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Casini B, Spagnolo AM, Sartini M, Tuvo B, Scarpaci M, Barchitta M, Pan A, Agodi A, Cristina ML, Castiglia P, De Giusti M, Distefano M, Longhitano A, Laganà P, Mentore B, Canale F, Mantero F, Opezzi M, Marciano E, Zurlo L, Segata A, Torre I, Vay D, Vecchi E, Vincenti S. Microbiological surveillance post-reprocessing of flexible endoscopes used in digestive endoscopy: a national study. J Hosp Infect 2023; 131:139-147. [PMID: 36244520 DOI: 10.1016/j.jhin.2022.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/17/2022] [Accepted: 09/19/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Microbiological surveillance of endoscopes is a safety measure for verifying the quality of reprocessing procedures and identifying contaminated devices, but duodenoscope-related outbreaks are still reported. AIM To assess the effectiveness of duodenoscope reprocessing procedures in Italy. METHODS Between December 2019 and April 2020, data obtained from microbiological surveillance post-reprocessing in 15 Italian endoscopy units were collected. Sampling was carried out after reprocessing or during storage in a cabinet. In keeping with international guidelines and the Italian position paper, the micro-organisms were classified as high-concern organisms (HCOs) and low-concern organisms (LCOs). FINDINGS In total, 144 samples were collected from 51 duodenoscopes. Of these, 36.81% were contaminated: 22.92% were contaminated with HCOs and 13.89% were contaminated with LCOs [2.08% with an LCO load of 11-100 colony-forming units (CFU)/device and 0.69% with an LCO load of >100 CFU/device]. The contamination rate was 27.5% in samples collected after reprocessing, 40% in samples collected during storage in a cabinet that was compliant with EN 16442:2015 (C-I), and 100% in samples collected during storage in a cabinet that was not compliant with EN 16442:2015 (NC-I). The respective HCO rates were 15.00%, 27.27% and 66.67%. Correlation between LCO contamination and storage time was demonstrated (Spearman's rho=0.3701; P=0.0026). The Olympus duodenoscope TJFQ180V demonstrated the lowest rate of contamination (29.82%), although the contamination rate was 100% for duodenoscopes stored in an NC-I cabinet. CONCLUSION Microbiological surveillance, along with strict adherence to reprocessing protocols, may help to detect endoscope contamination at an early stage, and reduce the risk of duodenoscope-associated infections.
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Affiliation(s)
- B Casini
- Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - A M Spagnolo
- Department of Health Sciences, University of Genova, Genova, Italy; Operating Unit Hospital Hygiene, Galliera Hospital, Genoa, Italy.
| | - M Sartini
- Department of Health Sciences, University of Genova, Genova, Italy; Operating Unit Hospital Hygiene, Galliera Hospital, Genoa, Italy.
| | - B Tuvo
- Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - M Scarpaci
- Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - M Barchitta
- Department of Medical, Surgical and Advanced Technology Sciences "G.F. Ingrassia", University of Catania, Catania, Italy
| | - A Pan
- Operating Unit of Infectious Diseases, ASST Cremona, Cremona, Italy
| | - A Agodi
- Department of Medical, Surgical and Advanced Technology Sciences "G.F. Ingrassia", University of Catania, Catania, Italy
| | - M L Cristina
- Department of Health Sciences, University of Genova, Genova, Italy; Operating Unit Hospital Hygiene, Galliera Hospital, Genoa, Italy
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Tuvo B, Cristina ML, Spagnolo AM, Totaro M, Baggiani A, Privitera G, Casini B. Microbiological surveillance in reducing potential infection risk. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Failure in reprocessing of endoscopes has been reported as one of the top ten most important threats to patient health.
Materials/Methods
The study was conducted in two digestive endoscopy centres of a teaching hospital (29,000 endoscopies/year, of which 550 endoscopic retrograde cholangiopancreatography (ERCP). Following two cases of bacteremia due to KPC-producing Klebsiella pneumoniae temporally related to ERCP and 89% of non-compliance detected on endoscopes subjected to microbiological surveillance, the reprocessing activities were audited and implemented to ensure guideline compliance. Clinical and microbiological surveillance were reinforced and all responsibilities for each phase identified according to UNI/TR11662. Microbiological surveillance was performed according to the 'Duodenoscope Surveillance Sampling and Culturing Protocols' protocol, CDC, 2018.
Results
In the 11 months of surveillance, 47 endoscopes were sampled (13 colonoscopes, 9 gastroscopes, 23 duodenoscopes and 2 echoendoscopes), 19 washer-disinfector machines and 9 medical cabinets. 36% (17/47) of endoscope internal channels resulted non-compliant, 17% (4/23) in duodenoscopes. NDM-producing K. pneumoniae was isolated in 2 gastroscopes always associated with the use on a colonized patient. The inlet and final rinsing water of washer-disinfectors and medical cabinets resulted always conformed. Non-conformities were managed immediately in order to avoid infectious risks for patients.
Conclusions
Microbiological surveillance of endoscopes after reprocessing allowed to prevent infections in patients undergoing endoscopic procedures.
Key messages
Training of health workers followed by strict adherence to guidelines is the most appropriate tool in preventing and controlling infections related to the use of endoscopes. Endoscopy and reprocessing staff should follow a formal recognized endoscopy reprocessing training program, followed by regular practice and periodically updated training to maintain competency.
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Affiliation(s)
- B Tuvo
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - M L Cristina
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - A M Spagnolo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M Totaro
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - A Baggiani
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - G Privitera
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - B Casini
- Department of Translational Research, University of Pisa, Pisa, Italy
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Cristina ML, Valeriani F, Casini B, Agodi A, D'Errico MM, Gianfranceschi G, Laganà P, Liguori G, Liguori R, Mucci N, Mura I, Pasquarella C, Piana A, Sotgiu G, Privitera G, Protano C, Quattrocchi A, Ripabelli G, Rossini A, Scaramucci E, Spagnolo AM, Tamburro M, Tardivo S, Veronesi L, Vitali M, Romano Spica V. Procedures in endoscope reprocessing and monitoring: an Italian survey. Ann Ig 2018; 30:45-63. [PMID: 30374511 DOI: 10.7416/ai.2018.2250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND The high diffusion of endoscopes worldwide and the need for effective reprocessing methods requested the development of guidelines and implementation of surveillance procedures at local level. STUDY DESIGN In order to collect data on everyday's practice and adherence to available guidelines, endoscopy units from different public institutions were surveyed using a dedicated questionnaire. METHODS Between July and November 2015 a survey was carried in 12 main hospitals from 10 different Italian regions, involving 22 endoscopy units. The state of the art of national and international guidelines was investigated to compare the protocols adopted at local level. RESULTS In all the surveyed hospitals, the reprocessing activity is based on pre-established protocols in adherence with principal guidelines. Enzymatic detergents, which are recommended by the international guidelines, are used in 55.6% of units and peracetic acid is currently the most widely used chemical disinfectant. Discrepancies were observed in the application of periodic quality controls. CONCLUSION Updated guidelines are generally applied in reprocessing practice. Quality controls may represent a critical issue to improve effectiveness and surveillance. The whole of acquired data can promote a positive trend towards the application of best practices.
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Affiliation(s)
- M L Cristina
- Department of Health Sciences, University of Genoa - UOS Igiene Ospedaliera E.O. Ospedali Galliera, Genoa, Italy
| | - F Valeriani
- Unit of Public Health, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - B Casini
- Department of Translational Research and New Technologies in Medicine and Surgery, Pisa University, Pisa, Italy
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - M M D'Errico
- Department of Biomedical Sciences and Public Health, Politechnic University of Marche, Ancona, Italy
| | - G Gianfranceschi
- Unit of Public Health, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - P Laganà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - G Liguori
- Department of Movement and Health Sciences, University "Parthenope," Napoli, Italy
| | - R Liguori
- Department of Science and Technology, University "Parthenope," Napoli, Italy
| | - N Mucci
- Department of Technological Innovations and Safety of Plants, Products and Anthropic Settlements, National Institute for Insurance against Accidents at Work, INAIL, Rome, Italy
| | - I Mura
- Department of Biomedical Science-Hygiene Section, University of Sassari, Sassari, Italy
| | - C Pasquarella
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - A Piana
- Department of Biomedical Science-Hygiene Section, University of Sassari, Sassari, Italy
| | - G Sotgiu
- Department of Biomedical Science-Hygiene Section, University of Sassari, Sassari, Italy
| | - G Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, Pisa University, Pisa, Italy
| | - C Protano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - A Quattrocchi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - G Ripabelli
- Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
| | - A Rossini
- Fondazione Santa Lucia Institute for Research and Health Care, IRCCS, Rome, Italy
| | | | - A M Spagnolo
- Department of Health Sciences, University of Genoa - UOS Igiene Ospedaliera E.O. Ospedali Galliera, Genoa, Italy
| | - M Tamburro
- Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - L Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - M Vitali
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - V Romano Spica
- Unit of Public Health, Department of Movement, Human and Health Sciences, University of Rome 'Foro Italico', Rome, Italy
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Spagnolo AM, Sartini M, Battistella A, Casini B, Lo Pinto G, Schinca E, Cristina ML. A Clostridium difficile outbreak in an Italian hospital: the efficacy of the multi-disciplinary and multifaceted approach. J Prev Med Hyg 2018; 59:E132-E138. [PMID: 30083620 PMCID: PMC6069399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 05/30/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION We described an outbreak of C. difficile that occurred in the Internal Medicine department of an Italian hospital and assessed the efficacy of the measures adopted to manage the outbreak. METHODS The outbreak involved 15 patients and was identified by means of continuous integrated microbiological surveillance, starting with laboratory data (alert organism surveillance). Diarrheal fecal samples from patients with suspected infection by C. difficile underwent rapid membrane immuno-enzymatic testing, which detects both the presence of the glutamate dehydrogenase antigen and the presence of the A and B toxins. Extensive microbiological sampling was carried out both before and after sanitation of the environment, in order to assess the efficacy of the sanitation procedure. RESULTS The outbreak lasted one and a half month, during which time the Committee for the Prevention of Hospital Infections ordered the implementation of multiple interventions, which enabled the outbreak to be controlled and the occurrence of new cases to be progressively prevented. The strategies adopted mainly involved patient isolation, reinforcement of proper hand hygiene techniques, antimicrobial stewardship and environmental decontamination by means of chlorine-based products. Moreover, the multifaceted management of the outbreak involved numerous sessions of instruction/training for nursing staff and socio-sanitary operatives during the outbreak. Sampling of environmental surfaces enabled two sites contaminated by C. difficile to be identified. CONCLUSIONS Joint planning of multiple infection control practices, together with effective communication and collaboration between the Hospital Infections Committee and the ward involved proved to be successful in controlling the outbreak.
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Affiliation(s)
- A. M. Spagnolo
- UO SSD Hospital Hygiene, Galliera Hospital, Genoa, Italy
- Department of Health Sciences, University of Genoa, Italy
| | - M. Sartini
- UO SSD Hospital Hygiene, Galliera Hospital, Genoa, Italy
- Department of Health Sciences, University of Genoa, Italy
| | | | - B. Casini
- Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Italy
| | | | - E. Schinca
- UO SSD Hospital Hygiene, Galliera Hospital, Genoa, Italy
- Department of Health Sciences, University of Genoa, Italy
| | - M. L. Cristina
- UO SSD Hospital Hygiene, Galliera Hospital, Genoa, Italy
- Department of Health Sciences, University of Genoa, Italy
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Spagnolo AM, Orlando P, Panatto D, Amicizia D, Perdelli F, Cristina ML. Staphylococcus aureus with reduced susceptibility to vancomycin in healthcare settings. J Prev Med Hyg 2014. [PMID: 26137787 DOI: 10.15167/2421-4248/jpmh2014.55.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Glycopeptide resistance in Staphylococcus aureus is a source of great concern because, especially in hospitals, this class of antibiotics, particularly vancomycin, is one of the main resources for combating infections caused by methicillin-resistant Staphylococcus aureus strains (MRSA). Reduced susceptibility to vancomycin (VISA) was first described in 1996 in Japan; since then, a phenotype with heterogeneous resistance to vancomycin (h-VISA) has emerged. H-VISA isolates are characterised by the presence of a resistant subpopulation, typically at a rate of 1 in 10(5) organisms, which constitutes the intermediate stage betweenfully vancomycin-susceptible S. aureus (VSSA) and VISA isolates. As VISA phenotypes are almost uniformly cross-resistant to teicoplanin, they are also called Glycopeptides-intermediate Staphylococcus aureus strains (GISA) and, in the case of heterogeneous resistance to glycopeptides, h-GISA. The overall prevalence of h-VISA is low, accounting for approximately 1.3% of all MRSA isolates tested. Mortality due to h-GISA infections is very high (about 70%), especially among patients hospitalised in high-risk departments, such as intensive care units (ICU). Given the great clinical relevance of strains that are heteroresistant to glycopeptides and the possible negative impact on treatment choices, it is important to draw up and implement infection control practices, including surveillance, the appropriate use of isolation precautions, staff training, hand hygiene, environmental cleansing and good antibiotic stewardship.
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Spagnolo AM, Ottria G, Amicizia D, Perdelli F, Cristina ML. Operating theatre quality and prevention of surgical site infections. J Prev Med Hyg 2013; 54:131-7. [PMID: 24783890 PMCID: PMC4718372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Surgical site infections (SSI) account for 14% to 17% of all hospital-acquired infections and 38% of nosocomial infections in surgical patients. SSI remain a substantial cause of morbidity and death, possibly because of the larger numbers of elderly surgical patients or those with a variety of chronic and immunocompromising conditions, and emergence of antibiotic-resistant microorganisms. Factors causing surgical site infection are multifarious. Several studies have identified the main patient-related (endogenous risk factors) and procedure-related (external risk factors) factors that influence the risk of SSI. The rate of surgical wound infections is strongly influenced by operating theatre quality, too. A safe and salubrious operating theatre is an environment in which all sources of pollution and any micro-environmental alterations are kept strictly under control. This can be achieved only through careful planning, maintenance and periodic checks, as well as proper ongoing training for staff Many international scientific societies have produced guidelines regarding the environmental features of operating theatres (positive pressure, exchanges of filtered air per hour, air-conditioning systems with HEPA filters, etc.) and issued recommendations on healthcare-associated infection, including SSI, concerning surveillance methods, intervention to actively prevent SSI and approaches to monitoring the implementation of such strategies. Therefore, the prevention of SSI requires a multidisciplinary approach and the commitment of all concerned, including that of those who are responsible for the design, layout and functioning of operating theatres.
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Ottria G, Dallera M, Aresu O, Manniello MA, Parodi B, Spagnolo AM, Cristina ML. Environmental monitoring programme in the cell therapy facility of a research centre: preliminary investigation. J Prev Med Hyg 2010; 51:133-138. [PMID: 21553557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Recent discoveries in cell therapy research present new opportunities for cellular products to be used to treat severe, and as yet incurable, diseases. It is therefore essential to implement a quality control programme in order to ensure that safe cells and tissues are provided. METHODS In a preliminary phase of the setting up of a the cellfactory, monitoring was carried out monthly over a 6-month period in one out of three cell therapy laboratories and filter rooms in order to evaluate the microbial contamination of air and surfaces and the presence of airborne particulates. RESULTS The mean total bacterial and fungal loads measured in the air in the centre of the filter room were 20.7 +/1 28.9 colony-forming units (cfu)/m3 and 9.2 +/- 15.4 cfu/m3, respectively, and 5.2 +/- 4.1 cfu/m3 and 6.8 +/- 13.4 cfu/m3, respectively, in the laboratory. The mean fungal load values recorded on the surfaces sampled in the laboratory were in 6 out of 18 cases higher than the reference values (5 cfu/plate). As to the results of particulate monitoring, with regard to the 0.5 microm particles, about 83% of the samples revealed values below the limit of 350.000 particles per cubic metre. CONCLUSIONS In this set-up phase, monitoring was able to pick out structural and organisational flaws acceptable in a laboratory compliant with Good Manufacturing Practices class C (Annex 1), but not in a class B facility. Thanks to this preliminary monitoring phase, and by correcting these flaws, the clean room facility could achieve compliance to class B.
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Affiliation(s)
- G Ottria
- Department of Health Sciences, University of Genoa, Italy
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Sartini M, Cristina ML, Spagnolo AM, Cremonesi P, Costaguta C, Monacelli F, Garau J, Odetti P. The epidemiology of domestic injurious falls in a community dwelling elderly population: an outgrowing economic burden. Eur J Public Health 2009; 20:604-6. [DOI: 10.1093/eurpub/ckp165] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cristina ML, Spagnolo AM, Sartini M, Dallera M, Ottria G, Perdelli F, Orlando P. Investigation of organizational and hygiene features in dentistry: a pilot study. J Prev Med Hyg 2009; 50:175-180. [PMID: 20411652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION In dentistry, as in surgery, there is a risk of cross-infection for both patients and staff The aim of this research was to evaluate procedures and behaviors enacted by dental staff which might engender a risk for themselves and their patients. METHODS A questionnaire was administered to 106 dental workers in Genoa (Italy), both public and private. Whenever personal interviews were conducted, the facilities involved were also inspected and the activities of the dental staff were observed directly. RESULTS This research highlighted some critical points in both structural and organizational features and in the management of infective hazards in the sample considered. In some cases, inadequacies were noted with regard to the prevention of cross-infections, such as the lack of disinfection of work surfaces and the handles of chair-set accessories. DISCUSSION AND CONCLUSIONS The particular nature of dental work, in which aerosols of blood and saliva may be produced by rotating instruments, engenders a risk of infection. Application of the various preventive measures available can significantly reduce microbial contamination and the risk of occupational infection and cross-infections. Furthermore, improvement in the structural and organizational features of dental surgeries and the continuing education of health-care workers is indispensable to the control and prevention of infectious diseases.
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Affiliation(s)
- M L Cristina
- Department of Health Sciences, University of Genoa, Italy.
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Cristina ML, Sartini M, Spagnolo AM. Health care-acquired aspergillosis and air conditioning systems. J Prev Med Hyg 2009; 50:3-8. [PMID: 19771754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- M L Cristina
- Department of Health Sciences, University of Genoa, Italy.
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Sartini M, Ottria G, Dallera M, Spagnolo AM, Cristina ML. Nitrous oxide pollution in operating theatres in relation to the type of leakage and the number of efficacious air exchanges per hour. J Prev Med Hyg 2006; 47:155-9. [PMID: 17263163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
INTRODUCTION As occupational exposure to anaesthetic gases is one of the main risks for operating theatre staff an environmental monitoring campaign was conducted in order to evaluate the degree of pollution by nitrous oxide (N2O) in the operating theatres of some hospital facilities in Liguria. METHODS Any leaks (systemic and/or managerial) of anaesthetic gas and the number of efficacious air exchanges per hour supplied by air-conditioning systems were evaluated by means of an IR spectrometer, which was wired to a computer for data collection and analysis. The concentration of nitrous oxide in the centre of each operating theatre was measured by means of chemo-adsorbent cartridges analysed by gas chromatography. RESULTS In 76.0% of the operating theatres examined a mean environmental concentration of N2O below the legal limits was recorded. The highest mean concentrations were generally associated with the presence of systemic leaks. Supplying an adequate number of efficacious air exchanges per hour enabled environmental concentrations of anaesthetic gas to be kept within acceptable levels. DISCUSSION AND CONCLUSIONS Training personnel in the correct management of the operating theatre and of anaesthesia equipment, and ensuring the availability of an adequate air-conditioning system enable the risk of exposure to nitrous oxide to be minimised. This can be achieved through a concerted effort on the part of all involved, in accordance with the concept of ongoing improvement in healthcare services.
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Affiliation(s)
- M Sartini
- Department of Health Sciences, University of Genoa, Italy
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Perdelli F, Spagnolo AM, Cristina ML, Sartini M, Dallera M, Ottria G, Orlando P. [Occupational exposure to formaldehyde in three pathology departments]. Ann Ig 2006; 18:481-90. [PMID: 17228606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Although formaldehyde has recently been classified by the IARC as "carcinogenic in humans" (class 1), it is still widely used in pathology departments for the fixing and conservation of biological tissues. Its use therefore raises the question of occupational exposure. The present paper reports the results of an environmental monitoring campaign to evaluate pollution by formaldehyde in various areas of three pathology departments. Chemi-adsorbent cartridges able to adsorb airborne formaldehyde were used to detect the substance. Quantitative determination of the formaldehyde was carried out by means of liquid chromatography (HPLC). The concentrations of airborne formaldehyde in the areas monitored were fairly modest, being below the limits of indoor concentration proposed by the OSHA. In one of the three departments, however these limits were exceeded in 40% of the samples taken in the room used for the storage of containers. As yet, in spite of the recent class 1 classification by the IARC, no provisions have been made to ban the use of formaldehyde. It is therefore essential to draw up environmental monitoring programmes in order to evaluate occupational exposure and to assess the efficacy of any preventive measures adopted.
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Affiliation(s)
- F Perdelli
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
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Perdelli F, Cristina ML, Sartini M, Spagnolo AM, Dallera M, Ottria G, Lombardi R, Grimaldi M, Orlando P. Fungal contamination in hospital environments. Infect Control Hosp Epidemiol 2006; 27:44-7. [PMID: 16418986 DOI: 10.1086/499149] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2003] [Accepted: 02/22/2005] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To assess the degree of fungal contamination in hospital environments and to evaluate the ability of air conditioning systems to reduce such contamination. METHODS We monitored airborne microbial concentrations in various environments in 10 hospitals equipped with air conditioning. Sampling was performed with a portable Surface Air System impactor with replicate organism detection and counting plates containing a fungus-selective medium. The total fungal concentration was determined 72-120 hours after sampling. The genera most involved in infection were identified by macroscopic and microscopic observation. RESULTS The mean concentration of airborne fungi in the set of environments examined was 19 +/- 19 colony-forming units (cfu) per cubic meter. Analysis of the fungal concentration in the different types of environments revealed different levels of contamination: the lowest mean values (12 +/- 14 cfu/m(3)) were recorded in operating theaters, and the highest (45 +/- 37 cfu/m(3)) were recorded in kitchens. Analyses revealed statistically significant differences between median values for the various environments. The fungal genus most commonly encountered was Penicillium, which, in kitchens, displayed the highest mean airborne concentration (8 +/- 2.4 cfu/m(3)). The percentage (35%) of Aspergillus documented in the wards was higher than that in any of the other environments monitored. CONCLUSIONS The fungal concentrations recorded in the present study are comparable to those recorded in other studies conducted in hospital environments and are considerably lower than those seen in other indoor environments that are not air conditioned. These findings demonstrate the effectiveness of air-handling systems in reducing fungal contamination.
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Affiliation(s)
- F Perdelli
- Department of Health Sciences, University of Genoa, Genova, Italy.
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