1
|
Bloch N, Männer J, Gardiol C, Kohler P, Kuhn J, Münzer T, Schlegel M, Kuster SP, Flury D. Effective infection prevention and control measures in long-term care facilities in non-outbreak and outbreak settings: a systematic literature review. Antimicrob Resist Infect Control 2023; 12:113. [PMID: 37853477 PMCID: PMC10585745 DOI: 10.1186/s13756-023-01318-9] [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: 04/13/2023] [Accepted: 10/05/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Healthcare-associated infections in long-term care are associated with substantial morbidity and mortality. While infection prevention and control (IPC) guidelines are well-defined in the acute care setting, evidence of effectiveness for long-term care facilities (LTCF) is missing. We therefore performed a systematic literature review to examine the effect of IPC measures in the long-term care setting. METHODS We systematically searched PubMed and Cochrane libraries for articles evaluating the effect of IPC measures in the LTCF setting since 2017, as earlier reviews on this topic covered the timeframe up to this date. Cross-referenced studies from identified articles and from mentioned earlier reviews were also evaluated. We included randomized-controlled trials, quasi-experimental, observational studies, and outbreak reports. The included studies were analyzed regarding study design, type of intervention, description of intervention, outcomes and quality. We distinguished between non-outbreak and outbreak settings. RESULTS We included 74 studies, 34 (46%) in the non-outbreak setting and 40 (54%) in the outbreak setting. The most commonly studied interventions in the non-outbreak setting included the effect of hand hygiene (N = 10), oral hygiene (N = 6), antimicrobial stewardship (N = 4), vaccination of residents (N = 3), education (N = 2) as well as IPC bundles (N = 7). All but one study assessing hand hygiene interventions reported a reduction of infection rates. Further successful interventions were oral hygiene (N = 6) and vaccination of residents (N = 3). In outbreak settings, studies mostly focused on the effects of IPC bundles (N = 24) or mass testing (N = 11). In most of the studies evaluating an IPC bundle, containment of the outbreak was reported. Overall, only four articles (5.4%) were rated as high quality. CONCLUSION In the non-outbreak setting in LTCF, especially hand hygiene and oral hygiene have a beneficial effect on infection rates. In contrast, IPC bundles, as well as mass testing seem to be promising in an outbreak setting.
Collapse
Affiliation(s)
- Nando Bloch
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St.Gallen, St.Gallen, Switzerland.
| | - Jasmin Männer
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St.Gallen, St.Gallen, Switzerland
| | | | - Philipp Kohler
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St.Gallen, St.Gallen, Switzerland
| | - Jacqueline Kuhn
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St.Gallen, St.Gallen, Switzerland
| | - Thomas Münzer
- Geriatrische Klinik St.Gallen, St.Gallen, Switzerland
| | - Matthias Schlegel
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St.Gallen, St.Gallen, Switzerland
| | - Stefan P Kuster
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St.Gallen, St.Gallen, Switzerland
| | - Domenica Flury
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St.Gallen, St.Gallen, Switzerland
| |
Collapse
|
2
|
Antiviral Peptides in Antimicrobial Surface Coatings—From Current Techniques to Potential Applications. Viruses 2023; 15:v15030640. [PMID: 36992349 PMCID: PMC10051592 DOI: 10.3390/v15030640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 03/06/2023] Open
Abstract
The transmission of pathogens through contact with contaminated surfaces is an important route for the spread of infections. The recent outbreak of COVID-19 highlights the necessity to attenuate surface-mediated transmission. Currently, the disinfection and sanitization of surfaces are commonly performed in this regard. However, there are some disadvantages associated with these practices, including the development of antibiotic resistance, viral mutation, etc.; hence, a better strategy is necessary. In recent years, peptides have been studied to be utilized as a potential alternative. They are part of the host immune defense and have many potential in vivo applications in drug delivery, diagnostics, immunomodulation, etc. Additionally, the ability of peptides to interact with different molecules and membrane surfaces of microorganisms has made it possible to exploit them in ex vivo applications such as antimicrobial (antibacterial and antiviral) coatings. Although antibacterial peptide coatings have been studied extensively and proven to be effective, antiviral coatings are a more recent development. Therefore, this study aims to highlight antiviral coating strategies and the current practices and application of antiviral coating materials in personal protective equipment, healthcare devices, and textiles and surfaces in public settings. Here, we have presented a review on potential techniques to incorporate peptides in current surface coating strategies that will serve as a guide for developing cost-effective, sustainable and coherent antiviral surface coatings. We further our discussion to highlight some challenges of using peptides as a surface coating material and to examine future perspectives.
Collapse
|
3
|
Abney SE, Wilson AM, Ijaz MK, McKinney J, Reynolds KA, Gerba CP. Minding the matrix: The importance of inoculum suspensions on finger transfer efficiency of virus. J Appl Microbiol 2022; 133:3083-3093. [PMID: 35916494 DOI: 10.1111/jam.15758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 01/07/2023]
Abstract
AIMS The aim of this study was to determine how the transfer efficiency of MS-2 coliphage from the toilet seat to hands and fingertip to lip differs according to the suspension of the inoculum. METHODS AND RESULTS Hands were sampled after lifting a toilet seat which was inoculated with MS-2 on the underneath side. MS-2 was suspended in a spectrum of proteinaceous and non-proteinaceous solutions. Transfer efficiencies were greatest with the ASTM tripartite soil load (3.02% ± 4.03) and lowest with phosphate-buffered saline (PBS) (1.10% ± 0.81) for hand-to-toilet seat contacts. Finger-to-lip transfer rates were significantly different (p < 0.05) depending on suspension matrix, with PBS yielding the highest transfer (52.53% ± 4.48%) and tryptose soy broth (TSB) the lowest (23.15% ± 24.27%). Quantitative microbial risk assessment was used to estimate the probability of infection from adenovirus and norovirus from finger contact with a toilet seat. CONCLUSIONS The greatest transfer as well as the largest variation of transfer were measured for finger-to-lip contacts as opposed to toilet seat-to-finger contacts. These factors influence the estimation of the probability of infection from micro-activity, that is, toilet seat adjustment. SIGNIFICANCE AND IMPACT Viruses may be transferred from various human excreta with differing transfer efficiencies, depending on the protein content.
Collapse
Affiliation(s)
- Sarah E Abney
- Department of Environmental Science, University of Arizona, Tucson, Arizona, USA
| | - Amanda M Wilson
- Department of Community, Environment, and Policy, University of Arizona, Tucson, Arizona, USA
| | - M Khalid Ijaz
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, New Jersey, USA.,Department of Biology, Medgar Evers College of the City University of New York (CUNY), Brooklyn, New York, USA
| | - Julie McKinney
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, New Jersey, USA
| | - Kelly A Reynolds
- Department of Environmental Science, University of Arizona, Tucson, Arizona, USA.,Department of Community, Environment, and Policy, University of Arizona, Tucson, Arizona, USA
| | - Charles P Gerba
- Department of Environmental Science, University of Arizona, Tucson, Arizona, USA
| |
Collapse
|
4
|
Ikner LA, Torrey JR, Gundy PM, Gerba CP. Efficacy of an antimicrobial surface coating against human coronavirus 229E and SARS-CoV-2. Am J Infect Control 2021; 49:1569-1571. [PMID: 34499978 PMCID: PMC8420084 DOI: 10.1016/j.ajic.2021.08.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/26/2022]
Abstract
The COVID-19 pandemic has accelerated the demand for alternatives to standard cleaning and disinfection practices. Antiviral coatingsmay provide an alternative to common surface treatments. A newly developed quaternary ammonium polymer coating was applied to stainless steel coupons and evaluated for efficacy against human coronavirus 229E and SARS-CoV-2. The polymer coating reduced levels of both test viruses by greater than 99.9% relative to non-coated stainless steel coupons during a 2-hour contact time.
Collapse
|
5
|
Assessment of antibiotic-resistant organism transmission among rooms of hospitalized patients, healthcare personnel, and the hospital environment utilizing surrogate markers and selective bacterial cultures. Infect Control Hosp Epidemiol 2020; 41:539-546. [PMID: 31969206 DOI: 10.1017/ice.2019.376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To assess potential transmission of antibiotic-resistant organisms (AROs) using surrogate markers and bacterial cultures. DESIGN Pilot study. SETTING A 1,260-bed tertiary-care academic medical center. PARTICIPANTS The study included 25 patients (17 of whom were on contact precautions for AROs) and 77 healthcare personnel (HCP). METHODS Fluorescent powder (FP) and MS2 bacteriophage were applied in patient rooms. HCP visits to each room were observed for 2-4 hours; hand hygiene (HH) compliance was recorded. Surfaces inside and outside the room and HCP skin and clothing were assessed for fluorescence, and swabs were collected for MS2 detection by polymerase chain reaction (PCR) and selective bacterial cultures. RESULTS Transfer of FP was observed for 20 rooms (80%) and 26 HCP (34%). Transfer of MS2 was detected for 10 rooms (40%) and 15 HCP (19%). Bacterial cultures were positive for 1 room and 8 HCP (10%). Interactions with patients on contact precautions resulted in fewer FP detections than interactions with patients not on precautions (P < .001); MS2 detections did not differ by patient isolation status. Fluorescent powder detections did not differ by HCP type, but MS2 was recovered more frequently from physicians than from nurses (P = .03). Overall, HH compliance was better among HCP caring for patients on contact precautions than among HCP caring for patients not on precautions (P = .003), among nurses than among other nonphysician HCP at room entry (P = .002), and among nurses than among physicians at room exit (P = .03). Moreover, HCP who performed HH prior to assessment had fewer fluorescence detections (P = .008). CONCLUSIONS Contact precautions were associated with greater HCP HH compliance and reduced detection of FP and MS2.
Collapse
|
6
|
Lee MH, Lee GA, Lee SH, Park YH. Effectiveness and core components of infection prevention and control programmes in long-term care facilities: a systematic review. J Hosp Infect 2019; 102:377-393. [PMID: 30794854 DOI: 10.1016/j.jhin.2019.02.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 02/13/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Infection prevention and control (IPC) is a measure to prevent healthcare-associated infections in healthcare settings. There is limited evidence of the effectiveness of IPC programmes in long-term care facilities (LTCFs). AIM To review and analyse the effectiveness and the components of IPC programmes in LTCFs for older adults. METHODS Electronic databases (PubMed, EMBASE, CINAHL and Cochrane CENTRAL) were searched systematically for English-language articles assessing IPC interventions in LTCFs, published over the last decade (2007-2016). The components of IPC programmes were analysed based on the World Health Organization (WHO) manuals for improving IPC activities. Two reviewers independently assessed the quality of studies using the Cochrane risk-of-bias tool and the risk-of-bias assessment tool for non-randomized studies. FINDINGS Seventeen studies met the eligibility criteria; 10 studies were randomized trials (58.8%) and the others were non-randomized trials to examine the impact of IPC programmes on infection and/or performance outcomes of healthcare workers. None of the included studies implemented all of the WHO core components. Behavioural change strategies using education, monitoring and feedback were reported to be successful interventions for reducing the threat of healthcare-associated infections. Generally, studies using four or more elements of the WHO multi-modal strategy reported significant reductions in infection rates. CONCLUSIONS There is some evidence for the effectiveness of IPC interventions using education, monitoring, feedback and four or more elements of the WHO multi-modal strategy to control healthcare-associated infections in LTCFs.
Collapse
Affiliation(s)
- M H Lee
- The Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - G A Lee
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - S H Lee
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Y-H Park
- The Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul, Republic of Korea.
| |
Collapse
|
7
|
Microbial transmission in an outpatient clinic and impact of an intervention with an ethanol-based disinfectant. Am J Infect Control 2019; 47:128-132. [PMID: 30195405 PMCID: PMC7173130 DOI: 10.1016/j.ajic.2018.06.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/26/2018] [Accepted: 06/27/2018] [Indexed: 11/20/2022]
Abstract
Background Halting the spread of harmful microbes requires an understanding of their transmission via hands and fomites. Previous studies explored acute and long-term care environments but not outpatient clinics. Objectives of this study were to track microbial movement throughout an outpatient clinic and evaluate the impact of a disinfectant spray intervention targeting high-touch point surfaces. Methods At the start of the clinic day, a harmless viral tracer was placed onto 2 fomites: a patient room door handle and front desk pen. Patient care, cleaning, and hand hygiene practices continued as usual. Facility fomites (n = 19), staff hands (n = 4), and patient hands (n = 3-4) were sampled after 2, 3.5, and 6 hours. Tracer concentrations at baseline (before intervention) were evaluated 6 hours after seeding. For the intervention trials, high-touch surfaces were cleaned 4 hours after seeding with an ethanol-based disinfectant and sampled 2 hours after cleaning. Results At 2, 3.5, and 6 hours after seeding, virus was detected on all surfaces and hands sampled, with examination room door handles and nurses’ station chair arms yielding the highest concentrations. Virus concentrations decreased by 94.1% after the disinfectant spray intervention (P = .001). Conclusions Microbes spread quickly in an outpatient clinic, reaching maximum contamination levels 2 hours after inoculation, with the highest contamination on examination room door handles and nurses’ station chairs. This study emphasizes the importance of targeted disinfection of high-touch surfaces.
Collapse
|
8
|
Kurgat EK, Sexton JD, Garavito F, Reynolds A, Contreras RD, Gerba CP, Leslie RA, Edmonds-Wilson SL, Reynolds KA. Impact of a hygiene intervention on virus spread in an office building. Int J Hyg Environ Health 2019; 222:479-485. [PMID: 30655228 DOI: 10.1016/j.ijheh.2019.01.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 12/27/2018] [Accepted: 01/02/2019] [Indexed: 10/27/2022]
Abstract
Viral illnesses have a significant direct and indirect impact on the workplace that burdens employers with increased healthcare costs, low productivity, and absenteeism. Workers' direct contact with each other and contaminated surfaces contributes to the spread of viruses at work. This study quantifies the impact of an office wellness intervention (OWI) to reduce viral load in the workplace. The OWI includes the use of a spray disinfectant on high-touch surfaces and providing workers with alcohol-based hand sanitizer gel and hand sanitizing wipes along with user instructions. Viral transmission was monitored by applying an MS2 phage tracer to a door handle and the hand of a single volunteer participant. At the same time, a placebo inoculum was applied to the hands of four additional volunteers. The purpose was to evaluate the concentration of viruses on workers' hands and office surfaces before and after the OWI. Results showed that the OWI significantly reduced viable phage concentrations per surface area on participants' hands, shared fomites, and personal fomites (p = 0.0001) with an 85.4% average reduction. Reduction of virus concentrations on hands and fomites is expected to subsequently minimize the risk of infections from common enteric and respiratory pathogens. The surfaces identified as most contaminated were the refrigerator, drawer handles and sink faucets in the break room, along with pushbar on the main exit of the building, and the soap dispensers in the women's restroom. A comparison of contamination in different locations within the office showed that the break room and women's restrooms were the sites with the highest tracer counts. Results of this study can be used to inform quantitative microbial risk assessment (QMRA) models aimed at defining the relationship between surface contamination, pathogen exposure and the probability of disease that contributes to high healthcare costs, absenteeism, presenteeism, and loss of productivity in the workplace.
Collapse
Affiliation(s)
- Elkana K Kurgat
- Environment, Exposure Science and Risk Assessment Center, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - Jonathan D Sexton
- Environment, Exposure Science and Risk Assessment Center, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - Fernanda Garavito
- Environment, Exposure Science and Risk Assessment Center, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - Adriana Reynolds
- Environment, Exposure Science and Risk Assessment Center, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - R David Contreras
- Environment, Exposure Science and Risk Assessment Center, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - Charles P Gerba
- Department of Soil, Water & Environmental Science, The University of Arizona, Tucson, AZ, USA
| | - Rachel A Leslie
- Research and Development, GOJO Industries, Inc., Akron, OH, USA
| | | | - Kelly A Reynolds
- Environment, Exposure Science and Risk Assessment Center, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA.
| |
Collapse
|
9
|
Wilson AM, Reynolds KA, Sexton JD, Canales RA. Modeling Surface Disinfection Needs To Meet Microbial Risk Reduction Targets. Appl Environ Microbiol 2018; 84:e00709-18. [PMID: 29980557 PMCID: PMC6121971 DOI: 10.1128/aem.00709-18] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/29/2018] [Indexed: 11/29/2022] Open
Abstract
Nosocomial viral infections are an important cause of health care-acquired infections where fomites have a role in transmission. Using stochastic modeling to quantify the effects of surface disinfection practices on nosocomial pathogen exposures and infection risk can inform cleaning practices. The purpose of this study was to predict the effect of surface disinfection on viral infection risks and to determine needed viral reductions to achieve risk targets. Rotavirus, rhinovirus, and influenza A virus infection risks for two cases were modeled. Case 1 utilized a single fomite contact approach, while case 2 assumed 6 h of contact activities. A 94.1% viral reduction on surfaces and hands was measured following a single cleaning round using an Environmental Protection Agency (EPA)-registered disinfectant in an urgent care facility. This value was used to model the effect of a surface disinfection intervention on infection risk. Risk reductions for other surface-cleaning efficacies were also simulated. Surface reductions required to achieve risk probability targets were estimated. Under case 1 conditions, a 94.1% reduction in virus surface concentration reduced infection risks by 94.1%. Under case 2 conditions, a 94.1% reduction on surfaces resulted in median viral infection risks being reduced by 92.96 to 94.1% and an influenza A virus infection risk below one in a million. Surface concentration in the equations was highly correlated with dose and infection risk outputs. For rotavirus and rhinovirus, a >99.99% viral surface reduction would be needed to achieve a one-in-a-million risk target. This study quantifies reductions of infection risk relative to surface disinfectant use and demonstrates that risk targets for low-infectious-dose organisms may be more challenging to achieve.IMPORTANCE It is known that the use of EPA-registered surface disinfectant sprays can reduce infection risk if used according to the manufacturer's instructions. However, there are currently no standards for health care environments related to contamination levels on surfaces. The significance of this research is in quantifying needed reductions to meet various risk targets using realistic viral concentrations on surfaces for health care environments. This research informs the design of cleaning protocols by demonstrating that multiple applications may be needed to reduce risk and by highlighting a need for more models exploring the relationship among microbial contamination of surfaces, patient and health care worker behaviors, and infection risks.
Collapse
Affiliation(s)
- Amanda M Wilson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Kelly A Reynolds
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Jonathan D Sexton
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Robert A Canales
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| |
Collapse
|
10
|
Evaluation of hospital-grade disinfectants on viral deposition on surfaces after toilet flushing. Am J Infect Control 2018; 46:507-511. [PMID: 29305284 DOI: 10.1016/j.ajic.2017.11.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 11/03/2017] [Accepted: 11/03/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Past studies have shown that infectious aerosols created during toilet flushing result in surface contamination of the restroom. The goals of this study were to quantify viral contamination of surfaces in restrooms after flushing and the impact of disinfectants added to the toilet bowl prior to flushing on reducing surface contamination. METHODS The degree of contamination of surfaces in the restroom was assessed with and without the addition of coliphage MS2 to the toilet bowl before flushing. The bowl water and various surfaces in the restroom were subsequently tested for the presence of the virus. RESULTS The toilet bowl rim, toilet seat top, and toilet seat underside were contaminated in all trials without a disinfectant added to the bowl water before flushing. All disinfectants significantly reduced concentrations on surfaces when the contact time was ≥15 minutes. Hydrogen peroxide resulted in very little reduction of virus in the toilet bowl (<1 log10). Peracetic acid and quaternary ammonium had the greatest log reductions on virus in the organic matter in the toilet. CONCLUSIONS Toilet flushing resulted in extensive contamination of surfaces within the restroom. Addition of disinfectant to the toilet bowl prior to flushing reduced the level of contamination in the bowl and fomites after flushing.
Collapse
|
11
|
Sassi HP, Ikner LA, Abd-Elmaksoud S, Gerba CP, Pepper IL. Comparative survival of viruses during thermophilic and mesophilic anaerobic digestion. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 615:15-19. [PMID: 28961437 DOI: 10.1016/j.scitotenv.2017.09.205] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 09/18/2017] [Accepted: 09/19/2017] [Indexed: 04/14/2023]
Abstract
Micro-scale technology was used to obtain survival data for three animal viruses and two bacteriophages during anaerobic digestion. The data for adenoviruses, MS2 and Φ6 provide the first published reports for survival of these viruses during mesophilic anaerobic digestion. Data were also obtained for thermophilic digestion, which showed greater inactivation of viruses at the higher temperature. Data on the survival of Φ6 are of particular interest since it is a lipid-based virus which has been suggested as a surrogate for the Ebola virus. In contrast, MS2 was found to be an inappropriate surrogate for Ebola.
Collapse
Affiliation(s)
- Hannah P Sassi
- Water and Energy Sustainable Technology Center, University of Arizona, 2959 W. Calle Agua Nueva, Tucson, AZ 85745, USA
| | - Luisa A Ikner
- Water and Energy Sustainable Technology Center, University of Arizona, 2959 W. Calle Agua Nueva, Tucson, AZ 85745, USA
| | - Sherif Abd-Elmaksoud
- Environmental Virology Laboratory, Department of Water Pollution Research, National Research Centre (NRC), Cairo, Egypt
| | - Charles P Gerba
- Water and Energy Sustainable Technology Center, University of Arizona, 2959 W. Calle Agua Nueva, Tucson, AZ 85745, USA
| | - Ian L Pepper
- Water and Energy Sustainable Technology Center, University of Arizona, 2959 W. Calle Agua Nueva, Tucson, AZ 85745, USA.
| |
Collapse
|
12
|
Lacombe A, Niemira BA, Gurtler JB, Kingsley DH, Li X, Chen H. Surfactant-Enhanced Organic Acid Inactivation of Tulane Virus, a Human Norovirus Surrogate. J Food Prot 2018; 81:279-283. [PMID: 29360400 DOI: 10.4315/0362-028x.jfp-17-330] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Combination treatments of surfactants and phenolic or short-chain organic acids (SCOA) may act synergistically or additively as sanitizers to inactive foodborne viruses and prevent outbreaks. The purpose of this study was to investigate the effect of gallic acid (GA), tannic acid, p-coumaric acid, lactic acid (LA), or acetic acid (AA), in combination with sodium dodecyl sulfate (SDS), against Tulane virus (TV), a surrogate for human norovirus. An aqueous stock solution of phenolic acids or SCOA with or without SDS was prepared and diluted in a twofold dilution series to 2× the desired concentration with cell growth media (M119 plus 10% fetal bovine serum). The solution was inoculated with an equal proportion of 6 log PFU/mL TV with a treatment time of 5 min. The survival of TV was quantified using a plaque assay with LLC-MK2 cells. The minimum virucidal concentration was 0.5:0.7% (v/v) for LA-SDS at pH 3.5 (4.5-PFU/mL reduction) and 0.5:0.7% (v/v) AA-SDS at pH 4.0 (2.6-log PFU/mL reduction). GA and SDS demonstrated a minimum virucidal concentration of 12.5 mM GA-SDS at pH 7.0 (0.2:0.3% GA-SDS) with an 0.8-log PFU/mL reduction and 50 mM GA-SDS (0.8:1.4% GA-SDS at pH 7.0) increased log reduction to 1.6 log PFU/mL. The combination treatments of AA or LA with SDS at pH 7.0 did not produce significant log reduction, nor did individual treatments of tannic acid, GA, p-coumaric acid, AA, LA, or SDS. This study demonstrates that a surfactant, such as SDS, aids in the phenolic acid and SCOA toxicities against viruses. However, inactivation of TV by combination treatments is contingent upon the pH of the sanitizing solution being lower than the pKa value of the organic acid being used. This information can be used to develop sanitizing washes to disinfect food contact surfaces, thereby aiding in the prevention of foodborne outbreaks.
Collapse
Affiliation(s)
- Alison Lacombe
- 1 National College of Natural Medicine, 014 S.E. Porter Street, Portland, Oregon 97201
| | - Brendan A Niemira
- 2 Food Safety and Intervention Technologies Research Unit, U.S. Department of Agriculture, Eastern Regional Research Center, 600 East Mermaid Lane, Wyndmoor, Pennsylvania 19038 (ORCID: http://orcid.org/0000-0001-5844-7794 [J.B.G.])
| | - Joshua B Gurtler
- 2 Food Safety and Intervention Technologies Research Unit, U.S. Department of Agriculture, Eastern Regional Research Center, 600 East Mermaid Lane, Wyndmoor, Pennsylvania 19038 (ORCID: http://orcid.org/0000-0001-5844-7794 [J.B.G.])
| | - David H Kingsley
- 2 Food Safety and Intervention Technologies Research Unit, U.S. Department of Agriculture, Eastern Regional Research Center, 600 East Mermaid Lane, Wyndmoor, Pennsylvania 19038 (ORCID: http://orcid.org/0000-0001-5844-7794 [J.B.G.])
| | - Xinhui Li
- 3 Department of Microbiology, University of Wisconsin-La Crosse, 1725 State Street, La Crosse, Wisconsin 54601
| | - Haiqiang Chen
- 4 Department of Food and Animal Sciences, University of Delaware, 20 Townsend Hall, Newark, Delaware 19716, USA
| |
Collapse
|
13
|
Alhmidi H, Koganti S, Cadnum JL, Jencson AL, John A, Donskey CJ. Dissemination of a nonpathogenic viral DNA surrogate marker from high-touch surfaces in rooms of long-term care facility residents. Am J Infect Control 2017; 45:1165-1167. [PMID: 28526313 DOI: 10.1016/j.ajic.2017.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 04/05/2017] [Accepted: 04/06/2017] [Indexed: 11/28/2022]
Abstract
A nonpathogenic DNA marker inoculated onto the television remote controls in rooms of 2 ambulatory long-term care facility (LTCF) residents disseminated to the hands of the LTCF residents, to high-touch surfaces in the room and on the ward, and to shared portable equipment. These findings suggest that contaminated high-touch surfaces in rooms of ambulatory LTCF residents are a potential source for widespread dissemination of pathogens.
Collapse
Affiliation(s)
- Heba Alhmidi
- Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH
| | - Sreelatha Koganti
- Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH
| | - Jennifer L Cadnum
- Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH
| | - Annette L Jencson
- Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH
| | - Amrita John
- Department of Medicine, Division of Infectious Diseases and HIV Medicine, University Hospitals Case Medical Center, Cleveland, OH
| | - Curtis J Donskey
- Geriatric Research, Education and Clinical Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH; Case Western Reserve University School of Medicine, Cleveland, OH.
| |
Collapse
|
14
|
Kwon JH, Burnham CAD, Reske KA, Liang SY, Hink T, Wallace MA, Shupe A, Seiler S, Cass C, Fraser VJ, Dubberke ER. Assessment of Healthcare Worker Protocol Deviations and Self-Contamination During Personal Protective Equipment Donning and Doffing. Infect Control Hosp Epidemiol 2017; 38:1077-1083. [PMID: 28606192 PMCID: PMC6263164 DOI: 10.1017/ice.2017.121] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate healthcare worker (HCW) risk of self-contamination when donning and doffing personal protective equipment (PPE) using fluorescence and MS2 bacteriophage. DESIGN Prospective pilot study. SETTING Tertiary-care hospital. PARTICIPANTS A total of 36 HCWs were included in this study: 18 donned/doffed contact precaution (CP) PPE and 18 donned/doffed Ebola virus disease (EVD) PPE. INTERVENTIONS HCWs donned PPE according to standard protocols. Fluorescent liquid and MS2 bacteriophage were applied to HCWs. HCWs then doffed their PPE. After doffing, HCWs were scanned for fluorescence and swabbed for MS2. MS2 detection was performed using reverse transcriptase PCR. The donning and doffing processes were videotaped, and protocol deviations were recorded. RESULTS Overall, 27% of EVD PPE HCWs and 50% of CP PPE HCWs made ≥1 protocol deviation while donning, and 100% of EVD PPE HCWs and 67% of CP PPE HCWs made ≥1 protocol deviation while doffing (P=.02). The median number of doffing protocol deviations among EVD PPE HCWs was 4, versus 1 among CP PPE HCWs. Also, 15 EVD PPE protocol deviations were committed by doffing assistants and/or trained observers. Fluorescence was detected on 8 EVD PPE HCWs (44%) and 5 CP PPE HCWs (28%), most commonly on hands. MS2 was recovered from 2 EVD PPE HCWs (11%) and 3 CP PPE HCWs (17%). CONCLUSIONS Protocol deviations were common during both EVD and CP PPE doffing, and some deviations during EVD PPE doffing were committed by the HCW doffing assistant and/or the trained observer. Self-contamination was common. PPE donning/doffing are complex and deserve additional study. Infect Control Hosp Epidemiol 2017;38:1077-1083.
Collapse
Affiliation(s)
- Jennie H. Kwon
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Carey-Ann D. Burnham
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Kimberly A. Reske
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Stephen Y. Liang
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Tiffany Hink
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Meghan A. Wallace
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Angela Shupe
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sondra Seiler
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Candice Cass
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Victoria J. Fraser
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Erik R. Dubberke
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, USA
| | | |
Collapse
|
15
|
Alhmidi H, John A, Mana TC, Koganti S, Cadnum JL, Shelton MB, Donskey CJ. Evaluation of Viral Surrogate Markers for Study of Pathogen Dissemination During Simulations of Patient Care. Open Forum Infect Dis 2017; 4:ofx128. [PMID: 28752103 DOI: 10.1093/ofid/ofx128] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 06/16/2017] [Indexed: 11/12/2022] Open
Abstract
During patient care simulations, cauliflower mosaic virus DNA and bacteriophage MS2 performed similarly as surrogate markers of pathogen dissemination. These markers disseminated to the environment in a manner similar to Clostridium difficile spores but were more frequently detected on skin and clothing of personnel after personal protective equipment removal.
Collapse
Affiliation(s)
| | - Amrita John
- Geriatric Research, Education and Clinical Center, Louis Stokes Veterans Affairs Medical Center.,Department of Medicine, Division of Infectious Diseases and HIV Medicine, University Hospitals Case Medical Center, and
| | | | | | | | - Melissa B Shelton
- Research Service, and.,Department of Medicine, Division of Infectious Diseases and HIV Medicine, University Hospitals Case Medical Center, and
| | - Curtis J Donskey
- Geriatric Research, Education and Clinical Center, Louis Stokes Veterans Affairs Medical Center.,Case Western Reserve University School of Medicine, Cleveland, Ohio
| |
Collapse
|
16
|
Beards G. Rotavirus. WIKIJOURNAL OF MEDICINE 2017. [DOI: 10.15347/wjm/2017.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|