Hospital Disinfection Research Articles

MODERN APPLICATIONS OF OZONE FOR COVID-19 DISINFECTION AND TREATMENT

Coronavirus disease 2019 represents a serious challenge for modern society worldwide because of the considerable and unfavourable consequences of the pandemic in terms of human health, economics and social life. In the present concise survey, some essential peculiarities of ozone as disinfecting and therapeutic means under the conditions of COVID-19 pandemic as reflected in the recent literature are described. Particularttention is paid to modern hospital disinfection means and methods. Ozone exerts antiviral activity through the inhibition of viral replication and direct inactivation of viruses by interfering with the virus replication phase and attacking capsid proteins. Ozone therapy is very inexpensive and may safely exploit the critical vulnerability in COVID-19.

Optimal control analysis for a Candida auris nosocomial infection model with environmental transmission

In this paper, we propose a mathematical model to investigate the role of environmental reservoirs in the transmission dynamics of the rising Candida auris infections in nosocomial settings. The ability of the pathogen to resist commonly used hospital disinfectants ensures its persistent contamination of hospital surfaces and medical equipment readily leading to patient colonization. Colonized patients shed the pathogen into their surroundings thereby increasing the fungal concentration in the hospital environment. We analyze the model for its basic mathematical properties, perform sensitivity analysis, and formulate an optimal problem to determine the efficiency of control interventions, namely, standard transmission precautions, proper laboratory identification, and isolation of patients identified with colonization in reducing the contamination and transmission of C. auris infections. We characterize the optimal controls using Pontryagin's Minimum Principle and further prove the uniqueness of the optimality system. Numerical simulations are performed to substantiate the theoretical analysis, and the results are illustrated graphically.

Potassium Linoleate (Isomerized) Satisfies the United States Environmental Protection Agency MB-05-16 for Hospital Disinfectant on Hard, Non-porous Surfaces.

Potassium conjugated linoleic acid or potassium linoleate (isomerized), 86 mM, satisfies the United States Environmental Protection Agency protocol hospital disinfectant for non-porous surfaces MB-05-16 with one-minute treatment. This stringent protocol requires separate preparations of Staphylococcus aureus (American Type Culture Collection 6538) and Pseudomonas aeruginosa (American Type Culture Collection 15442) unstirred for 48 hours, submerging 10 mm polished cylinders in the culture, and placing for 45 minutes in a 37°C humidified chamber before treating. Since potassium linoleate (isomerized) also satisfies the United States Environmental Protection Agency protocol MB-35-00 for Candida auris, this study establishes potassium linoleate (isomerized) as an effective cross-kingdom antimicrobial plant salt, soap, or cleanser. We affirm the need for formal post-treatment plating on agar to establish efficacy and not rely on OD600 when testing for antimicrobial capacity. Aqueous dilution of the soap causes variable opalescence making optical density an unreliable marker for antimicrobial efficacy.

Focused multivector ultraviolet (FMUV) technology rapidly eradicates SARS-CoV-2 in-vitro: Implications for hospital disinfection of COVID-19 environments

Focused Multivector Ultraviolet technology rapidly killed the SARS-CoV-2 coronavirus in-vitro. Plates were inoculated with a mean of greater than 106 plaque forming units of USA-WA1 Washington index patient strain of SARS-CoV-2 and exposed to ultraviolet, resulting in mean reductions of 99.99% within 30 seconds, 99.999% within 60 seconds, and 99.9999% within 90 seconds. These results support the effectiveness of Focused Multivector Ultraviolet technology for SARS-CoV-2 disinfection.

Antibiotic Profile of Pathogenic Bacteria Isolated from Postsurgical Site Infections in Public Hospitals in Northern Jordan.

BackgroundSurgical site infections are hospital-acquired, vary from one hospital to another, and can cause significant postoperative morbidity, mortality, and prolonged hospital stay.ObjectiveThe main aim of the study was to identify the bacterial pathogens associated with surgical site infections and their antibiotic susceptibility in a public hospital in northern Jordan.MethodsPostsurgical wound samples were collected and processed in a microbiology laboratory using standard microbiological techniques. Antibiotic susceptibility tests were performed using 13 antibiotics covering the gram-positive and gram-negative bacteria using the disc diffusion test.ResultsThe bacterial species that were identified in this study include Escherichia coli 8 (29%), Pseudomonas aeruginosa 3 (11%), Proteus mirabilis 1 (3.5%), Klebsiella pneumoniae 4 (14%), Salmonella enterica 2 (7%), Staphylococcus aureus 8 (29%), Staphylococcus epidermidis 1 (3.5%), and Streptococcus pyogenes 1 (4%). The antibiotic profiles of these bacteria showed high resistance. The MAR indices showed that 17 of 28 bacteria isolated were above 0.2 indicating high resistance.ConclusionResistant bacteria are becoming more dominant in wound infections with a high prevalence of multidrug resistant isolates. Hospital disinfection and treatment protocols regarding the use of antibiotics should be practiced vigorously and monitored regularly to combat resistance.

Implementation of Environmental Sanitation and Disinfection in Hospitals to Reduce the Spread of Covid19: A Literature Review

Introduction: SARS-CoV-2 is a new variant of virus that attacks the human respiratory tract which was declared by WHO as a Covid19 pandemic. Covid19 transmission through solid surfaces, air, and waste occurring in hospital areas require disinfection and sanitation monitoring to ensure that new clusters are not created and outpatients are not infected with the SARS-CoV-2 virus in hospitals. Discussion: Using literature review method, 11 relevant articles that meet the inclusion criteria were selected. In the results of the study, there was a collection of samples in the solid surfaces, air and waste in both medical and non-medical areas containing SARS-CoV-2 RNA. The common objects where SARS-CoV-2 was discovered include doorknobs, toilet bowls, toilet flush buttons, and medical devices. In non-medical areas, the objects include computer keyboards, mice, and monitors. Chlorine-based disinfection for surfaces, monitoring in environmental sanitation by changing pillow and bedsheets and cleaning tables regularly were subsequently implemented. Conclusion: The implementation of environmental sanitation and disinfection is effective in eliminating the SARS-CoV-2 virus in hospitals. Studies indicated that disinfection is 95% to 99.99% effective in eliminating the SARS-CoV-2 virus. In addition, the SARS-CoV-2 virus was not discovered in isolation rooms but was located in other public hospital areas.

Determination of Resistance of Enterococcal Isolates to Common Chemicals used for Disinfection in Homes and Hospitals

Aim: To determine the resistance Enterococcal isolates to common chemical agents used for disinfection in homes and hospitals.
 Place and Duration of the Study: Enugu State University of Technology (ESUT) Teaching Hospital, Parklane and University of Nigeria Teaching Hospital (UNTH), Ituku Ozalla, Enugu State, Nigeria, between July 2012 and June 2014.
 Methods: The study analysed antimicrobial products such as Dettol, Hibitane and Jik. Identification of the organism was based on standard procedure and biochemical test.
 Results: All the three representative isolates, E. facium, E. faecalis and E. avium showed luxuriant growth with optical density (OD) range of 0.31 to 0.35 at Sodium Chloride concentration of 0.5%. The growth (OD) reduced as the salt concentration increased. E. faecium, E. faecalis and E. avium showed no growth at the concentration of 10%. Dettol had MIC of 0.385 mg/ml and MBC of 0.75 mg/ml on E. faecium; MIC of 0.75 mg/ml and MBC of 1.5 mg/ml on E. faecalis; MIC of 0.193 mg/ml and MBC of 0.385 mg/ml on E. avium. Hibitane had MIC of 0.781 mg/ml and MBC of 1.568 mg/ml on E. faecium; MIC of 1.563 mg/ml and MBC of 3.125 mg/ml on E. faecalis; MIC of 0.781 mg/ml and MBC of 1.563 mg/ml on E. avium. Jik had an MIC of 0.547 mg/ml and MBC of 1.094 mg/ml on E. faecium; MIC of 1.094 mg/ml and MBC of 2.188 mg/ml on E. faecalis; MIC of 0.547 mg/ml and MBC of 1.094 mg/ml on E. avium.
 Conclusion: The growth of the isolates reduced as the salt concentration increased. The MICs and MBCs values from this study showed that these disinfectants are effective against Enterococci sp. in the following order; Dettol (Chloroxylenol), Jik (sodium hypochlorite) and Habitane (Chlorhexidine gluconate). The study therefore showed that concentration of various disinfectants/antiseptics used in hospital settings, medical laboratory section and at home should be of paramount interest for safe elimination of Enterococci.

ARE THE DISINFECTANTS USED IN HOSPITALS ALSO EFFECTIVE ON BACTERIA THAT CAUSE NOSOCOMIAL INFECTIONS?: A UNIVERSITY HOSPITAL INVESTIGATION

Objective: Determining the disinfectant activity regularly will result in proper disinfection. In our study, it was aimed to determine the efficacy, effective concentrations and durations of some disinfectants used in Trakya University Hospital against nosocomial bacteria isolated from the same center. Material and Method: MRSA, VRE, Klebsiella pneumoniae and Acinetobacter baumannii isolates and 10 different disinfectants supplied from the same center were included in the study. Susceptibility tests and Qualitative Suspension Test were applied through the guidelines of CLSI M100-S25 and TS/EN/1040:2005 (formerly TS/EN/1040:1999), respectively. Qualitative Suspension Test was modified by using D/E Neutralizing Broth instead of adding a neutralizing agent. Result and Discussion: As a result, it was determined that all isolates were susceptible in the application conditions. However, peracetic acid, sodium dichloroisocyanurate, non-ionic active agent and sodium hypochlorite containing disinfectants being used in the hospital were not effective against some strains isolated from the hospital. Even the resistance of a single isolate to the application conditions of a disinfectant may lead to selection and proliferation of the strains and this may cause hospital infections. Our results might provide a reference to indicate the importance of selecting appropriate disinfectants and appropriate conditions for cleaning and disinfection in hospitals.

Review of modern methods for reducing nosocomial infection in the operating room and air disinfection in surgical hospitals in the healthcare organization of the Russian Federation

Review of modern methods for reducing nosocomial infection in the operating room and air disinfection in surgical hospitals in the healthcare organization of the Russian Federation

Research on the Application Effect of Risk Management in Hospital Disinfection Supply Room and Its Influence on the Qualified Rate

Research on the Application Effect of Risk Management in Hospital Disinfection Supply Room and Its Influence on the Qualified Rate

Effect of a UV-C Automatic Last-Generation Mobile Robotic System on Multi-Drug Resistant Pathogens.

Background: Healthcare-associated infections caused by multi-drug resistant (MDR) pathogens are associated with increased mortality and morbidity among hospitalized patients. Inanimate surfaces, and in particular high-touch surfaces, have often been described as the source for outbreaks of nosocomial infections. The present work aimed to evaluate the efficacy of a last-generation mobile (robotic) irradiation UV-C light device R2S on MDR microorganisms in inanimate surfaces and its translation to hospital disinfection. Methods: The efficacy of R2S system was evaluated in environmental high-touch surfaces of two separate outpatient rooms of Perugia Hospital in Italy. The static UV-C irradiation effect was investigated on both the bacterial growth of S. aureus, MRSA, P. aeruginosa, and K. pneumoniae KPC and photoreactivation. The antimicrobial activity was also tested on different surfaces, including glass, steel, and plastic. Results: In the environmental tests, the R2S system decreased the number of bacteria, molds, and yeasts of each high-touch spot surface (HTSs) compared with manual sanitization. UV-C light irradiation significantly inhibits in vitro bacterial growth, also preventing photoreactivation. UV-C light bactericidal activity on MDR microorganisms is affected by the type of materials of inanimate surfaces. Conclusions: The last-generation mobile R2S system is a more reliable sanitizing procedure compared with its manual counterpart.

Virucidal effect of povidone-iodine against SARS-CoV-2 in vitro.

ObjectiveTo evaluate the antiviral activity of the oral disinfectant povidone-iodine (PVP-I) against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV2) in vitro.MethodsThe cytotoxic effects of PVP-I were determined in Vero and Calu-3 cell lines using that by Cell Counting Kit-8 assay. Viral load in the cell culture medium above infected cells was quantitated using real-time polymerase chain reaction. The cytopathic effect (CPE) and viral infective rate were observed by immunofluorescence microscopy.ResultsPVP-I at a concentration >0.5 mg/ml in contact with SARS-CoV-2 for 30 s, 1 min, 2 min and 5 min showed up to 99% viral inhibition. For in vitro testing, upon exposure for 1 min, PVP-I showed a virucidal effect. PVP-I had no cytotoxic effects at the range of concentrations tested (0.125–1 mg/ml; CC50 > 2.75 mM) in Vero and Calu-3 cells.ConclusionThese results demonstrate that the ideal contact time was 1 min and the optimal concentration was 1 mg/ml, which provides an experimental basis for the use of oral disinfectants in dental hospitals.

The Environmental Deposition of Severe Acute Respiratory Syndrome Coronavirus 2 in Nosocomial Settings: Role of the Aerosolized Hydrogen Peroxide

BackgroundData on the role of aerosolized hydrogen peroxide (AHP) systems in the control of the COVID-19 pandemic are still emerging. This study provides evidence of the environmental shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the hospital environment, and the efficacy of AHP to eliminate it.MethodsA total of 324 environmental sites (224 surfaces and 100 air samples) belonging to 54 patient rooms were contextually collected and tested for genes of SARS-CoV-2 using RT-PCR assays and Xpert® Xpress SARS-CoV-2.ResultsThe SARS-CoV-2 viral genome was detected in seven sites (2.5%) of three patients’ rooms, including six highly touched surfaces and one air sample. Viral shedding was directly related to the distance from the patient, with 1, 1.9, and 3.5% of samples testing positive at 3, 2, and 1 meter, respectively (P-value=0.02). None of the sites showed the viral genome following application of 6% AHP. Of note, the viral genome was detected at 2 meters of a mildly symptomatic case on a face mask in the absence of aerosol generating procedures.ConclusionOur data support the possible role of the hospital environment as a source of infection, and the efficacy of AHP to eliminate the virus. Further studies are needed to address the viability of the pathogen in these nosocomial sites and the cost-effectiveness of routine hospital disinfection procedures using AHP for SARS-CoV-2.

Discussion of the Effect of Hierarchical Management Mode on the Work Quality of Hospital Disinfection Supply Room

Discussion of the Effect of Hierarchical Management Mode on the Work Quality of Hospital Disinfection Supply Room

An emerging innovative UV disinfection technology: virucide activity on SARS-CoV-2

Abstract Background Surface sanitation is one of the key points to reduce the risk of transmission both in healthcare and other public spaces. UV-C is already used in hospital and laboratory's disinfection procedure furthermore some recent studies show effectiveness on SARS-CoV-2. UV-C may be generated by Lamps and Light Emitting Diode, but novel sources are emerging. The aim of the study was to test a device having UV chips for inactivating SARS-CoV2. Methods The descriptive study was conducted in the period between June and July 2019, in laboratories of the University of Siena and of the scientific park of Toscana life sciences. The device, shaped in a rectangular box, contained six UV chips (10 mW each, with a peak at 264nm nm ranging from 260 to 350 nm) placed in the bottom. Central and short side long positions were tested expecting different dose levels. Each experiment was conducted in triplicate, with and without the device lid, at 3, 6 and 10 minutes. All repetitions were tested for SARS-CoV-2 having a virus suspension of 10^7.2. Results The zones with the higher value of irradiance (max 187.9 µW/cm2) were near the corners of the box, while the lowest (min 61.9 µW/cm2) near one of the long sides. The light distribution was almost symmetrical. The tests revealed a viral charge reduction from an initial concentration of virus suspension of 10^7.2 TCID50/mL, of more than 99.9% after 3 minutes of UV exposure; at 6 minutes, the minimum Log10 attenuation value was over 5 Log10(99,999%); the maximum detectable attenuation value of Log10 = 5.7 was measured at 10 minutes. Conclusions This device is the first one which introduces this novel UV chip source, similarly it is the first time it was tested against the SARS-CoV-2. Objects that need to be disinfected may benefit of such devices according a proper exposition time for homogeneous disinfections of the surfaces. Key messages Implementation of cleaning and disinfection devices has been shown to reduce Sars-cov-2 infection incidence. In the hospital sanitation field, but also in public places and homes, using viable alternatives as UV-C can contribute to the reduction of pandemic spread.

A Smart Sterilization Robot System With Chlorine Dioxide for Spray Disinfection

The highly infectious and serious nature of coronavirus disease 2019 (COVID-19) has highlighted the need for hospital space disinfection technology and the prevention of human exposure to pathogenic environments. This research developed novel chlorine dioxide (ClO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> ) sterilization technology to reduce bacteria and viruses in the air and on surfaces. A smart sterilization robot system was also developed to spray disinfectants in operating theaters or patients’ rooms, designed according to the results of controlled experiments and the requirements for hospital disinfection. The system was built incorporated a semi-automatic remote-controlled module and an automatic intelligent disinfection function; that is, it could operate independently according to specific epidemic prevention strategies, which were implemented using a combination of Internet of Things (IoT) applications and a gesture recognition function. The elimination of Escherichia coli ( <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">E. coli</i> ) bacteria on sample plates was 99.8 % effective. This paper reviews the evolution of various disinfection technologies and describes a disinfection robot system in detail.

Acetic Acid Versus Chlorine Tablet Solution as Disinfectant of Non-Critical Environmental Surfaces

Objectives: This study aims to determine the bactericidal activity of 4% acetic acid versus chlorine tablets against gram negative and gram-positive microorganisms based on percentage reduction of microorganisms in hospital surfaces and suggest that it may be an effective alternative disinfectant. Methodology: This was an experimental study where microbiological sampling of hospital surfaces was used to determine bacterial growth. The study was conducted from November to December 2020 at National Children’s Hospital, a 200 bed capacity tertiary government hospital catering to children 0 to less than 19 years old. Non-critical hospital surfaces such as beds, bed rails and bedside tables were swabbed before and after intervention cleaning with chlorine tablets or 4% acetic acid solution. Result: Pre-swabbing, hospital surfaces showed the presence of Bacillus sp., Klebsiella pneumoniae and Coagulase Negative Staphylococcus (CONS). Post-application of 4% acetic acid solution resulted to 100% reduction of Bacillus sp., 70.8% reduction of CONS, and 19.5% reduction of Klebsiella pneumoniae while post-application of chlorine tablet solution showed 100% reduction of Klebsiella pneumoniae and CONS and 95.2% reduction of Bacillus species. Conclusion: The use of 4% acetic acid solution significantly reduced more gram-positive than gram-negative organisms and is a highly effective disinfectant against Bacillus sp. but is not effective against gram-negative organisms as it does not fulfil the criteria of at least 90 percent reduction in bacterial growth. Chlorine tablet solution is a more effective disinfectant against gram-negative organisms than gram-positive organisms. Acetic acid 4% solution is not an effective alternative disinfectant to chlorine tablet solution, the currently used hospital disinfectant, but maybe used as an adjunct for better reduction of hospital environmental pathogens.

Common Problems and Relevant Nursing Countermeasures of Hand Cleaning Endoscope Instruments in Hospital Disinfection Supply Room

Common Problems and Relevant Nursing Countermeasures of Hand Cleaning Endoscope Instruments in Hospital Disinfection Supply Room

Fighting Antibiotic Resistance in Hospital-Acquired Infections: Current State and Emerging Technologies in Disease Prevention, Diagnostics and Therapy.

Rising antibiotic resistance is a global threat that is projected to cause more deaths than all cancers combined by 2050. In this review, we set to summarize the current state of antibiotic resistance, and to give an overview of the emerging technologies aimed to escape the pre-antibiotic era recurrence. We conducted a comprehensive literature survey of >150 original research and review articles indexed in the Web of Science using “antimicrobial resistance,” “diagnostics,” “therapeutics,” “disinfection,” “nosocomial infections,” “ESKAPE pathogens” as key words. We discuss the impact of nosocomial infections on the spread of multi-drug resistant bacteria, give an overview over existing and developing strategies for faster diagnostics of infectious diseases, review current and novel approaches in therapy of infectious diseases, and finally discuss strategies for hospital disinfection to prevent MDR bacteria spread.

Ultraviolet C lamps for disinfection of surfaces potentially contaminated with SARS-CoV-2 in critical hospital settings: examples of their use and some practical advice

BackgroundUltraViolet-C (UV-C) lamps may be used to supplement current hospital cleaning and disinfection of surfaces contaminated by SARS-CoV-2. Our aim is to provide some practical indications for the correct use of UV-C lamps.MethodsWe studied three UV-C lamps, measuring their spatial irradiance and emission over time. We quantify the error that is committed by calculating the irradiation time based exclusively on the technical data of the lamps or by making direct irradiance measurements. Finally, we tested specific dosimeters for UV-C.ResultsOur results show that the spatial emission of UV-C lamps is strongly dependent on the power of the lamps and on the design of their reflectors. Only by optimizing the positioning and calculating the exposure time correctly, is it possible to dispense the dose necessary to obtain SARS-CoV-2 inactivation. In the absence of suitable equipment for measuring irradiance, the calculated irradiation time can be underestimated. We therefore consider it precautionary to increase the calculated times by at least 20%.ConclusionTo use UV-C lamps effectively, it is necessary to follow a few simple precepts when choosing, positioning and verifying the lamps. In the absence of instruments dedicated to direct verification of irradiance, photochromic UV-C dosimeters may represent a useful tool for easily verifying that a proper UV-C dose has been delivered.