidis were experimentally determined in the laboratory and hospital. The obtained results showed that the UV irradiance and, thus, the UV-C disinfection efficiency decreased significantly at distances greater than 100 cm from the UV-C lamp. Moreover, increasing the total power of the radiators does not improve the performance of UV-C lamps under real conditions. The UV-C disinfection efficiency greater than 90% was achieved only under laboratory conditions at a close distance from the UV-C lamp, i.e., 10 cm. These findings provide novel insights into the limitations of UV-C lamps in real-world conditions and highlight the need for more effective disinfection strategies in hospitals.
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Affiliation(s)
- Katarzyna Arkusz
- Department of Biomedical Engineering, Faculty of Mechanical Engineering, University of Zielona Gora, Zielona Gora, Poland
| | - Kamila Pasik
- Department of Biomedical Engineering, Faculty of Mechanical Engineering, University of Zielona Gora, Zielona Gora, Poland
| | - Aleksandra Jędrzejewska
- Department of Biomedical Engineering, Faculty of Mechanical Engineering, University of Zielona Gora, Zielona Gora, Poland
| | - Tomasz Klekiel
- Department of Biomedical Engineering, Faculty of Mechanical Engineering, University of Zielona Gora, Zielona Gora, Poland
| | - Waldemar Woźniak
- Department of Production and Transport Engineering, Faculty of Mechanical Engineering, University of Zielona Gora, Zielona Gora, Poland
| | - Marta Nycz
- Department of Biomedical Engineering, Faculty of Mechanical Engineering, University of Zielona Gora, Zielona Gora, Poland
| | - Roman Stryjski
- Department of Production and Transport Engineering, Faculty of Mechanical Engineering, University of Zielona Gora, Zielona Gora, Poland
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Ezeh UC, Achlatis E, Crosby T, Kwak PE, Phillips MS, Amin MR. The Effectiveness of Ultraviolet Smart D60 in Reducing Contamination of Flexible Fiberoptic Laryngoscopes. Laryngoscope 2023; 133:3512-3519. [PMID: 37485725 DOI: 10.1002/lary.30869] [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: 03/24/2023] [Revised: 06/12/2023] [Accepted: 06/21/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE To compare the effectiveness of disinfection protocols utilizing a ultraviolet (UV) Smart D60 light system with Impelux™ technology with a standard Cidex ortho-phthalaldehyde (OPA) disinfection protocol for cleaning flexible fiberoptic laryngoscopes (FFLs). METHODS Two hundred FFLs were tested for bacterial contamination after routine use, and another 200 FFLs were tested after disinfection with one of four methods: enzymatic detergent plus Cidex OPA (standard), enzymatic detergent plus UV Smart D60, microfiber cloth plus UV Smart D60, and nonsterile wipe plus UV Smart D60. Pre- and post-disinfection microbial burden levels and positive culture rates were compared using Kruskal-Wallis ANOVA and Fisher's two-sided exact, respectively. RESULTS After routine use, approximately 56% (112/200) of FFLs were contaminated, with an average contamination level of 9,973.7 ± 70,136.3 CFU/mL. The standard reprocessing method showed no positive cultures. The enzymatic plus UV, microfiber plus UV, and nonsterile wipe plus UV methods yielded contamination rates of 4% (2/50), 6% (3/50), and 12% (6/50), respectively, with no significant differences among the treatment groups (p > 0.05). The pre-disinfection microbial burden levels decreased significantly after each disinfection technique (p < 0.001). The average microbial burden recovered after enzymatic plus UV, microfiber plus UV, and nonsterile wipe plus UV were 0.40 CFU/mL ± 2, 0.60 CFU/mL ± 2.4, and 12.2 CFU/mL ± 69.5, respectively, with no significant difference among the treatment groups (p > 0.05). Micrococcus species (53.8%) were most frequently isolated, and no high-concern organisms were recovered. CONCLUSION Disinfection protocols utilizing UV Smart D60 were as effective as the standard chemical disinfection protocol using Cidex OPA. LEVEL OF EVIDENCE NA Laryngoscope, 133:3512-3519, 2023.
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Affiliation(s)
- Uche C Ezeh
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Efstratios Achlatis
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Tyler Crosby
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Paul E Kwak
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Michael S Phillips
- Division of Infectious Disease, Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA
| | - Milan R Amin
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
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Rutala WA, Weber DJ. Reprocessing semicritical items: An overview and an update on the shift from HLD to sterilization for endoscopes. Am J Infect Control 2023; 51:A96-A106. [PMID: 37890958 DOI: 10.1016/j.ajic.2023.01.002] [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: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Semicritical medical devices are defined as items that come into contact with mucous membranes or nonintact skin (e.g., gastrointestinal endoscopes, endocavitary probes). Such medical devices require minimally high-level disinfection. METHODS Analyze the methods used to reprocess semicritical medical devices and identify methods and new technologies to reduce the risk of infection. RESULTS The reprocessing methods for semicritical medical devices is described as well as a shift from high-level disinfection to sterilization for lumened endoscopes. CONCLUSIONS Strict adherence to current guidelines and transition to sterilization for endoscopes is required as more outbreaks have been linked to inadequately disinfected endoscopes and other semicritical items than any other reusable medical devices.
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Affiliation(s)
- William A Rutala
- Statewide Program for Infection Control and Epidemiology, University of North Carolina Hospitals, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC.
| | - David J Weber
- Statewide Program for Infection Control and Epidemiology, University of North Carolina Hospitals, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC; Department of Infection Prevention, Hospital Epidemiology, University of North Carolina Hospitals, Chapel Hill, NC
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Tan C, Wang S, Yang H, Huang Q, Li S, Liu X, Ye H, Zhang G. Understanding the interaction of nucleotides with UVC light: an insight from quantum chemical calculation-based findings. Phys Chem Chem Phys 2023; 25:3270-3278. [PMID: 36625732 DOI: 10.1039/d2cp05054d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Short-wave ultraviolet (also called UVC) irradiation is a well-adopted method of viral inactivation due to its ability to damage genetic material. A fundamental problem with the UVC inactivation method is that its mechanism of action on viruses is still unknown at the molecular level. To address this problem, herein we investigate the response mechanism of genome materials to UVC light by means of quantum chemical calculations. The spectral properties of four nucleotides, namely, adenine, cytosine, guanine, and uracil, are mainly focused on. Meanwhile, the transition state and reaction rate constant of uracil molecules are also considered to demonstrate the difficulty level of adjacent nucleotide reaction without and with UVC irradiation. The results show that the peak wavelengths are 248.7 nm, 226.1 nm (252.7 nm), 248.3 nm, and 205.8 nm (249.2 nm) for adenine, cytosine, guanine, and uracil nucleotides, respectively. Besides, the reaction rate constants of uracil molecules are 6.419 × 10-49 s-1 M-1 and 5.436 × 1011 s-1 M-1 for the ground state and excited state, respectively. Their corresponding half-life values are 1.56 × 1048 s and 1.84 × 10-12 s. This directly suggests that the molecular reaction between nucleotides is a photochemical process and the reaction without UVC irradiation almost cannot occur.
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Affiliation(s)
- Chunjian Tan
- Electronic Components, Technology and Materials, Delft University of Technology, 2628 CD Delft, The Netherlands. .,Engineering Research Center of Integrated Circuits for Next-Generation Communications, Ministry of Education, School of Microelectronics, Southern University of Science and Technology, Shenzhen 518055, P. R. China.
| | - Shaogang Wang
- Electronic Components, Technology and Materials, Delft University of Technology, 2628 CD Delft, The Netherlands. .,Engineering Research Center of Integrated Circuits for Next-Generation Communications, Ministry of Education, School of Microelectronics, Southern University of Science and Technology, Shenzhen 518055, P. R. China.
| | - Huiru Yang
- Engineering Research Center of Integrated Circuits for Next-Generation Communications, Ministry of Education, School of Microelectronics, Southern University of Science and Technology, Shenzhen 518055, P. R. China.
| | - Qianming Huang
- Engineering Research Center of Integrated Circuits for Next-Generation Communications, Ministry of Education, School of Microelectronics, Southern University of Science and Technology, Shenzhen 518055, P. R. China.
| | - Shizhen Li
- Engineering Research Center of Integrated Circuits for Next-Generation Communications, Ministry of Education, School of Microelectronics, Southern University of Science and Technology, Shenzhen 518055, P. R. China.
| | - Xu Liu
- Electronic Components, Technology and Materials, Delft University of Technology, 2628 CD Delft, The Netherlands. .,Engineering Research Center of Integrated Circuits for Next-Generation Communications, Ministry of Education, School of Microelectronics, Southern University of Science and Technology, Shenzhen 518055, P. R. China.
| | - Huaiyu Ye
- Engineering Research Center of Integrated Circuits for Next-Generation Communications, Ministry of Education, School of Microelectronics, Southern University of Science and Technology, Shenzhen 518055, P. R. China.
| | - Guoqi Zhang
- Electronic Components, Technology and Materials, Delft University of Technology, 2628 CD Delft, The Netherlands.
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Pineau L, Radix C, Weber DJ. Comparison of the sporicidal activity of a UV disinfection process with three FDA cleared sterilants. Am J Infect Control 2022; 50:1316-1321. [PMID: 35263613 DOI: 10.1016/j.ajic.2022.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Endocavitary probes are semi-critical devices and must undergo, at least, high level disinfection (HLD) between uses. Therefore, they should be high level disinfected between uses (i.e., with a product/process that kills all forms of microbial life; bacteria, fungi, mycobacteria, and virus, and in some countries, a demonstrated potential for sporicidal activity). In this study, the sporicidal activity of three common Food and Drug Administration cleared sterilants (CIDEX OPA Solution, SPOROX II Sterilizing and Disinfection Solution and CIDEX Activated Dialdehyde Solution) was compared with the sporicidal activity of an ultraviolet disinfection technology (Hypernova Chronos, Germitec) against Bacillus subtilis ATCC 19659 spores spread on silicone flat carriers in the presence of inorganic and organic soil. RESULTS The results indicate that the UV disinfection process presented within a 35 seconds exposure time a sporicidal efficacy substantially higher than the chemical sterilants used according to manufacturer instructions for HLD. CONCLUSIONS This study demonstrated that even if it cannot be tested/approved as a sterilant according to AOAC 966.04, the UV unit is much more effective than usual Food and Drug Administration approved chemical HLD products to kill spores in real use conditions. This finding questions the relevancy of evaluating product efficacy within extended conditions giving results that could mislead users to select the most effective HLD product/process for the reprocessing of their medical devices.
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Affiliation(s)
- Lionel Pineau
- Division of Medical Device Testing, Eurofins Biotech Germande, Aix-en-Provence, France.
| | - Caroline Radix
- Division of Medical Device Testing, Eurofins Biotech Germande, Aix-en-Provence, France
| | - David J Weber
- Division of Infectious Diseases, Department of Hospital Epidemiology, University of North Carolina School of Medicine, University of North Carolina Hospitals, Chapel Hill, NC, USA
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Kyriacou C, Robinson E, Barcroft J, Parker N, Tuomey M, Stalder C, Gould D, Al‐Memar M, Bourne T. Time-effectiveness and convenience of transvaginal ultrasound probe disinfection using ultraviolet vs chlorine dioxide multistep wipe system: prospective survey study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2022; 60:132-138. [PMID: 34919771 PMCID: PMC9414347 DOI: 10.1002/uog.24834] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/26/2021] [Accepted: 12/01/2021] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To compare the efficiency, ease of use and user satisfaction of two methods of transvaginal ultrasound probe high-level disinfection: ultraviolet-C radiation (UV-C) and a chlorine dioxide multistep wipe system. METHODS This was a prospective survey study. UV-C units were introduced into a busy early pregnancy assessment service and compared with a multiwipe system for disinfection. Before seeing each patient, healthcare professionals (HCPs) measured with a stopwatch the time taken to complete a cycle of disinfection using either UV-C or chlorine dioxide multistep wipes and responded to a quick-response (QR) code-linked survey. Additional essential tasks that could be completed before seeing the next patient during probe disinfection were also documented. Using another QR code-linked survey, data on ease of use, satisfaction with the system used and preferred system were collected. The ease of use and satisfaction with the system were rated on a 0 to 10 Likert scale (0 poor, 10 excellent). A free-text section for comments was then completed. RESULTS Disinfection using UV-C (n = 331) was 60% faster than the chlorine dioxide multiwipe system (n = 332) (101 vs 250 s; P < 0.0001). A greater number of tasks were completed during probe disinfection when using UV-C, saving a further 74 s per patient (P < 0.0001). The HCPs using UV-C (n = 71) reported greater ease of use (median Likert score, 10 vs 3; P < 0.0001) and satisfaction (median Likert score, 10 vs 2; P < 0.0001) compared with those using the multiwipe system (n = 43). HCPs reported that the chlorine dioxide system was time-consuming and environmentally unfriendly, while the UV-C system was efficient and easy to use. Overall, 98% of the HCPs preferred using the UV-C system. CONCLUSIONS UV-C technology is more time-efficient and allows more essential tasks to be completed during disinfection. For a 4-h ultrasound list of 15 patients, the use of UV-C would save 55 min 45 s. HCPs found UV-C preferable and easier to use. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- C. Kyriacou
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
| | - E. Robinson
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
| | - J. Barcroft
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
| | - N. Parker
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
| | - M. Tuomey
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
| | - C. Stalder
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
| | - D. Gould
- St Mary's Hospital, Department of Obstetrics and GynaecologyImperial College LondonLondonUK
| | - M. Al‐Memar
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
| | - T. Bourne
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and GynaecologyQueen Charlotte's & Chelsea Hospital, Imperial College LondonLondonUK
- Department of Obstetrics and GynecologyUniversity Hospitals LeuvenLeuvenBelgium
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Kyriacou C, Bourne T. Reply. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2022; 60:147-148. [PMID: 35776007 DOI: 10.1002/uog.24954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- C Kyriacou
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and Gynecology, Queen Charlotte's & Chelsea Hospital, Imperial College London, London, UK
| | - T Bourne
- Tommy's National Centre for Miscarriage Research, Department of Obstetrics and Gynecology, Queen Charlotte's & Chelsea Hospital, Imperial College London, London, UK
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
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Robins LI, Clark A, Gafken PR, Alam S, Milici J, Hassan R, Wang C, Williams J, Meyers C. Hypochlorous Acid as a Disinfectant for High‐risk HPV: Insight into the mechanism of action. J Med Virol 2022; 94:3386-3393. [DOI: 10.1002/jmv.27716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/11/2022] [Accepted: 02/12/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Lori I. Robins
- Department of Physical Sciences, University of Washington Bothell, 18115 Campus Way NE BothellWA98011USA
| | - Andrew Clark
- Department of Physical Sciences, University of Washington Bothell, 18115 Campus Way NE BothellWA98011USA
| | - Philip R. Gafken
- Fred Hutchinson Cancer Research Center, 1100 Fairview Ave NSeattleWA98109USA
| | - Samina Alam
- Department of Microbiology and Immunology, Pennsylvania State College of MedicineHersheyPA17033USA
| | - Janice Milici
- Department of Microbiology and Immunology, Pennsylvania State College of MedicineHersheyPA17033USA
| | - Reem Hassan
- Department of Microbiology and Immunology, Pennsylvania State College of MedicineHersheyPA17033USA
| | - Che‐Yen Wang
- Department of Microbiology and Immunology, Pennsylvania State College of MedicineHersheyPA17033USA
| | - Jeff Williams
- Briotech Inc., 14120 NE 200th StWoodinvilleWA98072USA
| | - Craig Meyers
- Department of Microbiology and Immunology, Pennsylvania State College of MedicineHersheyPA17033USA
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de Souza Hajar K, Quartim de Moraes Bruna C, Uchikawa Graziano K. Infection Transmission Associated With Contaminated Ultrasound Probes: A Systematic Review. AORN J 2021; 115:42-51. [PMID: 34958475 DOI: 10.1002/aorn.13572] [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: 12/28/2020] [Revised: 03/10/2021] [Accepted: 03/26/2021] [Indexed: 11/07/2022]
Abstract
A systematic review of seven studies on infections related to contaminated ultrasound probes showed that the infections were related to a failure in the decontamination process of ultrasound devices used on immature skin of neonates in an intensive care unit and transesophageal echocardiography probes. Six of the studies involved outbreaks in patients who underwent transesophageal echocardiography either during or after surgery or as a part of treatment for a nonsurgical cardiac condition. The evidence shows links between the infection outbreaks and environmental contamination, lack of standardized ultrasound probe disinfection processes, inadequate storage, and lack of monitoring of probe integrity. When personnel addressed the deficiencies (eg, improving the disinfection process, cleaning the probes immediately after use, inspecting the probes for defects), the infections ceased. Personnel involved with the reprocessing of ultrasound probes should clean, disinfect, inspect, and store ultrasound probes in a manner that maintains device integrity and prevents contamination.
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11
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Bhardwaj SK, Singh H, Deep A, Khatri M, Bhaumik J, Kim KH, Bhardwaj N. UVC-based photoinactivation as an efficient tool to control the transmission of coronaviruses. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 792:148548. [PMID: 34465056 PMCID: PMC8238411 DOI: 10.1016/j.scitotenv.2021.148548] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/28/2021] [Accepted: 06/15/2021] [Indexed: 05/04/2023]
Abstract
The ongoing COVID-19 pandemic made us re-realize the importance of environmental disinfection and sanitation in indoor areas, hospitals, and clinical rooms. UVC irradiation of high energy and short wavelengths, especially in the 200-290-nm range possesses the great potential for germicidal disinfection. These properties of UVC allow to damage or destruct the nucleic acids (DNA/RNA) in diverse microbes (e.g., bacteria, fungi, and viruses). UVC light can hence be used as a promising tool for prevention and control of their infection or transmission. The present review offers insights into the historical perspective, mode of action, and recent advancements in the application of UVC-based antiviral therapy against coronaviruses (including SARS CoV-2). Moreover, the application of UVC lights in the sanitization of healthcare units, public places, medical instruments, respirators, and personal protective equipment (PPE) is also discussed. This article, therefore, is expected to deliver a new path for the developments of UVC-based viricidal approach.
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Affiliation(s)
- Sanjeev K Bhardwaj
- Department of Nanomaterials and Application Technology, Center of Innovative and Applied Bioprocessing, Sector 81 (Knowledge City), S.A.S. Nagar 140306, Punjab, India
| | - Harpreet Singh
- Department of Biotechnology, University Institute of Engineering Technology (UIET), Panjab University, Chandigarh, India
| | - Akash Deep
- Central Scientific Instruments Organisation, Sector 30-C, Chandigarh 160030, India
| | - Madhu Khatri
- Department of Biotechnology, University Institute of Engineering Technology (UIET), Panjab University, Chandigarh, India
| | - Jayeeta Bhaumik
- Department of Nanomaterials and Application Technology, Center of Innovative and Applied Bioprocessing, Sector 81 (Knowledge City), S.A.S. Nagar 140306, Punjab, India
| | - Ki-Hyun Kim
- Department of Civil and Environmental Engineering, Hanyang University, 222 Wangsimni-Ro, Seoul 04763, Republic of Korea.
| | - Neha Bhardwaj
- Department of Biotechnology, University Institute of Engineering Technology (UIET), Panjab University, Chandigarh, India.
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12
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Möllers M, Wagner J, Oelmeier K, Braun J, Schmitz R. [Disinfection of transvaginal ultrasound probes-A current overview of methods and recommendations]. DER GYNAKOLOGE 2021; 54:688-693. [PMID: 34248176 PMCID: PMC8261395 DOI: 10.1007/s00129-021-04824-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 11/04/2022]
Abstract
Disinfection of ultrasound probes, especially of transvaginal probes, has been under discussion during recent years and there have been several new regulations and recommendations as well as trends in the field of disinfection methods. This article provides a review and summary of the current state of knowledge.
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Affiliation(s)
- Mareike Möllers
- Bereich Geburtshilfe und Pränatalmedizin, Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, Deutschland
| | - Johanna Wagner
- Bereich Geburtshilfe und Pränatalmedizin, Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, Deutschland
| | - Kathrin Oelmeier
- Bereich Geburtshilfe und Pränatalmedizin, Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, Deutschland
| | - Janina Braun
- Bereich Geburtshilfe und Pränatalmedizin, Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, Deutschland
| | - Ralf Schmitz
- Bereich Geburtshilfe und Pränatalmedizin, Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, Deutschland
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13
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Dannhorn A, Ling S, Powell S, McCall E, Maglennon G, Jones GN, Pierce AJ, Strittmatter N, Hamm G, Barry ST, Bunch J, Goodwin RJA, Takats Z. Evaluation of UV-C Decontamination of Clinical Tissue Sections for Spatially Resolved Analysis by Mass Spectrometry Imaging (MSI). Anal Chem 2021; 93:2767-2775. [PMID: 33474935 DOI: 10.1021/acs.analchem.0c03430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Clinical tissue specimens are often unscreened, and preparation of tissue sections for analysis by mass spectrometry imaging (MSI) can cause aerosolization of particles potentially carrying an infectious load. We here present a decontamination approach based on ultraviolet-C (UV-C) light to inactivate clinically relevant pathogens such as herpesviridae, papovaviridae human immunodeficiency virus, or SARS-CoV-2, which may be present in human tissue samples while preserving the biodistributions of analytes within the tissue. High doses of UV-C required for high-level disinfection were found to cause oxidation and photodegradation of endogenous species. Lower UV-C doses maintaining inactivation of clinically relevant pathogens to a level of increased operator safety were found to be less destructive to the tissue metabolome and xenobiotics. These doses caused less alterations of the tissue metabolome and allowed elucidation of the biodistribution of the endogenous metabolites. Additionally, we were able to determine the spatially integrated abundances of the ATR inhibitor ceralasertib from decontaminated human biopsies using desorption electrospray ionization-MSI (DESI-MSI).
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Affiliation(s)
- Andreas Dannhorn
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, 605 SAF Building, South Kensington Campus, London CB4 0FZ, U.K.,Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge SW7 2AZ, U.K
| | - Stephanie Ling
- Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge SW7 2AZ, U.K
| | - Steven Powell
- Safety, Health and Environment (SHE), Cambridge Operations, BioPharmaceuticals R&D, AstraZeneca, Cambridge CB4 0FZ, U.K
| | - Eileen McCall
- Safety, Health and Environment (SHE), Cambridge Operations, BioPharmaceuticals R&D, AstraZeneca, Cambridge CB4 0FZ, U.K
| | - Gareth Maglennon
- Oncology Safety, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB22 3AT, U.K
| | - Gemma N Jones
- Translational Medicine, Oncology R&D, AstraZeneca, Cambridge SG8 6EH, U.K
| | - Andrew J Pierce
- Translational Medicine, Oncology R&D, AstraZeneca, Cambridge SG8 6EH, U.K
| | - Nicole Strittmatter
- Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge SW7 2AZ, U.K
| | - Gregory Hamm
- Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge SW7 2AZ, U.K
| | - Simon T Barry
- Bioscience, Discovery, Oncology R&D, AstraZeneca, Cambridge CB2 0RE, U.K
| | - Josephine Bunch
- National Centre of Excellence in Mass Spectrometry Imaging (NiCE-MSI), National Physical Laboratory, Teddington TW11 0LW, U.K
| | - Richard J A Goodwin
- Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge SW7 2AZ, U.K.,Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, U.K
| | - Zoltan Takats
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, 605 SAF Building, South Kensington Campus, London CB4 0FZ, U.K
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14
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Ozbun MA, Bondu V, Patterson NA, Sterk RT, Waxman AG, Bennett EC, McKee R, Sharma A, Yarwood J, Rogers M, Eichenbaum G. Infectious titres of human papillomaviruses (HPVs) in patient lesions, methodological considerations in evaluating HPV infectivity and implications for the efficacy of high-level disinfectants. EBioMedicine 2021; 63:103165. [PMID: 33422988 PMCID: PMC7808919 DOI: 10.1016/j.ebiom.2020.103165] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/07/2020] [Accepted: 11/27/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Recent publications from a single research group have suggested that aldehyde-based high-level disinfectants (HLDs), such as ortho-phthalaldehyde (OPA), are not effective at inactivating HPVs and that therefore, patients may be at risk of HPV infection from medical devices. These results could have significant public health consequences and therefore necessitated evaluation of their reproducibility and clinical relevance. METHODS We developed methods and used standardised controls to: (1) quantify the infectious levels of clinically-sourced HPVs from patient lesions and compare them to laboratory-derived HPVs, (2) evaluate experimental factors that should be controlled to ensure consistent and reproducible infectivity measurements of different HPV genotypes, and (3) determine the efficacy of select HLDs. FINDINGS A novel focus forming unit (FFU) infectivity assay demonstrated that exfoliates from patient anogenital lesions and respiratory papillomas yielded infectious HPV burdens up to 2.7 × 103 FFU; therefore, using 2.2 × 102 to 1.0 × 104 FFU of laboratory-derived HPVs in disinfection assays provides a relevant range for clinical exposures. RNase and neutralising antibody sensitivities were used to ensure valid infectivity measures of tissue-derived and recombinant HPV preparations. HPV infectivity was demonstrated over a dynamic range of 4-5 log10; and disinfection with OPA and hypochlorite was achieved over 3 to >4 log10 with multiple genotypes of tissue-derived and recombinant HPV isolates. INTERPRETATION This work, along with a companion publication from an independent lab in this issue, address a major public health question by showing that HPVs are susceptible to HLDs. FUNDING Advanced Sterilization Products; US NIH (R01CA207368, U19AI084081, P30CA118100).
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Affiliation(s)
- Michelle A Ozbun
- Department of Molecular Genetics & Microbiology, The University of New Mexico School of Medicine, Albuquerque, NM 87131, United States; Department of Obstetrics & Gynecology, The University of New Mexico School of Medicine, Albuquerque, NM 87131, United States; The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, United States.
| | - Virginie Bondu
- Department of Molecular Genetics & Microbiology, The University of New Mexico School of Medicine, Albuquerque, NM 87131, United States
| | - Nicole A Patterson
- Department of Molecular Genetics & Microbiology, The University of New Mexico School of Medicine, Albuquerque, NM 87131, United States
| | - Rosa T Sterk
- Department of Molecular Genetics & Microbiology, The University of New Mexico School of Medicine, Albuquerque, NM 87131, United States
| | - Alan G Waxman
- Department of Obstetrics & Gynecology, The University of New Mexico School of Medicine, Albuquerque, NM 87131, United States
| | - Erica C Bennett
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, The University of New Mexico School of Medicine, Albuquerque, NM 87131, United States
| | - Rohini McKee
- Department of Surgery, Division of General Surgery, The University of New Mexico School of Medicine, Albuquerque, NM 87131, United States
| | - Ankur Sharma
- Advanced Sterilization Products, Inc., 33 Technology Drive, Irvine, CA 92618, United States
| | - Jeremy Yarwood
- Advanced Sterilization Products, Inc., 33 Technology Drive, Irvine, CA 92618, United States
| | - Marc Rogers
- Advanced Sterilization Products, Inc., 33 Technology Drive, Irvine, CA 92618, United States
| | - Gary Eichenbaum
- Johnson & Johnson, Office of the Chief Medical Officer, 410 George Street, New Brunswick, NJ 08901, United States
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Hamm RF, Combs CA, Davidson CM, Davidson CM. Society for Maternal-Fetal Medicine Special Statement: Reducing the risk of transmitting infection by transvaginal ultrasound examination. Am J Obstet Gynecol 2020; 223:B2-B6. [PMID: 32470457 DOI: 10.1016/j.ajog.2020.05.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Recent surveys have shown widespread lapses in the procedures used to reduce the risk of transmitting infection via medical devices. Transvaginal ultrasound examination has the potential to transmit vaginal infections, including human papillomavirus. Areas of particular concern are the use of probe covers with high rates of leakage, disinfectants that are not effective against human papillomavirus, and coupling gel from multiple-use containers. We reviewed these issues, and we recommend 4 steps to reduce the risk of transmitting infection. First, during every transvaginal ultrasound exam, the probe should be covered with a sterile, single-use "viral barrier" cover or a condom. Second, sterile, single-use ultrasound gel packets should be used. Third, after every examination, the probe should be cleaned to remove any visible gel or debris. Finally, after cleaning, the probe should undergo high-level disinfection using an agent with proven efficacy against the human papillomavirus, including hydrogen peroxide, hypochlorite, or peracetic acid. Glutaraldehyde, orthophthalaldehyde, phenols, and isopropyl alcohol have virtually no efficacy against the human papillomavirus.
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Affiliation(s)
| | | | | | - Christina M Davidson
- Patient Safety and Quality Improvement Committee, Society for Maternal-Fetal Medicine, Washington, DC
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16
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A comparative carbon footprint analysis of disposable and reusable vaginal specula. Am J Obstet Gynecol 2020; 223:225.e1-225.e7. [PMID: 32067971 DOI: 10.1016/j.ajog.2020.02.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/28/2019] [Accepted: 02/03/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Healthcare systems in the United States have increasingly turned toward the use of disposable medical equipment in an attempt to save time, lower costs, and reduce the transmission of infections. However, the use of disposable instruments is associated with increased solid waste production and may have negative impacts on the environment, such as increased greenhouse gas emissions. OBJECTIVE The purpose of this study was to inform this discussion; we applied life cycle assessment methods to evaluate the carbon footprints of 3 vaginal specula: a single-use acrylic model and 2 reusable stainless steel models. STUDY DESIGN The functional unit of the study was defined as the completion of 20 gynecologic examinations by either type of speculum. The greenhouse gas emissions (eg, carbon dioxide, methane, nitrous oxide) across all life cycle stages, which includes material production and manufacturing, transportation, use and reprocessing, and end-of-life, were analyzed with the use of SimaPro life cycle assessment software and converted into carbon dioxide equivalents. RESULTS The reusable stainless steel grade 304 speculum was found to have a lesser carbon footprint over multiple model scenarios (different reprocessing techniques, autoclave loading/efficiency, and number of uses) than either the reusable stainless steel grade 316 or the disposable acrylic specula. The material production and manufacturing phase contributed most heavily to the total life cycle carbon footprint of the acrylic speculum, whereas the use and reprocessing phase contributed most to the carbon footprints of both stainless steel specula. CONCLUSION The use of disposable vaginal specula is associated with increased greenhouse gas equivalents compared with reusable alternatives with no significant difference in clinical utility. These findings can be used to inform decision-making by healthcare systems, because they weigh a wide range of considerations in making final purchase decisions; similar analytic methods can and should be applied to other components of health systems' waste streams.
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17
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Sawatsky ML, Lalumière ML. Effect of a Condom Cover on Vaginal Photoplethysmographic Responses. J Sex Med 2020; 17:702-715. [PMID: 32035833 DOI: 10.1016/j.jsxm.2019.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/28/2019] [Accepted: 12/13/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The vaginal photoplethysmograph (VPP) is a reusable intravaginal device often employed in sexual psychophysiology studies to assess changes in vaginal blood flow, an indicator of sexual arousal. AIM To test whether placing a disposable cover on the VPP probe impacts the acquired data. A condom cover would reduce risk of disease transmission and likely increase participant comfort but may negatively impact the VPP signal. METHOD The genital responses of 25 cisgender women (mean age = 21.3 years, standard deviation = 2.6) were assessed with VPP in a within-subjects design with 2 conditions-with and without a polyisoprene condom cover. Sexual responses were elicited by audiovisual film clips that varied in erotic intensity: nonsexual (nonsexual male-female interaction), low-intensity sexual (nude exercise), and high-intensity sexual (male-female intercourse). Women continuously rated their sexual arousal during stimulus presentations. MAIN OUTCOME MEASURE Change in vaginal pulse amplitude and also self-reported sexual arousal. RESULTS The magnitude of sexual response to each stimulus category and the overall pattern of results were found to be highly similar in the cover-off and cover-on conditions. The high-intensity sexual stimulus category elicited a greater sexual response than all other categories. The low-intensity sexual category elicited a (small) genital response in only the cover-on condition, although we suspect this is a spurious finding. There was no difference in the average number of edited movement artifacts across conditions. CLINICAL IMPLICATIONS Potential benefits of encasing the VPP probe with a protective cover include enhanced participant safety and comfort, especially if assessing genital responses of high-risk or immunocompromised samples. The use of a cover complies with current guidelines for reprocessing semi-critical medical devices (eg, vaginal ultrasound probes) in many regions. STRENGTHS & LIMITATIONS Although the idea of a VPP probe cover had been discussed among sexual psychophysiology researchers, this is the first study to empirically test whether a cover could jeopardize VPP data. Potential limitations include the use of a 10-Hz VPP sampling rate and a cover that was not tailored to the size of the VPP probe. CONCLUSION Placing a protective cover on the VPP probe did not appear to meaningfully impact sexual arousal or the VPP data. Based on these results and the potential advantages of a protective cover, researchers may wish to integrate the use a condom cover in their experiment protocols and clinical applications. Sawatsky ML, Lalumière ML. Effect of a Condom Cover on Vaginal Photoplethysmographic Responses. J Sex Med 2020; 17:702-715.
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Affiliation(s)
- Megan L Sawatsky
- University of Ottawa, Faculty of Social Sciences, Department of Psychology, Ottawa, ON, Canada
| | - Martin L Lalumière
- University of Ottawa, Faculty of Social Sciences, Department of Psychology, Ottawa, ON, Canada.
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18
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Meyers C, Milici J, Robison R. The ability of two chlorine dioxide chemistries to inactivate human papillomavirus-contaminated endocavitary ultrasound probes and nasendoscopes. J Med Virol 2020; 92:1298-1302. [PMID: 31919857 PMCID: PMC7497195 DOI: 10.1002/jmv.25666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/07/2020] [Indexed: 12/18/2022]
Abstract
Sexual transmission is the most common pathway for the spread of Human papillomavirus (HPV). However, the potential for iatrogenic HPV infections is also real. Even though cleared by the Food and Drug Administration and recommended by the World Federation for Ultrasound in Medicine and Biology, several disinfectants including glutaraldehyde and o-phthalaldehyde have shown a lack of efficacy for inactivating HPV. Other methods such as ultraviolet C and concentrated hydrogen peroxide have been shown highly effective at inactivating infectious HPV. In this study, two chlorine dioxide systems are also shown to be highly efficacious at inactivating HPV. An important difference in these present studies is that as opposed to testing in suspension or using a carrier, we dried the infectious virus directly onto endocavitary ultrasound probes and nasendoscopes, therefore, validating a more realistic system to demonstrate disinfectant efficacy.
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Affiliation(s)
- Craig Meyers
- Department of Microbiology and Immunology, Pennsylvania State College of Medicine, Hershey, Pennsylvania
| | - Janice Milici
- Department of Microbiology and Immunology, Pennsylvania State College of Medicine, Hershey, Pennsylvania
| | - Richard Robison
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, Utah
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Pichon M, Lebail-Carval K, Billaud G, Lina B, Gaucherand P, Mekki Y. Decontamination of Intravaginal Probes Infected by Human Papillomavirus (HPV) Using UV-C Decontamination System. J Clin Med 2019; 8:jcm8111776. [PMID: 31653074 PMCID: PMC6912769 DOI: 10.3390/jcm8111776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/17/2019] [Accepted: 10/22/2019] [Indexed: 12/03/2022] Open
Abstract
Background: This three-step study evaluated ultraviolet-C (UV-C) efficacy against human papillomavirus (HPV) found on vaginal ultrasound probes. Methods: The first two steps evaluated UV-C disinfection of vaginal ultrasound probes in routine condition. During the first phase, the probe (n = 100) was sampled after a complete cleaning and disinfection protocol, i.e., cleaning with chemically impregnated wipes, followed by UV-C. During the second phase, the probe (n = 47) was sampled after cleaning and UV-C. The final step consisted of applying mixes of HPV on a dedicated, covered probe (n = 15) then sampling the cover, the probe after removal of the cover, after cleaning, and after UV-C. HPV detection was performed using CLART® HPV2 PCR (Genomica, Madrid, Spain). Results: In the first phase, no probes were found to be positive for both DNA after UV-C. In the second phase, eight probes were found to be positive after cleaning (seven with human DNA and one with HPV) and negative after UV-C. In the final phase, one probe was found to be positive for HPV for each sample except after UV-C. Conclusions: Covers followed by a chemically impregnated wipe are not sufficient to ensure patient safety during vaginal ultrasound examinations. UV-C is effective in routine conditions against contaminations found on vaginal ultrasound probes, especially HPV.
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Affiliation(s)
- Maxime Pichon
- University Hospital of Poitiers, Bacteriology and Infection Control Laboratory, Infectious Agents Department, 86021 Poitiers CEDEX, France.
| | - Karine Lebail-Carval
- Hospices Civils de Lyon, Département de Chirurgie Gynécologique, Hôpital Femme-Mère-Enfant, 69000 Lyon-Bron, France.
| | - Geneviève Billaud
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux, Groupement Hospitalier Nord, 69317 Lyon CEDEX 04, France.
| | - Bruno Lina
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux, Groupement Hospitalier Nord, 69317 Lyon CEDEX 04, France.
| | - Pascal Gaucherand
- Hospices Civils de Lyon, Département de Chirurgie Gynécologique, Hôpital Femme-Mère-Enfant, 69000 Lyon-Bron, France.
| | - Yahia Mekki
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux, Groupement Hospitalier Nord, 69317 Lyon CEDEX 04, France.
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21
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Abstract
Semicritical medical devices are defined as items that come into contact with mucous membranes or nonintact skin (eg, gastrointestinal endoscopes, endocavitary probes). Such medical devices require minimally high-level disinfection. As many of these items are temperature sensitive, low-temperature chemical methods must be used rather than steam sterilization. Strict adherence to current guidelines is required as more outbreaks have been linked to inadequately cleaned or disinfected endoscopes and other semicritical items than any other reusable medical devices.
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Kim MH, Lee SG, Kim KS, Heo YJ, Oh JE, Jeong SJ. Environmental disinfection with photocatalyst as an adjunctive measure to control transmission of methicillin-resistant Staphylococcus aureus: a prospective cohort study in a high-incidence setting. BMC Infect Dis 2018; 18:610. [PMID: 30509196 PMCID: PMC6276245 DOI: 10.1186/s12879-018-3555-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 11/26/2018] [Indexed: 11/10/2022] Open
Abstract
Background Environmental disinfection with continuously antimicrobial surfaces could offer superior control of surface bioburden. We sought to decide the efficacy of photocatalyst antimicrobial coating in reducing methicillin-resistant Staphylococcus aureus (MRSA) acquisition in high incidence setting. Methods We performed prospective cohort study involving patients hospitalized in medical intensive care unit. A titanium dioxide-based photocatalyst was coated on high touch surfaces and walls. Five months of pre-intervention data were compared with five months of post-intervention data. The incidence rates of multidrug-resistant organism acquisition and the rates of hospital-acquired blood stream infection, pneumonia, urinary tract infection, and Clostridium difficile–associated diseases were compared using Cox proportional hazards regression analysis. Results In total, 621 patients were included. There was significant decrease in MRSA acquisition rate after photocatalyst coating (hazard ratio, 0.37; 95% confidence interval, 0.14–0.99; p = 0.04). However, clinical identification of vancomycin-resistant Enterococcus spp. and multidrug-resistant Acinetobacter baumannii did not decrease significantly. The hazard of contracting hospital-acquired pneumonia during the intervention period compared to baseline period was 0.46 (95% confidence interval, 0.23–0.94; p = 0.03). Conclusions In conclusion, MRSA rate was significantly reduced after photocatalyst coating. We provide evidence that photocatalyst disinfection can be an adjunctive measure to control MRSA acquisition in high-incidence settings. Trial registration ISRCTN Registry (ISRCTN31972004). Registered retrospectively on November 19, 2018. Electronic supplementary material The online version of this article (10.1186/s12879-018-3555-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Min Hyung Kim
- Department of Internal Medicine, Bundang Jesaeng Hospital, 180-2Seohyeon-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-774, South Korea
| | - Seong Gyu Lee
- Department of Laboratory Medicine, Bundang Jesaeng Hospital, 180-2Seohyeon-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-774, South Korea
| | - Ki Sook Kim
- Department of Infection Control Office, Bundang Jesaeng Hospital, 180-2Seohyeon-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-774, South Korea
| | - Yoon Ji Heo
- Department of Infection Control Office, Bundang Jesaeng Hospital, 180-2Seohyeon-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-774, South Korea
| | - Ji Eun Oh
- Department of Nursing, Bundang Jesaeng Hospital, 180-2Seohyeon-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-774, South Korea
| | - Su Jin Jeong
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Pearlman O. Reviewing the Use of Glutaraldehyde for High-level Disinfection by Sonographers. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2018. [DOI: 10.1177/8756479318813361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A review of recent literature has demonstrated that ultrasound transducers may harbor bacteria and viruses that could cause cross-contamination for patients. Reducing the risk of cross-contamination is achieved by high-level disinfection of ultrasound transducers. One of the main types of high-level disinfectants (HLD) used in performing sonography is glutaraldehyde (GA). While GA-based HLDs are cleared in abundance by the FDA and compatible with most transducers, GA has been reported to cause extensive adverse effects and has limited efficacy as a disinfectant. This literature review provides a current set of studies that discuss high-level disinfection of ultrasound transducers, GA use, exposure, and alternatives. This information could be used by practitioners to carefully consider how to effectively clean ultrasound transducers and supporting equipment. Additional guidance is provided on how to potentially minimize GA exposure and suggestions for protecting patients during their imaging examination.
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