Healthcare-associated infection impact with bioaerosol treatment and COVID-19 mitigation measures

Control technologies to prevent aerosol-based disease transmission in animal agriculture production settings: a review of established and emerging approaches

Transmission of infectious agents via aerosols is an ever-present concern in animal agriculture production settings, as the aerosol route to disease transmission can lead to difficult-to-control and costly diseases, such as porcine respiratory and reproductive syndrome virus and influenza A virus. It is increasingly necessary to implement control technologies to mitigate aerosol-based disease transmission. Here, we review currently utilized and prospective future aerosol control technologies to collect and potentially inactivate pathogens in aerosols, with an emphasis on technologies that can be incorporated into mechanically driven (forced air) ventilation systems to prevent aerosol-based disease spread from facility to facility. Broadly, we find that control technologies can be grouped into three categories: (1) currently implemented technologies; (2) scaled technologies used in industrial and medical settings; and (3) emerging technologies. Category (1) solely consists of fibrous filter media, which have been demonstrated to reduce the spread of PRRSV between swine production facilities. We review the mechanisms by which filters function and are rated (minimum efficiency reporting values). Category (2) consists of electrostatic precipitators (ESPs), used industrially to collect aerosol particles in higher flow rate systems, and ultraviolet C (UV-C) systems, used in medical settings to inactivate pathogens. Finally, category (3) consists of a variety of technologies, including ionization-based systems, microwaves, and those generating reactive oxygen species, often with the goal of pathogen inactivation in aerosols. As such technologies are typically first tested through varied means at the laboratory scale, we additionally review control technology testing techniques at various stages of development, from laboratory studies to field demonstration, and in doing so, suggest uniform testing and report standards are needed. Testing standards should consider the cost-benefit of implementing the technologies applicable to the livestock species of interest. Finally, we examine economic models for implementing aerosol control technologies, defining the collected infectious particles per unit energy demand.

Impact of COVID-19 Pandemic on Healthcare-Associated Infections: A Systematic Review and Meta-Analysis

This study investigated how the Coronavirus Disease 2019 (COVID-19) pandemic has affected the rate of healthcare-associated infections (HAIs). PubMed, Scopus and Google Scholar were searched to identify potentially eligible studies published from December 2019 to September 2022. A random effect model was used to determine the changes in the rate of HAIs during the pandemic. Thirty-seven studies, mostly from the United States (n = 13), were included. Fifteen studies described how the pandemic affected the rate of CLABSIs and CAUTIs, and eight of them showed a significant increase in CLABSIs. The risk of CLABSIs and CDIs was 27% (pooled odds ratio [OR]: 0.73; confidence interval [CI]: 0.61-0.89; p < 0.001) and 20% (pooled OR: 1.20; CI: 1.10-1.31; p < 0.001) higher during the pandemic compared to before the COVID-19 pandemic period, respectively. However, the overall risk of HAIs was unaffected by the pandemic (pooled OR: 1.00; 95 CI: 0.80-1.24; p = 0.990). Furthermore, there were no significant changes in the risk of CAUTIs (pooled OR: 1.01; 95 CI: 0.88-1.16; p = 0.890), and SSIs (pooled OR: 1.27; CI: 0.91-1.76; p = 0.16) between the two periods. The COVID-19 pandemic had no effect on the overall risk of HAIs among hospitalized patients, but an increased risk of CLABSIs and CDI were observed during the pandemic. Therefore, more stringent infection control and prevention measures and prudent interventions to promote the rational use of antibiotics are warranted across all healthcare facilities to reduce the burden of HAIs.

Undergraduates' Negative Emotion and Academic Procrastination During COVID-19: Life Autonomy as a Mediator and Sense of School Belonging as a Moderator

Introduction

This study aims to investigate the impact of COVID-19 on undergraduate students' academic procrastination and negative emotions. It seeks to examine the relationship between negative affect and academic procrastination among university students, considering the mediating role of life autonomy and the moderating effect of a sense of school belonging.

Methods

The study sample consisted of 776 university students from the Guangxi Zhuang Autonomous Region, China. Data collection involved the use of the Negative Affect Scale, Academic Procrastination Scale, Life Autonomy Scale, and Sense of School Belonging Scale. SPSS version 26.0 and PROCESS V3.580 to conduct relationship analysis, test the mediation model (model 4) and the moderated mediating model (model 7).

Results

The findings revealed significant relationships among the variables. Negative emotions were negatively related with life autonomy and sense of school belonging, and positively related with academic procrastination. Academic procrastination showed a negative correlation with both life autonomy and sense of school belonging. Sense of school belonging exhibited a positive relationship with life autonomy. The study also identified life autonomy as a mediator in the relationship between negative emotions and academic procrastination. Additionally, the sense of school belonging moderated the initial segment of the negative emotion-life autonomy-academic procrastination pathway.

Discussion

This study contributes to a better understanding of the association between negative affect and academic procrastination. It highlights that negative emotions have a direct and indirect influence on academic procrastination through the mediating role of life autonomy. Moreover, the moderating role of sense of school belonging suggests that the relationship between negative affect and life autonomy is stronger when the sense of school belonging is weaker.

Trending prevalence of healthcare-associated infections in a tertiary hospital in China during the COVID-19 pandemic

BACKGROUND

The purpose of this study was to demonstrate both the four-year prevalence trend of healthcare-associated infections (HAIs) in a large tertiary hospital and the trend regarding the prevalence of HAIs following the outbreak of coronavirus disease 2019 (COVID-19) in order to provide evidence of hospital infection management during the COVID-19 pandemic.

METHODS

Based on the hospital's electronic nosocomial infection databases related to HAIs, we retrospectively identified the HAI cases to assess the epidemiological characteristics of HAIs from January 1, 2018, to December 31, 2021, in a large tertiary hospital in China. Similarly, the trends of HAIs after the COVID-19 outbreak and the seasonal variation of HAIs were further analyzed.

RESULTS

The HAI cases (n = 7833) were identified from the inpatients (n = 483,258) during the 4 years. The most frequently occurring underlying cause of HAIs was respiratory tract infections (44.47%), followed by bloodstream infections (11.59%), and urinary tract infections (8.69%). The annual prevalence of HAIs decreased from 2.39% in 2018 to 1.41% in 2021 (P = 0.032), with the overall prevalence of HAIs significantly decreasing since the outbreak of COVID-19 (2.20% in 2018-2019 vs. 1.44% in 2020-2021, P < 0.001). The prevalence of respiratory tract infections decreased most significantly; whereas, overall, the prevalence of HAIs was significantly greater during the winter compared with the rest of the year.

CONCLUSIONS

Not only did the annual prevalence of HAIs decrease from 2018 to 2021, but it also significantly decreased since the start of the COVID-19 pandemic, particularly respiratory tract infections. These results provide evidence for the need to prevent HAIs, especially during the winter season.

Direct and indirect healthcare and carbon savings with ACTIVE Particle ControlTM air-purification

Controlling airborne transmitted disease remains a challenge to clinicians, healthcare administrators, and engineers. Engineering measures are critical to any infection control program but can require extensive installation procedures, may be expensive to maintain, and may not always demonstrate clinical or financial benefit. We determined the financial and carbon benefits of an engineering solution to combat air pollutants and to control airborne transmitted disease. We determined the costs of healthcare associated infections (HAIs), and the costs of installation, maintenance, energy demands, and carbon impacts of an ACTIVE Particle ControlTM (APC) air-purification system. In a 20 month study with over 65,000 patient days the significant reductions in HAIs resulted in significant financial, energy, maintenance, and carbon savings from this engineering solution. Positive clinical and financial outcomes are possible with novel air-purification solutions such as APC.

A Blockchain-Based Life-Cycle Environmental Management Framework for Hospitals in the COVID-19 Context

During the coronavirus disease 2019 (COVID-19) emergency, many hospitals were built or renovated around the world to meet the challenges posed by the rising number of infected cases. Environmental management in the hospital life cycle is vital in preventing nosocomial infection and includes many infection control procedures. In certain urgent situations, a hospital must be completed quickly, and work process approval and supervision must therefore be accelerated. Thus, many works cannot be checked in detail. This results in a lack of work liability control and increases the difficulty of ensuring the fulfillment of key infection prevention measures. This study investigates how blockchain technology can transform the work quality inspection workflow to assist in nosocomial infection control under a fast delivery requirement. A blockchain-based life-cycle environmental management framework is proposed to track the fulfillment of crucial infection control measures in the design, construction, and operation stages of hospitals. The proposed framework allows for work quality checking after the work is completed, when some work cannot be checked on time. Illustrative use cases are selected to demonstrate the capabilities of the developed solution. This study provides new insights into applying blockchain technology to address the challenge of environmental management brought by rapid delivery requirements.

Role of bioaerosol in virus transmission and material-based countermeasures

Respiratory pathogens transmit primarily through particles such as droplets and aerosols. Although often overlooked, the resuspension of settled droplets is also a key facilitator of disease transmission. In this review, we discuss the three main mechanisms of aerosol generation: direct generation such as coughing and sneezing, indirect generation such as medical procedures, and resuspension of settled droplets and aerosols. The size of particles and environmental factors influence their airborne lifetime and ability to cause infection. Specifically, humidity and temperature are key factors controlling the evaporation of suspended droplets, consequently affecting the duration in which particles remain airborne. We also suggest material-based approaches for effective prevention of disease transmission. These approaches include electrostatically charged virucidal agents and surface coatings, which have been shown to be highly effective in deactivating and reducing resuspension of pathogen-laden aerosols.

Evaluation of a bipolar ionisation device in inactivation of antimicrobial resistant bacteria, yeast, Aspergillus and human coronavirus

Background

The efficacy of bipolar ionization in the healthcare setting has yet to be proven. A major limitation of studies sponsored by industry has been the assessment of efficiency within test chambers in which ozone levels are not adequately controlled.

Aim

To assess the effectiveness of bipolar ionization against antimicrobial-resistant bacteria, fungi and human coronavirus within a controlled test chamber designed to mitigate the effect of ozone.

Methods

Bacteria- and fungi-inoculated gauze pads, and human coronavirus 229E-inoculated stainless steel plates were placed within the vicinity of the AIO-2 bipolar ionizer and left at room temperature (2 h for coronavirus and 4 h for bacteria and fungi).

Findings

Four hours of exposure to bipolar ionization showed a 1.23–4.76 log reduction, corresponding to a 94.2–>99.9% colony-forming units/gauze reduction, in Clostridioides difficile, Klebsiella pneumoniae carbapenemase-producing K. pneumoniae, meticillin-resistant Staphylococcus aureus and multi-drug-resistant S. aureus. A 1.2 log 50% tissue culture infectious dose reduction in human coronavirus was observed after 2 h.

Conclusion

The assessment of bipolar ionization systems merits further investigation as an infection control measure.

Effectiveness of a novel, non-intrusive, continuous-use air decontamination technology to reduce microbial contamination in clinical settings: A multi-centric study

BACKGROUND

Despite rigorous disinfection and fumigation, healthcare associated infection (HAI) remains a significant concern in health care settings. We have developed a novel airborne-microbicidal technology "ZeBox" which clears over 99.999% of airborne microbial load under controlled lab conditions [1].

AIM

To evaluate the clinical performance of ZeBox in reducing airborne and surface microbial load.

METHODS

The study was conducted in single bed and multi bed ICU of two hospitals. Airborne and surface microbial loads were sampled pre- and post-deployment of ZeBox at pre-determined sites. Statistical significance of the reduction was determined using Mann-Whitney's U test.

RESULTS

ZeBox brought statistically significant reduction of both airborne and surface bacterial and fungal load. In both hospital ICUs, airborne and surface bacterial load decreased by 90% and 75% on average respectively, providing a low bioburden zone of ∼10-15 feet diameter around the unit. The reduced microbial level was maintained during ZeBox's operation over several weeks. Most clinical bacterial isolates recovered from one of the hospitals were antibiotic resistant, highlighting ZeBox's ability to eliminate antimicrobial-resistant bacteria among others.

CONCLUSIONS

ZeBox significantly reduces airborne and surface microbial burden in clinical settings. It thereby serves an unmet need for reducing the incidence of HAI.

COVID-19 Impact on Public Health, Environment, Human Psychology, Global Socioeconomy, and Education

The end of the year 2019 was marked by the introduction of a third highly pathogenic coronavirus, after SARS-CoV (2003) and MERS-CoV (2012), in the human population which was officially declared a global pandemic by the World Health Organization (WHO) on March 11, 2020. Indeed, the pandemic of COVID-19 (Coronavirus Disease 19) has evolved at an unprecedented rate: after its emergence in Wuhan, the capital of the province of Hubei of the People's Republic of China, in December 2019, the total number of confirmed cases did not cease growing very quickly in the world. In this manuscript, we have provided an overview of the impact of COVID-19 on health, and we have proposed different nutrients suitable for infected patients to boost their immune systems. On the other hand, we have described the advantages and disadvantages of COVID-19 on the environment including the quality of water, air, waste management, and energy consumption, as well as the impact of this pandemic on human psychology, the educational system, and the global economy. In addition, we have tried to come up with some solutions to counter the negative repercussions of the pandemic.

Elevator Cabin Decontamination With ACTIVE Particle Control™ Technology

Effectively reducing contamination and aerosolized bioburden may limit the risk of disease transmission in closed settings when social distancing is not possible. Unlike uncontrolled ionization and oxidation devices ACTIVE Particle Control™ conditions particles in a highly controlled fashion which provides effective air purification without the generation of ozone or other toxic by-products. The purpose of this study was to determine the impact of ACTIVE Particle Control™ on elevator cabin particle load compared to standard ventilation. The intervention trial utilized particle mass tools to determine the difference in particle clearance between standard elevator cabin ventilation and ACTIVE Particle Control™ technology. Cabin particulate contaminants were significantly reduced using ACTIVE Particle Control™ technology in an operating elevator.