Baseline Contamination Research Articles

Marine microdebris pollution in sediments from three environmental coastal areas in the southwestern Argentine Atlantic

Microplastics (MPs) and antifouling paint particles (APPs) are important components of marine microdebris (MDs), which constitute a potential environmental risk. This study analyzed baseline contamination levels of MDs and mesodebris (MesDs) in intertidal sediments at different depths, exploring the geomorphological influence in three Argentine coastal environments: Bahía Blanca Estuary (BBE), Los Pocitos (LP) and Puerto Madryn (PM). The MDs and MesDs samples were characterized by μ-FTIR, SEM/EDX and XRD. The abundance of MPs and APPs in sediments, range between 19.78 and 1087.19 and between 0 and 172.93 items/kg d.w., respectively. Despite variations in population and industrial developments in these areas, MPs abundance shows no significant differences in low and high intertidal zones. However, mean MPs concentrations were higher in the surface layer (0–5 cm) compared to the deeper sediments (5–10 cm), indicating recent MPs deposition. Chemical characterization evidenced the presence of cellulose (CE) and denser polymers as acrylonitrile butadiene styrene (ABS) and polyacrylics (PAN), APPs, metallic and black MDs. Surface degradation and heavy metals (Zn, Cr, and Ba) were also detected in APPs and other MDs, either as additives or adhered to their surfaces. Changes in crystallinity were also observed on the MesDs due to weathering. The calculated polymer hazard index (PHI) and the presence of hazardous polymers such as ABS and PAN indicated an increased risk of MPs pollution on the BBE and PM coasts. The pollution load index (PLI) values (from 4.63 to 5.34) suggested unpolluted to moderately polluted levels. These findings offer insights into potential risks associated with MDs in Argentine intertidal sediments, underscoring the critical need to comprehend the geomorphology and the influence of coastal dynamics. This is crucial for effectively addressing challenges linked to MDs pollution guiding the development of robust management and mitigation strategies.

An assessment of bacterial contamination of indirect ophthalmoscopes and condensing lenses used in clinical practice: A multi-center study.

To investigate bacterial contamination of indirect ophthalmoscopes and condensing lenses used in three UK veterinary referral centers, and the impact of an implemented cleaning protocol. Bacteriology samples from 10 indirect ophthalmoscopes and 10 condensing lenses were taken at each center (n = 30 T0), before initiating one of three cleaning frequencies (every 2 weeks/once weekly/daily) for 28 days. The most contaminated indirect ophthalmoscope and condensing lens from each center were re-sampled 30 min prior to (T1; n = 9) and 30 min after (T2; n = 9) the final clean. Sensitivity testing was completed using MIC. Seventy-three isolates representing 15 different bacterial populations (genus/species) were cultured from 36 of 48 (75%) swabs tested. The most frequently cultured isolates were Staphylococcus spp. 30%, Micrococcus 22%, and Bacillus 14%. Pseudomonas aeruginosa, Pantoea, and Staphylococcus pseudintermedius demonstrated resistance to >50% of antibiotics against which they were tested. Eighty-three percent of T0 samples (54 isolates across 11 species, median 2 isolates/swab), all T1 samples (15 isolates across 8 species, median 2 isolates/swab), and 22% of T2 samples (4 isolates across 4 species, median 0 isolates/swab) were contaminated. Head contact points were most contaminated irrespective of time point. A T1 sample was 57 times more likely (95% CI: 2.4-1376) to have a positive culture than a T2 sample (p = .01). Baseline contamination was high, representing a potential source of nosocomial infection in ophthalmic patients and handlers of diagnostic equipment. No center implemented a cleaning protocol prior to this study. Routine cleaning reduces bacterial contamination.

Pollution characteristics, sources and health risks assessment of potentially hazardous elements in sediments of ten ponds in the Saros Bay region (Türkiye)

Pollution of lentic ecosystems by potentially hazardous elements (PHE) due to human activities has become a global concern. In this study, the contents of eight PHEs in the sediments of 10 most important ponds located in the Saros Bay region (Türkiye) were evaluated. The contents of PHEs in the sediments of the ponds ranged from 0.14 mg/kg for Cd to 274 mg/kg for Mn. According to the enrichment factor (EF) results, ponds P3, P8 and P9 for Cd and pond P8 for Pb showed “moderate enrichment”. However, the pollution load index (PLI) results indicated that all ponds were in a “baseline contamination” state due to the combined effect of all PHEs. Similarly, based on ecological risk assessment indices, no ecological risk from PHEs was identified. In addition, Cd, Zn, As, Cr, Cu and Pb contents in all ponds were found below threshold effect concentrations. The results of the health risk assessment indicated that non-carcinogenic and carcinogenic risks were not expected for recreational receptors due to exposure to the PHEs in the sediments via incidental ingestion and dermal contact. Correlation and cluster analysis results indicated that although agricultural activities contributed slightly to the As content, all PHEs mainly originated from natural sources.

Baseline Soil Dioxin Levels from Sites Where Municipal Solid Waste Incineration Construction Is Planned throughout China: Characteristics, Sources and Risk Assessment

The determination of baseline dioxins levels in soils is fundamental for the quantitative assessment of the net environmental and health impacts of municipal solid waste (MSW) incineration plants, which remains unexplored. Therefore, this study develops a Chinese baseline soil dioxins database (covering 918 soil samples from 292 pre-construction MSW incineration plants nationwide during 2016–2020) to thoroughly explore the baseline contamination characteristics and health risks of dioxins in soils. The empirical results show that (1) for concentration levels, the baseline international toxic equivalency (I-TEQ) concentrations vary from 0.0015 to 32 ng I-TEQ/kg, which are close to or even lower than those in most existing studies and show significant heterogeneity across provinces; (2) for dioxins homolog, highly chlorinated dioxins (i.e., PCDDs) are the dominant contributor to the total dioxins in soils (contributing 54.30% of the total I-TEQ concentrations), implying that dioxins in baseline soils often have an atmospheric fingerprint; and (3) for health risks, the carcinogenic risk and non-carcinogenic risk of dioxins in soils are mostly below acceptable levels, close to or even lower than the results of previous studies. Despite these results being considered as quite preliminary, they have certain implications for local authorities. Future studies can expand the size of the database and the generalizability of the results, and if necessary, establish a long-term dynamic monitoring of dioxins in soils for systematically evaluating the net impact of MSW incineration on environment and human health.

An Enhanced Strategy for Daily Disinfection in Acute Care Hospital Rooms

Environmental contamination is a source of transmission between patients, health care practitioners, and other stakeholders in the acute care setting. To compare the efficacy of an enhanced daily disinfection strategy vs standard disinfection in acute care hospital rooms. This randomized clinical trial (RCT) was conducted in acute care hospital rooms at Duke University Hospital in Durham, North Carolina, from November 2021 to March 2022. Rooms were occupied by patients with contact precautions. Room surfaces (bed rails, overbed table, and in-room sink) were divided into 2 sides (right vs left), allowing each room to serve as its own control. Each side was randomized 1:1 to the intervention group or control group. The intervention was a quaternary ammonium, salt-based, 24-hour continuously active germicidal wipe. It was applied in addition to routine disinfection for the intervention group. The control group received no intervention beyond routine disinfection. The primary outcome was the total contamination, measured in colony-forming units (CFUs) on the bed rails, overbed table, and sink on study day 1. The secondary outcomes were the proportion of sample areas with positive test results for clinically important pathogens, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and carbapenem-resistant Enterobacteriaceae; the similarity in baseline contamination between sample area sides on study day 0 before application of the intervention, and the proportion of sample areas with removed UV luminescent gel on study day 1. A total of 50 study rooms occupied by 50 unique patients (median [IQR] age, 61 [45-69] years; 26 men [52%]) with contact precautions were enrolled. Of these patients, 41 (82%) were actively receiving antibiotics, 39 (78%) were bedridden, and 28 (56%) had active infections with study-defined clinically important pathogens. On study day 1, the median (IQR) total CFUs for the intervention group was lower than that for the control group (3561 [1292-7602] CFUs vs 5219 [1540-12 364] CFUs; P = .002). On study day 1, the intervention side was less frequently contaminated with patient-associated clinically important pathogens compared with the control side of the room (4 [14%] vs 11 [39%]; P = .04). Results of this RCT demonstrated that a quaternary ammonium, salt-based, 24-hour continuously active germicidal wipe decreased the environmental bioburden in acute care hospital rooms compared with routine disinfection. The findings warrant large-scale RCTs to determine whether enhanced daily disinfection strategies can decrease patient acquisition and adverse patient outcomes. ClinicalTrials.gov Identifier: NCT05560321.

Measuring the impact of an enhanced strategy for daily disinfection in acute-care hospital rooms

Background: Enhanced strategies for daily disinfection in acute-care hospital rooms are needed but are poorly understood. Methods: We conducted a randomized control trial pilot study in acute-care hospital rooms at Duke University Health System in Durham, North Carolina, comparing the efficacy of a novel EPA-registered quaternary ammonium disinfectant with 24-hour activity, Sani24, to routine daily disinfection. Rooms housing patients on contact precautions were enrolled. In each study room, the bedrails, overbed table, and sink were divided into 2 equal halves, or sides, labeled left and right, with sample areas of 2,000 cm2, 1,750 cm2, and 400 cm2, respectively. Each sample area side was then randomized 1:1 to intervention or control by a coin toss. Sani24 was applied to the surface of each intervention sample side and allowed to air dry. Control sides were left alone. Environmental services (EVS) staff were not involved in the study and were blinded to randomization status. Glogerm dots were applied to all 6 sample-area sides after application of the intervention to measure compliance of daily disinfection by EVS and the removal of the intervention agent. Microbiological samples were taken with sponges premoistened with neutralizing buffer from each sample area side for 6 total samples (3 intervention and 3 control) immediately before and 24 hours following application of the intervention agent. Clinically important pathogens (CIP) were defined as MRSA, VRE, and CRE. The primary outcome was room CFU on study day 1, which was compared using a Wilcoxon rank-sum test. Results: In total, 20 patient rooms were enrolled in the study, and 240 samples were obtained from 120 sites (60 intervention and 60 control) from November 2021 to January 2022. Enrolled patients were all on contact isolation and had an active infection; 15 (75%) were bedridden and 8 (40%) were female. On day 0, baseline contamination was similar between study arms: 7,460 (IQR,4,204–16,482) room CFU and 18 samples (30%) harboring CIP in the intervention arm versus 7,273 (IQR, 3,142–21,117) and 15 samples (25%) in the control arm (P = .49 and .47, respectively). On day 1, intervention areas had significantly lower CFU at 4,016 (IQR, 2,339–7,358) compared to controls at 6,112 CFU (IQR, 3,484–11,356; P = .01). No significant differences were detected between study arms regarding CIP recovery. Glogerm was minimally removed from sample areas (n = 7, 3%), and the result was similar between study arms. Conclusions: The use of the quaternary ammonium disinfectant with 24-hour activity on high-touch healthcare surfaces led to reduced contamination over a 24-hour period. Routine daily disinfection compliance by EVS was low since minimal sample areas had Glogerm removedFunding: PDIDisclosures: None

Microwave treatment for improved quality and safety of dehydrated pitted apricots

Dehydrated pitted apricots are widely used as a ready meal ingredient, which renders control of their quality and safety a relevant issue. Pitted apricots are rich in sugars, moisture and organic acids that serve a good medium for microorganisms. Therefore, these products require presale processing. Microwave treatment proved effective for the processing of raw and finished food products. Its impact on microorganisms depends on variant criteria, including taxonomic affiliation, total counts, dielectric cell properties and the treatment dose. The research aimed to study death kinetics in the native dried apricot surface microflora and its growth during subsequent storage. In this respect, we have studied the microwave treatment impact on dried apricot surface microflora depending on treatment dose and determined the residual microflora growth rate during subsequent storage. The doses of 120, 180 and 240 kJ at a 200 W radiation power have been shown to reduce baseline contamination of dehydrated pitted apricots by three orders of magnitude. Statistical kinetics analyses demonstrated a retarded surface microflora growth during subsequent storage. Microwave doses of 120–240 kJ (accounting for ±0.4 lg CFU/g error) exhibited a similar microflora dynamics in subsequent storage. The exposure of dried apricots to a lowest microwave field of 120 kJ ensured stability of the product microbiological dynamics.

Geochemical baseline establishment, contamination level and ecological risk assessment of metals and As in the Limoncocha lagoon sediments, Ecuadorian Amazon region

PurposeThe Limoncocha lagoon, inside a Ramsar site in the Ecuadorian Amazon, increasingly hosts ecotourism and energy development activities. This work estimates the local sediments’ baseline of As, Ba, Cd, Co, Cr, Cu, Mo, Ni, Pb, V and Zn using four methods. This makes it possible to apply single and integrated pollution indices to estimate the contamination level and the ecological risk of the sediments.MethodsSeven sites were analysed for metal(oid)s by ICP-MS. The local baseline was estimated using the relative cumulative frequency method, the iterative 2σ- and 4σ-outlier-techniques and the normalisation method to a “conservative” element. Combinations of single Cf and Ef and integrated indices (NPI, mNPI, mCd, MEQ, RI, mPELq, mERMq and TRI) were applied.ResultsThe relative cumulative frequency method had the best performance for the geochemical baselines. Cf and Ef indices classify sediments from a “low contamination” remote site to the “moderate contamination” and “minor enrichment” of the remaining sites due to As, Cd and Zn concentrations. The overall analysis of the integrated indices results in Ni, Zn and Cu being identified as priority pollutants because they have occasionally been associated with adverse biological effects in the centre of the lagoon and in the most anthropised areas. These are classified as moderately polluted with a medium–low priority risk level.ConclusionsThis work provides sediment baseline and contamination indicators for pollutants, which could be incorporated into the sediment quality assessment and monitoring programme of the Limoncocha lagoon. Ni, Cd and Cr due to the high baseline values in comparison with SQGs, and Cu and Zn due to their potential risk, should be of special attention.Graphical abstract

Urine Trouble: Reducing Midstream Clean Catch Urine Contamination Among Children 3-17 Years Old.

Children, caregivers, and clinicians often prefer midstream clean catch technique to urethral catheterization for obtaining urine cultures. However, contamination is common, potentially resulting in unnecessary medical intervention and cost. With this resident-led initiative, we aimed to reduce pediatric midstream clean catch urine culture contamination over 6 months. A bundled intervention was implemented in the emergency department, inpatient units, and outpatient clinics at our institution. Baseline contamination rates were collected April 2016 to September 2017; the intervention was introduced October 2017 to March 2018 and evaluated April 2018 to September 2018. Sustainability was measured October 2018 to September 2020. Balancing measures included rates of repeat urine cultures, positive cultures, and contaminated cultures by urethral catheterization. Rates of midstream clean catch urine culture contamination were 45.3% preintervention and 30.9% postintervention, a 14.7% (95% confidence interval: 8.0% to 21.5%) absolute decrease. Before and after intervention, girls and patients 16 to 17 years old had the highest rates of midstream clean catch contamination. Six months postintervention, the rate of repeat urine culture decreased from 4.9% to 0.9% with no change in positive culture results or contaminated cultures by urethral catheterization. Over the subsequent 2 years, the impact of the intervention decreased (rate of contamination over 30 months postintervention: 38.4%, a 7.3% [95% confidence interval: 2.9% to 11.6%] absolute decrease; rate of repeat urine culture: 3.2%). An intervention to improve midstream clean catch urine culture collection was associated with a clinically meaningful decrease in contamination. Impact of the resident-led intervention decreased over time.

Dioxins and dioxin-like PCBs in buffalo milk from the Campania region (Italy): Decreasing trend and baseline assessment over 10 years (2008–2018)

Polychlorodibenzo-p-dioxins, polychlorodibenzo-furans (PCDD/Fs) and dioxin-like polychlorobiphenyls (DL-PCBs) enter the food chain from the environment. In this study, we report the 2008–2018 time-trends in the PCDD/F and DL-PCB contamination of milk from buffaloes fed on local forage in rural areas of the Campania region. Validated according to QA/QC criteria, the dataset (N = 808 on a total of 2068 samples, after excluding follow-up results and outliers) was computed on the upper-bound value pg WHO-TEQ2005 g−1fat. We assessed time-trends and assayed baseline contamination levels, which displayed log-normal distribution. A significant decreasing trend (p < 0.01) was observed from 2008 to 2009 and 2010; the P50–P95 range fell from 2.37–8.48 pg WHO-TEQ2005 g−1fat (N = 393) in 2008 to 1.73–4.61 in 2009 (N = 86) and to 0.67–1.46 in 2010 (N = 42). From 2010 to 2018 (N = 329), no significant variation was found among years and the related dataset fitted a log-normal distribution (p < 0.05). Occurrence descriptors indicated that the baseline contamination of dairy products (mean = 0.54; P50–P95 = 0.47–1.24) in the Campania Region was well below the EU regulatory limit in force (5.5 pg WHO-TEQ2005 g−1fat). Given the Tolerable Weekly Intake of 2 pg WHO-TEQ kg−1 body weight (bw) proposed by the EFSA for PCDD/Fs and DL-PCBs, this level of baseline contamination is discussed with regard to the orientation of food safety and food security risk connected with buffalo mozzarella cheese production.

Unused Non-sterile Latex Disposable Gloves Contamination with Healthcare-associated Bacteria and Contamination Reduction by Reminder Signs

Background: Non-sterile latex disposable gloves (NSLDGs) can prevent infections, but may also cause them if improperly used. Aim: To study NSLDGs bacterial contamination and the effect of hand hygiene reminder notices. Methods: A controlled interventional study was conducted through a quantitative bacterial sampling of NSLDGs (n = 160 gloves) obtained from boxes immediately after they were opened (baseline contamination) and 48 hours afterwards (per-intervention), and after hand hygiene reminder notices were placed (post-intervention). Bacteria were isolated and identified by 16S rRNA gene sequencing and antibiotic sensitivity testing. Findings:Pre-intervention contamination was found to be 90% and 65% for skin commensals and pathogens, respectively. Post-intervention contamination by skin commensals and pathogens declined to 70% and 15%, respectively, representing a significant reduction in the prevalence of pathogens (p = 0.0006244). The average number of colony-forming units per glove pair was also reduced, from 57.05 to 4.95 (p = 1.5 × 10-5) and from 16.1 to 0.65 (p = 0.003374), for skin commensals and pathogenic bacteria, respectively. Discussion: NSLDGs are potential pathogen transmission vehicles. Hand hygiene reminder notices placed on glove boxes can lead to reductions in bacterial contamination levels.

787. Evaluation of Clostridioides difficile Environmental Contamination Surrounding C. difficile Patients vs. non-C. difficile Patients in Outpatient Infusion Centers

Background Clostridioides difficile infection (CDI) is the most common cause of healthcare-associated infection. CDI and non-CDI patients (pts) are often treated at the same time in outpatient infusion centers (OICs). This proximity may allow horizontal transfer of spores. However, C. difficile (C. diff) spores are ubiquitous in nature and baseline contamination rates at OICs are unknown. The purpose of this pilot study was to determine toxigenic C. diff contamination in the OIC surrounding CDI pts receiving bezlotoxumab compared to non-CDI pts receiving another infusion in the same OIC before and after cleaning.MethodsOIC contamination rates were assessed at baseline, after infusion and after cleaning the environment of CDI pts receiving bezlotoxumab compared to non-CDI pts receiving other infusions. For each pt receiving an infusion, 11 areas were sampled at each time period; the infusion chair (n=4), medical and non-medical equipment (n=3), and the floor surrounding the infusion chair (n=4). Five high traffic control areas per sampling day were included. Swabs were cultured anaerobically and PCR was used to identify toxin genes. Proportion of toxigenic C. diff positive samples were compared between CDI and non-CDI pts for each time point. Cleaning was performed using a standard protocol of bleach (CDI pt) or non-bleach (non-CDI pt) products.ResultsSamples (n=709) were obtained from 10 pts in each group (329 CDI, 330 non-CDI, 50 high-traffic) from 7 OICs over 4 months. Overall, 55 patient area cultures (8%) were positive for C. diff. Positive sampling areas were highest for floors (13%) followed by infusion chairs (7%) and equipment (4%). Baseline contamination in high traffic areas was 6%. Contamination rates (Table 1) for CDI were 7% at baseline, higher after infusion (15%) and lower after cleaning (5%). For non-CDI pts, rates were similar at baseline (8%), after infusion (6%) and after cleaning (9%).Table 1. Proportion of toxigenic C. difficile-positive samples in the environment of CDI and non-CDI patients. ConclusionCompared to non-CDI pts, CDI pts had similar baseline but lower after cleaning contamination rates. These preliminary results suggest that with a proper cleaning protocol in place, the presence of CDI patients in an OIC does not increase the likelihood of C. diff transmission for other at-risk populations.Disclosures Kevin W. Garey, PharmD, MS, FASHP, Merck & Co. (Grant/Research Support, Scientific Research Study Investigator) Richard L. Hengel, MD, Merck & Co. (Other Financial or Material Support, Grant Steering Committee Member) Timothy E. Ritter, MD, Merck & Co. (Other Financial or Material Support, Grant Steering Committee Member) Ramesh V. Nathan, MD, FIDSA, Merck & Co. (Other Financial or Material Support, Grant Steering Committee Member) Engels N. Obi, PhD, Merck & Co. (Employee) Lucinda J. Van Anglen, PharmD, Merck & Co. (Grant/Research Support)

From the coast to the shelf: Microplastics in Rías Baixas and Miño River shelf sediments (NW Spain)

Microplastics (<5 mm; MPs) are globally recognized as an issue of emerging concern in the marine environment. In this study, MPs were determined for the first time in sediments from Rías Baixas and Miño river shelf, to show the baseline contamination levels. The Rías is well known for its intense fishing and shellfish harvesting activities. The sampling stations were selected due to their different exposure to anthropogenic activities and/or pressures. Sediment samples were collected using a box corer dredge and analyzed with density separation and μF-TIR analysis to determine polymer type. The results showed MPs pollution in all stations. The mean concentration was 70.2 ± 74.2 particles/kg DW. The main MPs shape was fibers (88.8%) followed by fragments (5.80%). Regarding the polymers, the most abundant were PP (43%) and HDPE (29%). Once again, MPs are ubiquitous all along Rías and Miño river mouth as previously shown in different works.

Presence of Presumptive Shiga Toxin–Producing Escherichia coli and Salmonella on Sheep during Harvest in Honduras

ABSTRACT Shiga toxin–producing Escherichia coli (STEC) and Salmonella are foodborne pathogens commonly harbored in the gastrointestinal tract of sheep. These pathogens can be on the hide of sheep and transferred to the carcass, causing a foodborne hazard. Salmonella can also be found in the lymph nodes of sheep, creating a biological hazard during harvest and processing. Developing countries lack baseline data on the presence of these foodborne pathogens on meat products, specifically sheep meat. Therefore, the objective of this study was to evaluate the presence of STEC and Salmonella on sheep hides, preevisceration carcasses, and final carcasses and Salmonella in subiliac lymph nodes from two small Honduran harvest facilities, plants A and B. Sponge swabs from the foreshank region of hides and carcasses and subiliac lymph node samples were collected from 96 sheep (86 at plant A; 10 at plant B). Microbial detection of STEC and Salmonella was performed by using the BAX System to screen for prevalence, and suspect samples were subjected to conventional culture isolation for confirmation. Overall baseline contamination on hides were 34.4 and 10.4% present for STEC and Salmonella; however, through implementation of sanitary procedures, preevisceration and final carcass samples were significantly decreased from the hide for both pathogens (P = 0.05). Moreover, overall plant A had significantly higher rates (P = 0.05) of STEC and Salmonella at each carcass sampling site compared with plant B. After each sampling was performed, recommendations were provided to each facility on the basis of pathogen presence, performance techniques, and contamination risks. Through recommendations and implementation of hazard analysis and critical control points, good manufacturing practices, and sanitation standard operating procedures in each facility, the meat supply in Honduras will become safer and more wholesome. Therefore, the development of a baseline with continued sampling is crucial to understand the risk of foodborne pathogens to consumers in the Honduran sheep meat supply. HIGHLIGHTS

Anxiety and safety behavior usage during the COVID-19 pandemic: The prospective role of contamination fear

The coronavirus (COVID-19) pandemic has broadly increased anxiety and changed individual behavior. However, there is limited research examining predictors of pandemic-related changes, and the majority of existing research is cross-sectional in nature, which limits causal inference. Given functional links with disease avoidance processes, individual differences in contamination fear may be especially relevant in predicting responses to COVID-19. Accordingly, the present study prospectively examines contamination fear and obsessive-compulsive washing symptoms as predictors of anxiety and safety behaviors in response to COVID-19 in a student sample (N = 108). To examine specificity, anxiety and safety behaviors in response to seasonal influenza are also examined. In the early stages of the pandemic (March 2020), coronavirus-related anxiety was higher than flu-related anxiety (d = 1.38). Obsessive-compulsive washing symptoms also increased from before the pandemic (d = 0.4). Although baseline contamination fear and obsessive-compulsive washing symptoms did not significantly predict coronavirus-related anxiety, contamination fear did significantly predict safety behavior usage in response to both COVID-19 and influenza. The specificity of the prospective association between contamination fear and the use of safety behaviors are discussed in the context of the global COVID-19 pandemic and the broader literature on the role of safety behaviors in anxiety.

Modelling the influence of short-term climate variability on drinking water quality in tropical developing countries: A case study in Tanzania

Climate change is expected to increase the prevalence of water-borne diseases especially in developing countries. Climate-resilient drinking water supplies are critical to protect communities from faecal contamination and thus against increasing disease risks. However, no quantitative assessment exists for the impacts of short-term climate variability on faecal contamination at different drinking water sources in developing countries, while existing understanding remains largely conceptual. This critical gap limits the ability to predict drinking water quality under climate change or to recommend climate-resilient water sources for vulnerable communities. This study aims to provide such quantitative understanding by investigating the relationships between faecal contamination and short-term climate variability across different types of water sources. We collected a novel dataset with over 20 months' monitoring of weather, Escherichia coli (E. coli) and total coliforms, at 233 different water sources in three climatically different regions in Tanzania. We then took a rigorous statistical analysis with Bayesian hierarchical models, to relate both contamination occurrence and amount to climate variability. The model results explained the temporal variability in drinking water faecal contamination using climate predictors, and also revealed the climate sensitivity of faecal contamination for individual water sources. We found that: a) short-term climate variability and baseline contamination levels can explain about half the observed variability in faecal contamination (R2 ≥ 0.44); b) increased contamination was most consistently related to recent heavy rainfall and high temperature across different water sources; c) unimproved water sources such as the unprotected dug wells have substantially higher climate sensitivity. Based on these results, we can expect substantial increases in drinking water contamination risks across tropical Sub-Saharan Africa and South-East Asian developing countries under a warmer climate, which highlight the urgent need of protecting vulnerable communities from the severe climate impacts.

Universal Decolonization Reduces MDRO Burden on High-Touch Objects in Nursing Home Resident Rooms and Common Areas

Background: More than half of nursing home (NH) residents harbor a multidrug-resistant organism (MDRO), and MDRO contamination of the environment is common. Whether NH decolonization of residents reduces MDRO contamination remains unclear. The PROTECT trial was a cluster-randomized trial of decolonization versus routine care in 28 California NHs from April 2017 through December 2018. Decolonization involved chlorhexidine bathing plus nasal iodophor (Monday–Friday, every other week), and it reduced resident nares and skin MDRO colonization by 36%. Methods: We swabbed high-touch objects in resident rooms and common areas for MDROs before and after the 3-month decolonization phase-in (April–July 2017). Five high-touch objects (bedrail, call button and TV remote, doorknob, light switch, and bathroom handles) were swabbed in 3 resident rooms per NH based on care needs (Alzheimer’s disease and related dementias (ADRD), ie, total care; ADRD, ambulatory care; and short stay). Five high-touch objects were also swabbed in the common area (nursing station, table, chair, railing, and drinking fountain). Swabs were processed for methicillin-resistant S. aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae, and carbapenem-resistant Enterobacteriaceae (CRE). We used generalized linear mixed models to assess the impact of decolonization on MDRO environmental contamination when clustering by NH and room and adjusting for room type and object because unclustered and unadjusted results are likely to be inaccurate. Results: A high proportion of rooms were contaminated with any MDRO in control NHs: 43 of 56 (77%) in the baseline period and 46 of 56 (82%) in the intervention period. In contrast, decolonization NHs had similar baseline contamination (45 of 56, 80%) but lower intervention MDRO contamination (29 of 48, 60%). When evaluating the intervention impact using multivariable models, decolonization was associated with significantly less room contamination for any MDRO (OR, 0.25; 95% CI, 0.06–0.96; P = .04) and MRSA (OR, 0.16; 95% CI, 0.05–0.55; P = .004) but nonsignificant reductions in VRE contamination (OR, 0.86; 95% CI, 0.23–3.13) and ESBL contamination (OR, 0.13; 95% CI, 0.01–1.62). CRE was not modeled due to rare counts (2 rooms total). In addition, room type was important, with common areas associated with 5-fold, 9-fold, and 3-fold higher contamination with any MDRO, MRSA, and VRE, respectively, compared with short-stay rooms. Conclusions: The high burden of MDROs in NHs calls for universal prevention strategies that can protect all residents. Although decolonization was associated with an 84% reduction in odds of MRSA contamination of inanimate room objects, significant reductions in VRE or ESBL contamination were not seen, possibly due to the lower proportion of baseline contamination due to these organisms. Multimodal strategies are needed to address high levels of MDRO contamination in NHs.Funding: NoneDisclosures: Gabrielle Gussin: Stryker (Sage Products): Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes.

Reducing infant catheterization in the emergency department through clean-catch urine collection.

ObjectiveOur emergency department (ED) traditionally relied on urethral catheterization to obtain urine cultures when evaluating infants for urinary tract infections (UTIs). Catheterization is associated with adverse effects, and recent studies have demonstrated clean‐catch urine methods can be successfully used to obtain urine cultures. We pursued a quality improvement (QI) initiative aimed at decreasing the frequency of urethral catheterizations in our ED by using an established clean‐catch technique to obtain infant urine cultures.MethodsWe implemented a clean‐catch urine collection method, which we entitled “Bladder Massage,” for infants 0–6 months of age needing a urine culture in our ED. Exclusions included critical illness, known urologic abnormality, or prior UTI diagnosis. Our primary interventions were educational initiatives. We retrospectively collected data regarding the use of bladder massage. Our balancing measure was the contamination rate of urine cultures obtained via bladder massage technique compared to catheterization.ResultsIn our first‐year post‐implementation, we identified 334 eligible patients. Bladder massage was attempted on 136/334 (40.7%) eligible infants, with 87/136 (64%) successful attempts, thus avoiding catheterization in 26.1% of patients. Our baseline contamination rate from catheterization was 8/488 (1.6%), compared to 10/87 (12%) using bladder massage (P < 0.001), with 9/10 contaminants from female patients.ConclusionWe successfully introduced a method for clean‐catch urine cultures in our pediatric ED, averting the need for urethral catheterization in many well‐appearing infants. Ongoing efforts must focus on reduction of contamination in females, increased technique usage, and electronic health record changes to facilitate documentation to continue method use.

Baseline survey of sediment contamination with 210Polonium in three peri-urban creeks of Mombasa, Kenya

210Po in marine sediment from three peri-urban creeks in Mombasa was analyzed by alpha spectrometry in order to determine its baseline contamination levels. The mean 210Po activity in marine sediment from Mtwapa, Tudor and Makupa creeks were 18.67 ± 1.8, 21.17 ± 2.2 and 13.09 ± 1.6 Bq Kg−1 dw, for surface sediment and 37.56 ± 2.14, 28.64 ± 2.86 and 30.42 ± 2.1 Bq Kg−1 dw respectively, for sediment cores. Comparison of 210Po activity in surface sediment indicated that 210Po in the creeks could be originating from the same source. However, comparison of activities in the entire cores from the three creeks indicated that 210Po sources could have been different in the past. 210Po activities in this study were relatively elevated compared to marine environments under similar anthropogenic influence and there is need to understand its source and fate.

Adélie penguin colonies as indicators of brominated flame retardants (BFRs) in East Antarctica

While persistent organic pollutant (POP) contamination within Antarctica is largely caused by long-range atmospheric transport (LRAT), Antarctic research bases have been shown to be local sources of POPs such as brominated flame retardants (BFRs). This study compared concentrations of seven polybrominated diphenyl ethers (PBDE) congeners and five novel flame retardants (NBFRs) found in Adélie penguin (Pygoscelis adeliae) colony soils near the Australian research stations, Mawson and Davis, to assess the stations as local sources of these contaminants and provide a much needed baseline for contamination of BFRs in East Antarctica. Soil samples (n = 46) were collected from Adélie colonies at close proximity to the research stations as well as further afield during the 2016-17 austral summer. Samples were analysed using selective pressurised liquid extraction (S-PLE) and gas chromatography coupled to tandem mass spectrometry (GC-MS/MS). PBDEs (BDE-28, -47, -99, -100, -153, -154 and -183) were detected in 45/46 samples with ∑7PBDE concentrations ranging from <0.01 to 1.63 ng/g dry weight (dw) and NBFRs (2,3,4,5,6-pentabromotoluene (PBT), 2,3,4,5,6-pentabromoethylbenzene (PBEB), hexabromobenzene (HBB), 2-ethylhexyl-2,3,4,5-tetrabromobenzoate (EH-TBB) and bis(2,4,6-tribromophenoxy) ethane (BTBPE)) detected in 20/46 samples, with a range of ∑5NBFR from not detected (ND) to 0.16 ng/g dw. Soils taken from around the Davis and Mawson research stations were more highly contaminated (n = 10) than penguin colonies (n = 27) and control areas not affiliated with breeding seabirds (n = 8). The most common congener detected was BDE-99, reflecting inputs from LRAT. However, the congener profiles of station soils supported the hypothesis that research stations are a local source of PBDEs to the Antarctic environment. In addition, the NBFR pentabromoethylbenzene (PBEB) was quantified for the first time in Antarctic soils, providing essential information for baseline contamination within the region and highlighting the need for ongoing monitoring as global regulations for the use of BFRs continuously change.