úNo touch..Ñ methods for health care room disinfection: Focus on clinical trials

Effectiveness of ceiling-mounted ultraviolet-C lamps: An experimental study in a biocontainment unit of a tertiary care hospital

BACKGROUND

We aimed to evaluate the performance of ceiling-mounted UV-C lamps.

METHODS

This study was conducted in an empty room with UV-C lamps in the biocontainment unit of a tertiary care hospital in South Korea. Each pathogen (Staphylococcus aureus, Escherichia coli, Candida krusei, Bacillus cereus, and Mycobacterium peregrinum) was inoculated on blood agar plates and placed in 20 selected places from the UV-C lamp, and irradiation was applied for 15 min. As a control group, the bacterial solution was diluted 10,000 times and UV was not applied.

RESULTS

A mean ± SD of 5.95 ± 0.91 log reduction was observed with UV irradiation compared with the control. The log reduction was greatest for S. aureus [median, 7.05 (IQR, 6.49-7.26)] and least for M. peregrinum [median, 4.88 (IQR, 4.58-5.24)]. The degree of log reduction was inversely proportional to the square of the distance from the UV-C lamp (R2 = -0.12, P < .001).

CONCLUSIONS

In this study, ceiling-mounted UV-C demonstrated effective disinfection of at least 4-log reduction of the test organisms within a 4-m distance. Mounted UV-C lighting is a considerable option for improving surface disinfection.

Revealing Commercial Epoxy Resins' Antimicrobial Activity: A Combined Chemical-Physical, Mechanical, and Biological Study

In our continuing search for new polymer composites with antimicrobial activity, we observed that even unmodified epoxy resins exhibit significant activity. Considering their widespread use as starting materials for the realization of multifunctional nanocomposites with excellent chemical and mechanical properties, it was deemed relevant to uncover these unexpected properties that can lead to novel applications. In fact, in places where the contact with human activities makes working surfaces susceptible to microbial contamination, thus jeopardizing the sterility of the environment, their biological activity opens the way to their successful application in minimizing healthcare-associated infections. To this end, three commercial and widely used epoxy resins (DGEBA/Elan-TechW 152LR, 1; EPIKOTETM Resin MGS®/EPIKURETM RIM H 235, 2 and MC152/EW101, 3) have been investigated to determine their antibacterial and antiviral activity. After 24 h, according to ISO 22196:2011, resins 1 and 2 showed a high antibacterial efficacy (R value > 6.0 log reduction) against Staphylococcus aureus and Escherichia coli. Resin 2, prepared according to the ratio epoxy/hardener indicated by the supplier (sample 2a) and with 10% w/w hardener excess (sample 2b), exhibited an intriguing virucidal activity against Herpes Simplex Virus type-1 and Human Coronavirus type V-OC43 as a surrogate of SARS-CoV-2.

[Multi-resistant pathogens - are they also resistant to disinfectants?]

Epidemiological studies show that the care of patients in rooms with a previous stay by a person with evidence of multi-resistant pathogens (MRP) is associated with an increased risk of these pathogens occurring. The question therefore regularly arises as to whether MRP also exhibit resistance to the disinfectants used. To date, there are no standardised definitions for "resistance" to disinfectants. However, disinfectants authorised on the market are also effective against multi-resistant pathogens and the failure of efficient disinfection is mainly caused by application errors (insufficient cleaning, incomplete wetting, incorrect application concentration or exposure time etc.). The effectiveness of disinfectants depends on a variety of environmental factors (especially accompanying contamination). A reduced sensitivity to disinfectants can occur in individual isolates due to selection under sub-inhibitory concentrations of disinfectants. Resistance mechanisms to antibiotics do not mediate cross-resistance to disinfectants, but a change in the permeability of bacterial cells can influence sensitivity to disinfectants and antibiotics. In general, the success of routine disinfection can be improved by suitable process controls and contribute to reducing the transmission of MRP.

Laser-induced 2D/0D graphene-nanoceria freestanding paper-based films for on-site hydrogen peroxide monitoring in no-touch disinfection treatments

A one-shot CO2 laser-based strategy to generate conductive reduced graphene oxide (rGO) decorated with nanoceria (nCe) is proposed. The 2D/0D rGO-nCe films, integrated as catalytic sensing layers in paper-based sensors, were employed for on-site monitoring of indoor fogging treatments against Listeria monocytogenes (Lm), a ubiquitous pathogenic bacterium. The rGO-nCe laser-assisted synthesis was optimized to preserve the rGO film morphological and electron-transfer features and simultaneously integrate catalytic nCe. The films were characterized by microscopical (SEM), spectroscopical (EDX, Raman, and FTIR), and electrochemical techniques. The most performing film was integrated into a nitrocellulose substrate, and the complete sensor was assembled via a combination of xurography and stencil printing. The rGO-nCe sensor's catalytic activity was proved toward the detection of H2O2, obtaining sensitive determination (LOD = 0.3 µM) and an extended linear range (0.5-1500 µM). Eventually, the rGO-nCe sensor was challenged for the real-time continuous monitoring of hydrogen peroxide aerosol during no-touch fogging treatment conducted following the EU's recommendation for biocidal product use. Treatment effectiveness was proved toward three Lm strains characterized by different origins, i.e., type strain ATCC 7644, clinical strain 338, and food strain 641/6II. The sensor allows for discrimination and quantification treatments at different environmental biocidal amounts and fogging times, and correlates with the microbiological inhibition, promoting the proposed sensor as a useful tool to modulate and monitor no-touch treatments.

Understanding the significance of microbiota recovered from health care surfaces

BACKGROUND

Microbial contamination of hospital surfaces remains despite adherence to routine disinfection. Our study demonstrates bioburden from various types of hospital high-touch surfaces and the pathogenicity of all bacteria recovered.

METHODS

Several high-touch hospital surfaces from a single medical-surgical unit were sampled and cultured using replicate organism detection and counting (RODAC) Tryptic Soy agar plates. Colonies were then subcultured to blood agar plates and speciated using MALDI-TOF. The local microbiology laboratory database was queried for any clinical isolate match with the environmental samples recovered.

RESULTS

Manikins, bed rails, and workstations-on-wheels were the most contaminated surfaces with the largest variety of bacteria isolated from manikins and bed rails. A total of 60 different types of pathogens were isolated, 18 of which were well-known pathogens, and 7 were classified as important in the health care setting by CDC. Our clinical microbiology laboratory identified 29 of 60 hospital surface bacteria in clinical isolates. Urine, soft tissue, and blood were the most common sources of clinical isolates.

CONCLUSIONS

Surfaces in the health care environment harbor both well-known and not-so-well-known human pathogens. Several not-so-well-known pathogens are skin flora or environmental bacteria, which in the right setting, can become pathogenic and cause diseases including meningitis, brain abscess, endocarditis, and bacteremia.