Disinfection Protocols Research Articles

Bactericidal efficacy of low dose gaseous ozone against clinically relevant multidrug-resistant bacteria

IntroductionHealthcare-associated infections (HAIs) pose a significant challenge in acute care hospitals, particularly in intensive care units, due to persistent environmental contamination despite existing disinfection protocols and manual cleaning methods. Current disinfection methods are labor-intensive and often ineffective against multidrug-resistant (MDR) pathogens, highlighting the need for new, automated, hands-free approaches.MethodsThis study evaluates the bactericidal efficacy of low concentrations of gaseous ozone (5 ppm) against clinically relevant and often MDR bacteria under various concentrations, contact times, temperatures, and environmental conditions.ResultsWe observed a 3 log10-fold reduction in Escherichia coli and Salmonella Typhimurium and a 1–2 log10-fold reduction in group A Streptococcus and methicillin-resistant Staphylococcus aureus upon ozone exposure. The bactericidal effect was dose-dependent, with no significant difference between single and repeated exposures. Environmental conditions such as temperature and humidity had minimal impact on low-dose ozone efficacy, with slightly improved bacterial killing at colder temperatures and higher humidity levels. Gaseous ozone also showed significant bactericidal activity against the broad range of Gram-positive and -negative MDR clinical isolates.DiscussionThese findings highlight the potential of low-dose gaseous ozone as a versatile, effective, and hands-free disinfectant for healthcare and other settings. Further research is needed to establish long-term safety and efficacy guidelines for its use in occupied spaces and to explore potential synergy with other contemporary disinfection strategies.

A 4-year follow-up of root canal obturation using a calciumsilicate-based sealer and a zinc oxide-eugenol sealer: Arandomized clinical trial.

This randomized clinical trial assessed the outcomes of nonsurgical root canal treatment (RCT), comparing a calcium silicate-based sealer (CSBS) with the single-cone technique (SC) with a zinc oxide-eugenol (ZOE) sealer and warm vertical compaction (WVC). Ninety-two single- and multi-rooted teeth were divided into two groups and treated using either the SC with BioRoot™ RCS (BIO) or WVC with Pulp Canal Sealer™ EWT (PCS). Teeth with apical periodontitis (AP) in both groups were further divided into BIOAP and PCSAP subgroups. Standardized instrumentation and disinfection protocols were followed. Periapical index (PAI) was recorded, and clinical and radiographic follow-ups were conducted at 1, 3, 6, 12, 24, and 48 months. Outcomes considered included success rate (under strict and loose criteria), extraction, length of filling, voids, and extrusion rate, as well as changes in PAI score from baseline. Outcome variables and prognostic factors were analysed using binary and multiple logistic regression at p < .05. Sixty-seven teeth were included (recall rate, 73%). At 4-year follow-up, the overall success rates (BIO + PCS) were 89.6% by loose criteria and 83.3% by strict criteria. Subgroup success rates (BIOAP+PCSAP) were 88.5% by loose criteria and 80.4% by strict criteria. There were no significant differences between the groups in terms of success rate, extraction rate, length of filling, voids, or extrusion (p > .05). The pattern of PAI reduction was similar in both groups (p = .806). Treatment using the SC-CSBS technique and the ZOE sealer with the WVC technique demonstrated a similar success rate.

Validation of the effectiveness of pig farm repopulation protocol following African swine fever outbreaks in the Philippines

The African swine fever (ASF) epidemic has severely challenged the Philippines’ swine industry since 2019. The National African Swine Fever Prevention and Control Program (NASFPCP), launched in 2021, aims to provide guidance for managing ASF through surveillance, monitoring, and swine repopulation. This study evaluates the effectiveness of post-outbreak disinfection protocols and government-mandated measures for repopulation standard. Surveillance data from three repopulation phases—(I) depopulation, cleaning, and disinfection; (II) downtime (20 days); and (III) sentinel animals (40 days)—were collected from February 2020 to December 2021 in the province of Batangas. Time-to-detection of positive events were analyzed for different farm types, seasons, or location using survival analysis modeling. Probability of detecting infected farms at different sampling times was estimated in terms of sensitivity of the sampling time. Data from 145 swine farms, including 99 backyard and 46 commercial farms, revealed positive rates of 10.1 and 8.7%, respectively. The failure rate during repopulation surveillance was 9.66%, whereas 90.34% farms remained ASF negative. Sensitivity estimate increased from 18–21 to 89% by day 27, with sentinel animals on that day exhibiting the highest estimated sensitivity. This highlights the importance of sentinel pigs in the NASFPCP for effective ASF control in the Philippines. Survival analysis showed no statistically significant differences in the results between either farm type, season, or municipality level. Geographic mapping of surveyed farms and those with positive detections identified high-risk locations including San Juan and Lipa City as key areas of concern. Enhancing targeted surveillance is critical for improving an early ASF detection and national response in the Philippines.

UVC light as a strategy for disinfection of hospital air and surfaces

Objective: To evaluate a fixed UV-C light emitting device for its antimicrobial effectiveness in the disinfection of distinct surfaces and its antifungal effectiveness on air quality in the hospital environment. Methods: This quasi-experimental study was conducted in a hospital inpatient unit, in which a six-stage air Biosampler (Andersen®) was used for air analysis. In the evaluation of surfaces, three suspensions of microorganisms (Acinetobacter sp. multidrug-resistant, Escherichia coli, and KPC-producing Klebsiella pneumoniae) were used to contaminate the environment. In both evaluations, pre- (control) and post-activation of UV-C light (test) collections were made. Results: In the air evaluation, an important reduction was observed in the colony count after irradiation with UV-C light, and pathogenic or toxigenic fungi were not found in either of the two moments. Regarding the disinfection of surfaces, no bacterial growth was observed after the application of UV-C light, showing 100% bacterial inactivation under the tested conditions. Conclusion: The use of fixed UV-C light emission technology was effective and can be considered a promising intervention for hospital surface disinfection protocols.

Regenerative endodontic therapy in immature teeth using photobiomodulation and photodynamic therapy; a histomorphological study in canine model

BackgroundRegenerative endodontic therapy (RET) is still coming up short to demonstrate histological evidence for true regeneration with clinically feasible protocol of cell homing in single visit approach.AimThe aim of the present study is to evaluate the regenerative potential of photobiomodulation (PBM) on RET in immature roots when photodynamic therapy (PDT) protocol is implemented for root canal disinfection in canine model.Materials and methodsSeventy-two root canals were recruited, with sixty assigned to experimental groups and twelve to positive and negative controls. Following the induction of pulp necrosis and apical periodontitis, the roots were divided into two experimental groups: Group I received RET followed by PBM (seven sessions with an 808 nm diode laser at 300 mW for 90 s), and Group II received RET without PBM. Follow-ups were conducted at 1, 2, and 3 months (subgroups A, B, and C respectively). Qualitative and quantitative assessment was carried out histologically. All data were statistically analyzed with the Mann-Whitney U test and Bonferroni’s adjustment, as well as Chi square test.ResultsThe newly formed hard tissue highly resembled true dentine where the dentinal tubules looked well organized lined by poly layers palisading pattern of rounded odontoblast-like cells with cytoplasmic processes extending through the predentine layer. GI exhibited statistically significantly higher scores of vital tissue infiltration and hard tissue deposition in subgroups A and B (P ≤ 0.05). The inflammatory cells scores were significantly lower in GI than in GII at all time intervals. However, no significance could be detected regarding apical closure.ConclusionThe disinfection protocol of PDT and subsequent irradiation with low power laser in PBM protocol pose a promising potential for regenerative endodontics in immature teeth.

Mechanistic Insight into the Anti-Bacterial/Anti-Biofilm Effects of Low Chlorhexidine Concentrations on Enterococcus faecalis-In Vitro Study.

Endodontic treatment failures are often linked to the persistence of Enterococcus faecalis in the root canal system. This study aimed to investigate the antibacterial/antibiofilm mechanism of chlorhexidine (CHX), particularly at low concentrations, against E. faecalis, to improve endodontic treatment protocols. The antibacterial activity of CHX (0.125-20 μg/mL) was evaluated against E. faecalis ATCC 29212 using various assays, including planktonic growth inhibition, colony-forming units (CFUs), membrane permeability and potential assays, high-resolution scanning electron microscopy (HR-SEM), confocal laser scanning microscopy of biofilms, biomass and metabolic activity assays on matured biofilm, and quantitative real-time PCR for gene expression. Statistical analysis was performed using Student's t-test and ANOVA. CHX demonstrated concentration-dependent inhibition of E. faecalis, significantly reducing planktonic growth and CFUs. Membrane assays showed increased permeability and depolarization, indicating damage. HR-SEM revealed morphological changes, such as pore formation, while confocal microscopy showed a reduction in biofilm mass and extracellular substances. Gene expression analysis indicated the downregulation of virulence genes and upregulation of stress response genes. CHX at low concentrations disrupts E. faecalis at multiple levels, from membrane disruption to gene expression modulation, affecting mature biofilm. These findings support the refinement of endodontic disinfection protocols to reduce microbial persistence.

Cleaning and Disinfection of Surfaces in a COVID-19 Respiratory Syndrome Unit: A Quasi-Experimental Study

Objective: This study aimed to assess the impact of an educational intervention on the cleaning and disinfection processes within a respiratory syndrome unit, serving as a designated facility for COVID-19 patients. Methods: A quasi-experimental design was employed, incorporating a pre-intervention and postintervention assessment. The evaluation of surfaces involved various monitoring techniques, including Adenosine Triphosphate (ATP) testing, colony-forming unit analysis, and visual inspections. All statistical analyses were conducted at a significance level of 5% (p &lt; 0.05). Results: Following the implementation of the educational intervention, a notable reduction in surface contamination rates was observed. Significant improvements were noted for specific surfaces when utilizing the ATP testing method, including benchtops (p = 0.030), mattresses (p = 0.014), doorknobs (p = 0.014), and armchairs (p = 0.014). Furthermore, a decrease in the total count of aerobic bacteria was observed for benchtops (p = 0.014), mattresses (p = 0.014), and doorknobs (p = 0.014). Visual inspection results also indicated enhancements, with approval rates for benchtops, armchairs, and mattresses rising from 0% before the intervention to 37.5% afterward. Conclusion: The findings of this study demonstrate substantial improvements in approval rates following the implementation of the educational intervention. Additionally, this research provides valuable insights for the development of ongoing educational initiatives for the healthcare team, incorporating evaluation and feedback mechanisms as well as updates to cleaning and disinfection protocols.

Evaluation of the microbial contamination of the audiological diagnostic equipment and, their current disinfection techniques

BackgroundThe study aims to investigate the microbial contamination of commonly used audiological diagnostic equipment and to evaluate the effectiveness of existing disinfection methods in audiological clinics. MethodsHospitals with fully equipped audiology clinics in Istanbul were included in the study. Various audiological diagnostic devices, such as Pure Tone Audiometer, Tympanometer, and Auditory Brainstem Response (ABR), were examined. The study also investigated the disinfection practices in hospitals. A total of 60 swab samples were collected from the stimulus button on the audiometer, patient response switch, supraaural headphone cushion, bone conduction headphone (bone vibrator), and disinfected probe tips used in the Tympanometer and ABR. ResultsBacterial growth was observed on 40% of the analyzed plates, with 11.66% showing two different types of bacterial growth. Staphylococcaceae family were the most common bacteria identified. Other bacteria included Pseudomonas putida, Panteoa spp, Micrococcus luteus, Corynebacterium spp, and Bacillus spp. The highest bacterial growth occurred on the supraaural headphone cushion and bone vibrator. ConclusionsThe study highlights the presence of various bacteria on audiological diagnostic equipment, emphasizing Staphylococcus species as predominant. Current disinfection practices, particularly for supraural headphones and bone vibrators, were found to be inadequate, potentially posing risks for infections. The study suggests the need for disinfection protocols, particularly for frequently touched devices, to ensure patient safety in clinics.

Successful control of an environmental reservoir of NDM-producing Klebsiella pneumoniae associated with nosocomial transmissions in a low-incidence setting

BackgroundThe hospital wastewater system has been reported as a source of nosocomial acquisition of carbapenemase producing Enterobacteriaceae (CPE) in various settings. Cleaning and disinfection protocols or replacement of contaminated equipment often fail to eradicate these environmental reservoirs, which can lead to long-term transmission of CPE. We report a successful multimodal approach to control a New Delhi metallo-beta-lactamase positive Klebsiella pneumoniae (NDM-KP) nosocomial outbreak implicating contamination of sink traps in a low-incidence setting.MethodsFollowing the incidental identification of NDM-KP in a urine culture of an inpatient, we performed an epidemiological investigation, including patient and environmental CPE screening, and whole genome sequencing (WGS) of strains. We also implemented multimodal infection prevention and control (IPC) measures, namely the isolation of cases, waterless patient care, replacement of contaminated P-traps and connecting pieces, and bleach and steam disinfection of sinks for 6 months, followed by patient and environmental screenings for eradication.ResultsBetween February and May 2022, five NDM-KP cases were identified in an eight-bed neurosurgical intermediate care unit. Among the eight sink traps of the unit, three were positive for NDM-KP. Patient and environmental isolates belonged to multilocus sequence typing ST-268. All isolate genomes were genetically very similar suggesting cross-transmission and a potential role of the environment as the source of transmissions. Following the introduction of combined IPC measures, no new case was subsequently detected and sink traps remained negative for NDM-KP within 6 months after the intervention.ConclusionThe implementation of multimodal IPC measures, including waterless patient care combined with the replacement and disinfection of P-traps and connecting pieces, was successful in the control of NDM-KP after eight months. In a low-incidence setting, this approach has made it possible to pursue the objective of zero transmission of carbapenemase-producing Enterobacteriaceae (CPE).

Practice of Sterilization and Disinfection during Hysterosalpingography in some Hospitals of the Northwest, Southwest and Littoral Regions of Cameroon

Hysterosalpingography (HSG) is a diagnostic imaging procedure used to study the female reproductive system using contrast medium which is injected into the uterus and x-ray images are taken as the dye fills the uterus and fallopian tubes. Proper sterilization and disinfection protocols are essential to minimize the risk of introducing pathogens into the reproductive tract during the procedure. The purpose of this study was to investigate disinfection and sterilization practices of HSG equipment before HSG procedure in some hospitals in Cameroon. At the end of the study, collected data was compiled and analysed, the results showed 0% of proper sterilization was done for the equipment used, all the equipment were poorly disinfected with poorly made chemicals (sodium hypochlorite) solution (100%). Most of the equipment used were either about 80% stained or rusted. Based on the finding of this study, it was concluded that the practice of sterilization and disinfection of HSG equipment in Cameroon is poor, and there is need for improvements of the practice.

Highly Effective Biocides against Pseudomonas aeruginosa Reveal New Mechanistic Insights Across Gram-Negative Bacteria.

Pseudomonas aeruginosa is a major nosocomial pathogen that persists in healthcare settings despite rigorous disinfection protocols due to intrinsic mechanisms conferring resistance. We sought to systematically assess cationic biocide efficacy against this pathogen using a panel of multidrug-resistant P. aeruginosa clinical isolates. Our studies revealed widespread resistance to commercial cationic disinfectants that are the current standard of care, raising concerns about their efficacy. To address this shortcoming, we highlight a new class of quaternary phosphonium compounds that are highly effective against all members of the panel. To understand the difference in efficacy, mechanism of action studies were carried out, which identified a discrete inner-membrane selective target. Resistance selection studies implicated the SmvRA efflux system (a transcriptionally regulated, inner membrane-associated efflux system) as a major determinant of resistance. This system is also implicated in resistance to two commercial bolaamphiphile antiseptics, octenidine and chlorhexidine, which was further validated herein. In sum, this work highlights, for the first time, a discrete inner-membrane specific mechanism for the bolaamphiphile class of disinfectants that contrasts with the prevailing model of indiscriminate membrane interactions of commercial amphiphiles paving the way for future innovations in disinfectant research.

Molecular characterisation of virulence genes in bacterial pathogens from daycare centres in Ile-Ife, Nigeria: implications for infection control

BackgroundDaycare centres play a critical role in early childhood development but are high-risk environments for infectious disease transmission due to close physical contact, shared toys, inadequate hygiene, and poor ventilation. These risks are especially concerning in low- and middle-income countries (LMICs) like Nigeria, where resources for infection control may be limited. This study aimed to identify and characterise virulence genes in bacterial isolates from daycare centres in Ile-Ife, Nigeria, to assess infection risks.MethodsBetween November 2017 and July 2019, 233 samples were collected from 76 children, 33 daycare workers, and 124 fomites in 17 daycare centres. The bacterial isolates were analysed using conventional PCR and RAPD analysis to detect the presence of virulence genes. The frequency of crucial virulence genes and the prevalence of each bacterial species were recorded.ResultsKey virulence genes were detected, including fimH in Klebsiella species (22.73% of Gram-negative isolates), algD in Pseudomonas aeruginosa (50%), and icaA and cna in Staphylococcus aureus (16.67%). Staphylococcus aureus was the most prevalent species (35%), followed by Klebsiella (28%) and Pseudomonas aeruginosa (20%).ConclusionThis study highlights the presence of virulent bacterial pathogens in daycare environments, posing a severe infection risk to children. To mitigate these risks, it is essential to implement enhanced infection control measures, such as regular microbial screening, improved hand hygiene practices, and disinfection protocols for fomites. Training programs for daycare workers on hygiene practices and routine monitoring could also significantly reduce infection transmission. These interventions are vital for safeguarding the health of daycare children in Nigeria and similar settings globally.

Emergence of Mycobacterium gordonae in heater–cooler units: a five-year prospective surveillance of devices frequently subjected to chloramine-T booster disinfection

Worldwide, the detection of Mycobacterium chimaera in LivaNova heater-cooler units (HCUs) has led to their replacement with other HCUs, although non-tuberculous mycobacteria (NTM) have been reported also for HCUs produced by other manufacturers. In almost all hospitals of our region, LivaNova HCUs have been replaced with Maquet HCU40s, regularly disinfected with chloramine-T. To report the results of the surveillance over a 63-month operation period of the Maquet devices, and to provide a trend in NTM positivity over time. Twenty-nine Maquet devices (HCU40 and HU35) were monitored by two culture methods and PMA-PCR method. The trend in NTM positivity rate was evaluated through the Locally Estimated Scatterplot Smoothing regression and then modelled over time through segmented logistic regression. The data acquired during the study period demonstrate a remarkable increase in the positivity rate, especially after their third year (maximum slope change at 1280 days). Non-tuberculous mycobacteria were isolated in 150 water samples (37.2%); 100% and 62% of HCU40 and HU35 devices respectively were colonized with non-tuberculous mycobacteria. The most frequently detected species were Mycobacterium gordonae (73%) followed by Mycobacterium chelonae (41%) and Mycobacterium paragordonae (11%). Preventive strategies by disinfection with chloramine-T did not effectively reduce non-tuberculous mycobacteria colonization of Maquet devices. Although, to date, no cases of post-operative invasive infections linked to Maquet devices have been reported, our microbiological results emphasize the need for 1) designing changes to increase safety of devices and 2) researching and developing new disinfection protocols including alternative molecules.

Home Biofilm Management in Orthodontic Aligners: A Systematic Review.

Background. Transparent aligners are recently introduced orthodontic devices considered promising for the improvement of oral health conditions, in terms of faster treatment times and enhanced comfort, especially if compared with traditional fixed orthodontic therapy. This systematic review aimed to evaluate at-home protocols for proper oral hygiene and aligners cleaning during orthodontic treatment. Methods. A search was conducted using the following four databases: PubMed, Cochrane Library, Web of Science, and Scopus. The systematic review (registered as CRD 42024562215) followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and included prospective studies, randomized controlled trials (RCTs), controlled clinical trials, and in vivo and ex vivo studies; they had to assess treatment with invisible orthodontics compared to treatment with fixed orthodontics, home oral hygiene, or aligner disinfection protocols. The evidence in the studies was evaluated for risk of bias using the RoB-2 (for RCTs and randomized crossover studies) and ROBINS-I tools (for observational studies). Results. Eleven studies were included in this systematic review: four RCTs, four crossover studies, and three cross-sectional observational studies. Seven studies considered patients undergoing orthodontic treatment, whereas four examined orthodontic aligners. The cleaning protocols of the aligners were evaluated based on the analysis of residual biofilm on the thermoplastic surfaces. Studies included were characterized by a low level of certainty, thus further evidence is needed. Conclusions. The most effective protocols entailed a combination of mechanical and chemical agents, suggesting that it is fundamental for patients undergoing aligner treatment to focus on individually tailored home oral hygiene protocols.

Impact of Disinfection Protocols on Dentin Bond Strength: Chlorhexidine vs. Sodium Hypochlorite

Impact of Disinfection Protocols on Dentin Bond Strength: Chlorhexidine vs. Sodium Hypochlorite

Do reusables pose greater infectious risks than disposables for consumer goods? A systematic literature review

Increased concern over climate change and the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus resulted in a clash of political directives around reusable and disposable food serviceware. Decreasing single-use items will likely reduce consumption and environmental emissions; however, improper cleaning of reusable items could result in greater risks of disease transmission. We sought to assess the risks of reusable and disposable food serviceware and document disinfection protocols by conducting a systematic literature review of articles that assessed materials or products that could be fomites to specific food-borne pathogens. After initial screening, the study team extracted data from 122 articles. The most common pathogens studied were E. coli (25% of included studies), general bacteria (24%), and Norovirus (16%). Thirteen studies (8%) focused on SARS-CoV-2. A majority of studies analyzed plastics (27%), stainless steel (22%), or porous surfaces such as paper and cardboard (12%). Forty seven of the studies (35%) were conducted in a food service setting, and 40 studies (30%) tested disinfection techniques. Despite a large body of related literature, there is very little evidence suggesting that either reusable or disposable food serviceware is safer for minimizing infectious risks. Pathogens can survive on various fomites, though greater surface porosity and higher humidity levels increase viability of most pathogens. There appear to be no major differences in pathogen viability on various fomites. There is a paucity of research that can specifically aid in developing policy or guidelines for appropriate use of reusable food serviceware. Though given recent studies on SARS-CoV-2, banning reusable bags and food serviceware is an inappropriate response to this particular pathogen, which is rarely spread through surface contact. Further research is needed that explicitly studies pathogen viability, transmission risks, and appropriate disinfection techniques for disposable and reusable food serviceware in order to devise effective sustainability policies.

Disinfectants efficacy in reducing pathogens related to health-care infection associated in universities hospitals of Gorgan, North of Iran

BackgroundDisinfection has a fundamental role in the control of pathogens in the hospital environment. This study was designed to assess the efficacy and functional impact of disinfectants in reducing pathogens related to healthcare associated infections (HAIs) in hospitals.MethodsThis observation study was conducted at three university hospitals in Gorgan, Iran, from May to Oct 2023. The data including used disinfectants and microbiological examination were obtained from the infection control unit of each hospital.ResultsThe results showed that a variety of disinfectants from intermediate to high levels were employed in accordance with the World Health Organization (WHO) protocols. The microbial result revealed that 31.6% (286 out of 906) of the sample had at least one microorganism. Among identified organisms, Bacillus spp. were the predominant species followed by Staphylococcus epidermis, fungus genera, Enterobacter spp., Enterococcus spp., Pseudomonas spp., Escherichia coli, Alcaligenes spp., Staphylococcus aureus, Citrobacter spp., Corynebacterium spp., Klebsiella spp., Acinetobacter spp., Micrococcus spp., Staphylococcus saprophyticus, and Serratias spp. The highest prevalence rates of microorganisms were observed in the wards of ICU, emergency, internal medicine, and women’s ward. The chi-square test revealed a significant relationship between the presence of organisms and hospital wards (P < 0.05).ConclusionThe presence of pathogens indicates a defect in the disinfection process, probably due to both little attention to disinfection protocols and multidrug resistance. It is not yet possible to eliminate pathogens from the hospital environment, but it can be minimized by education intervention, standardizing disinfecting processes, and monitoring by the infection control committee.

The environmental microbial retrieving assessment of cell-processing facilities for cell therapy in a hospital laboratory.

Cell therapy represents a promising treatment modality. A critical component in the production of cell therapy products is maintaining the sterility of cell therapy clean rooms (CTCRs). This study aimed to evaluate the environmental microbial load within CTCRs. We systematically monitored microbial load in CTCRs, following established guidelines. Cultured microbial samples underwent metagenomic sequencing, and alpha and beta diversity analyses, functional annotation, and resistance gene profiling were performed using various bioinformatics tools to assess microbial diversity and function. From November 2023 to January 2024, we collected 42 environmental microbial colony samples from various sources within the CTCR and performed metagenomic sequencing on 39 samples. Alpha diversity analysis revealed no significant differences among surface, settle_plate, and airborne categories, but significant disparities within surface subgroups were revealed. Beta diversity analysis showed notable differences between surface and airborne categories and among surface subgroups. Species distribution analysis identified Bacillus as the predominant genus on surfaces. Functional annotation and resistance gene analysis indicated distinct resistance patterns, with significant variations between subgroups, such as microscopes and transfer windows, and hands and other Grade_B environments. Resistance to hydrogen peroxide was notably higher in the transfer window group. These findings highlight the importance of stringent disinfection protocols and enhanced hand hygiene to maintain sterility in CTCRs. These findings provide valuable insights for implementing effective measures to maintain cleanliness throughout CTCRs. The annotation and study of resistance genes can help rapidly identify methods to control cellular contamination under circumstances of environmental microbial pollution.IMPORTANCEMaintaining the sterility of cell therapy clean rooms (CTCRs) is crucial for the production of safe and effective cell therapy products. Our study systematically evaluated the environmental microbial load within CTCRs, revealing significant microbial diversity and distinct resistance patterns to disinfection methods. These findings underscore the need for stringent disinfection protocols and enhanced hand hygiene practices to ensure CTCR sterility. By identifying key microbial species and their resistance genes, our research provides essential insights into controlling contamination and safeguarding the production environment, ultimately contributing to the reliability and success of cell therapy treatments.

Development of optimal indoor air disinfection and ventilation protocols for airborne infectious diseases.

Since the COVID-19 pandemic, there has been persistent emphasis on the importance of indoor air disinfection and ventilation in isolation units in the hospital environment. Nevertheless, no optimal and concrete disinfection protocol has been proposed to inactivate the viruses as quickly as possible. In this study, we experimentally evaluated various ventilation and disinfection protocols based on the combination of negative-pressure ventilation, ultraviolet (UV) light illumination, and Hypochlorous acid (HOCl) spray against three active virus species in a 3.5 cubic meters isolation unit. This small-size unit has gained attention during the pandemic due to the high demand for compact mobile laboratory systems capable of rapid disease diagnosis. In accordance with the WHO laboratory biosafety guidance, which states that all enclosed units where diagnostic work is conducted must ensure proper ventilation and disinfection activities, we aim to propose virus removal protocols for units compact enough to be installed within a van or deployed outdoor. The results confirmed the superiority (in terms of virus removal rate and time required) of the virus removal methods in the order of UV light, ventilation, and HOCl spray. Ultimately, we propose two optimal protocols: (i) UV light alone for three minutes, and (ii) UV light with ventilation for three minutes, followed by one-minute ventilation only. The time span of three minutes in the latter protocol is based on the clinical practice such that the medical staffs have a sufficient time to process the samples taken in transition to next patient to care.

Efficacy of different protocols of non-surgical periodontal therapy in patients with type 2 diabetes: A systematic review and meta-analysis.

The aim of the present systematic review of the literature and meta-analysis was to evaluate the efficacy of different protocols of NSPT without any adjunctive therapy in subjects with type 2 diabetes, by considering clinical and patient-centered outcomes. For the purposes of the study randomized controlled clinical trials with more than 3-month follow-up were searched in MEDLINE, EMBASE, and Cochrane Central. Then the articles were screened for inclusion and considered based on the protocols adopted, the outcome measure, follow-up, and the level of glycemic control. A total of 23 articles about 22 studies were included. NSPT was more effective than just oral hygiene measures/no treatment in reducing periodontal probing depth (PPD) and clinical attachment loss (CAL) at 3 months (0.47 mm [0.29-0.65 mm] and 0.50 mm [0.24-0.76 mm], respectively) and 6 months (0.56 mm [0.28-0.84 mm] and 0.45 mm [0.13-0.77 mm], respectively for PPD and CAL) follow-up (very low and low level of evidence). The meta-analysis found no evidence of a difference between full-mouth disinfection versus quadrant protocol clinical outcomes (very low level of evidence). One study found no evidence of a difference in periodontal clinical response between good versus poor glycemic control. Based on the results of the present research NSPT protocols could be considered more efficacious than others in terms of clinical outcomes in subjects with type 2 diabetes. Moreover, NSPT resulted in efficacious improvement of periodontal parameters and HbA1c levels compared to no treatment or oral hygiene instructions alone.