Disinfection Protocols Research Articles

The microbiological load and microbiome of the Dutch dental unit; ‘please, hold your breath’

Dental unit water systems are prone to biofilm formation. During use of the dental unit, clumps of biofilm slough off and can subsequently be aerosolized and inhaled by both patient and staff, potentially causing infections. The aim of this study was to determine the microbial load and microbiome of dental unit water, in the Netherlands, and the factors influencing these parameters. In total, 226 dental units were sampled and heterotrophic plate counts (HPC) were determined on the traditional effluent sample. Of all dental units, 61% exceeded the recommended microbiological guidelines of 100 colony forming units per milliliter. In addition, the microbiome, with additional q-PCR analysis for specific species, was determined on an effluent sample taken immediately after an overnight stagnancy period, in which the biofilm is in its relaxed state. These relaxed biofilm samples showed that each dental unit had a unique microbiome. Legionella spp., amoeba and fungi were found in 71%, 43% and 98% of all units, respectively. The presence of amoeba was positively associated with nine bacterial biomarkers and correlated positively with bacterial and fungal DNA and Legionella spp. concentrations, but not with HPC. Only when adhering to disinfection protocols, statistically significant effects on the microbial load and microbiome were seen. The relaxed biofilm sample, in combination with molecular techniques gives better insight in the presence of opportunistic pathogens when compared to the heterotrophic plate counts. Infection control measures should focus on biofilm analysis and control in order to guarantee patient safety.

What is the relationship between indoor air quality parameters and airborne microorganisms in hospital environments? A systematic review and meta-analysis.

Airborne microorganisms in hospitals have been associated with several hospital-acquired infections (HAIs), and various measures of indoor air quality (IAQ) parameters such as temperature, relative humidity, carbon dioxide (CO2 ), particle mass concentration, and particle size have been linked to pathogen survival or mitigation of pathogen spread. To investigate whether there are quantitative relationships between the concentration of airborne microorganisms and the IAQ in the hospital environment. Web of Science, Scopus and PubMed databases were searched for studies reporting airborne microbial levels and any IAQ parameter(s) in hospital environments, from database inception to October 2020. Pooled effect estimates were determined via random-effects models. Seventeen of 654 studies were eligible for the meta-analysis. The concentration of airborne microbial measured as aerobic colony count (ACC) was significantly correlated with temperature (r=0.25 [95% CI=0.06-0.42], p=0.01), CO2 concentration (r=0.53 [95% CI=0.40-0.64], p˂0.001), particle mass concentration (≤5µg/m3 ; r=0.40 [95% CI=0.04-0.66], p=0.03), and particle size (≤5 and ˃5µm), (r=0.51 [95% CI=0.12-0.77], p=0.01 and r=0.55 [95% CI=0.20-0.78], p=0.003), respectively, while not being significantly correlated with relative humidity or particulate matter of size >5µm. Conversely, airborne total fungi (TF) were not significantly correlated with temperature, relative humidity, or CO2 level. However, there was a significant weak correlation between ACC and TF (r=0.31 [95% CI=0.07-0.52], p=0.013). Although significant correlations exist between ACC and IAQ parameters, the relationship is not definitive; the IAQ parameters may affect the microorganisms but are not responsible for the presence of airborne microorganisms. Environmental parameters could be related to the generating source, survival, dispersion, and deposition rate of microorganisms. Future studies should record IAQ parameters and factors such as healthcare worker presence and the activities carried out such as cleaning, sanitizing, and disinfection protocols. Foot traffic would influence both the generation of microorganisms and their deposition rate onto surfaces in the hospital environment. These data would inform models to improve the understanding of the likely concentration of airborne microorganisms and provide an alternative approach for real-time monitoring of the healthcare environment.

Implementation of measures to improve blood collection center employee safety and reduce callouts during the 2019 novel coronavirus pandemic.

BackgroundBlood collection center (BCC) employees are essential workers during the COVID‐19 pandemic. The employee callout rate, defined as the percentage of scheduled employees unable to report to work for any cause including COVID‐19 illness or asymptomatic quarantine, was tracked to determine the impact of safety measures including social distancing, masks, enhanced disinfection protocols, and temperature screening.Study design and methodsA contact tracing and quarantine program was implemented for all employees, followed by additional safety measures including social distancing, masks, enhanced disinfection protocols, and temperature screening. The weekly callout rate was tracked nationally for 19,517 BCC employees over 9 months, from March to December 2020.ResultsWeekly employee callout rates increased after implementation of the contact tracing program due to asymptomatic employees placed into COVID‐19‐related quarantine. Mobile collections callouts increased by nearly fivefold the pre‐pandemic baseline within the first 4 weeks, peaking at 9.7% in early April. Peaks for fixed site collections (5.0%) and manufacturing (6.7%) occurred nearly simultaneously. Shortly after implementation of all safety measures, the weekly callout rate declined for all three employee groups and has remained relatively stable with a mean callout rate of 4.3% for mobile collections, 2.4% for fixed site collections, and 3.7% for manufacturing despite further increase in new COVID‐19 cases in the United States.ConclusionCallouts for BCC employees during the COVID‐19 pandemic initially increased, but subsequently declined and stabilized after implementation of safety measures. Since multiple interventions were implemented simultaneously, it is not possible to determine the individual impact of each measure on callout rate.

Current practice of anesthetic equipment disinfection in the University of Gondar Comprehensive Specialized Hospital, 2020: a cross sectional study

Background: Anesthetic equipments undeniably occupy prime importance in clinical practice. However, their importance falls into question if they are not appropriately prepared and handled. Objectives: The objective of this audit was to assess the current practice of anesthetic equipment disinfection in comprehensive specialized hospital. Methods: An observational study was conducted. A total of 70 patients were operated during the study period and data was analyzed using Microsoft Excel as well as descriptive statistics was used. Results: Around 94.2% of anesthetists followed only the first step of disinfecting laryngoscope blade and 74.2% of anesthetists stored both the laryngoscope blade and handle appropriately but the rest of the steps were performed poorly and none of the anesthetists applied alcohol for both blade and handle disinfection. All anesthetists immersed the endotracheal tube or laryngeal mask airway in high level disinfection solution and then rinse them with water. However, none of the anesthetists were applied around 6 of the process of disinfecting these equipments. Regarding face mask, only 4 (5.7%) of the anesthetists washed the anesthetic face mask with soap and 2 (2.8%) stored it safely for further use but none of them used alcohol to disinfect this equipment. Conclusions: Even if all of the anesthetic equipments disinfection process needs improvement, special attention should be given to laryngoscope disinfection protocol since this equipment is being used frequently between patients as well as changing the high level disinfectant solution every 24 hours because more than this hour the solution cannot be used as disinfectant and finally we recommend that all anesthetists should follow the standards of anesthetic equipment disinfection process.

A Longitudinal Seroprevalence Study Evaluating Infection Control and Prevention Strategies at a Large Tertiary Care Center with Low COVID-19 Incidence

Personal protective equipment and adherence to disinfection protocols are essential to prevent nosocomial severe acute respiratory syndrome coronavirus (SARS-CoV-2) transmission. Here, we evaluated infection control measures in a prospective longitudinal single-center study at the Vienna General Hospital, the biggest tertiary care center in Austria, with a structurally planned low SARS-CoV-2 exposure. SARS-CoV-2-specific antibodies were assessed by Abbott ARCHITECT chemiluminescent assay (CLIA) in 599 health care workers (HCWs) at the start of the SARS-CoV-2 epidemic in early April and two months later. Neutralization assay confirmed CLIA-positive samples. A structured questionnaire was completed at both visits assessing demographic parameters, family situation, travel history, occupational coronavirus disease 2019 (COVID-19) exposure, and personal protective equipment handling. At the first visit, 6 of 599 participants (1%) tested positive for SARS-CoV-2-specific antibodies. The seroprevalence increased to 1.5% (8/553) at the second visit and did not differ depending on the working environment. Unprotected SARS-CoV-2 exposure (p = 0.003), positively tested family members (p = 0.04), and travel history (p = 0.09) were more frequently reported by positively tested HCWs. Odds for COVID-19 related symptoms were highest for congestion or runny nose (p = 0.002) and altered taste or smell (p < 0.001). In conclusion, prevention strategies proved feasible in reducing the risk of transmission of SARS-CoV-2 from patients and among HCWs in a low incidence hospital, not exceeding the one described in the general population.

Assessment of Prehospital Monitor/Defibrillators for Clostridioides difficile Contamination.

The purpose of this study was to determine if Clostridioides difficile (C. diff) was present on the electrocardiogram (ECG) right arm leads, blood pressure cuffs, and fingertip pulse oximetry sensors of monitor/defibrillators used in the prehospital setting. On March 22, 2019, a total of 20 prehospital monitor/defibrillators located at an Emergency Medical Service (EMS) station in Alabama (USA) were assessed for C. diff. The inside area of the fingertip pulse oximetry sensor, patient contact side of the blood pressure cuff, and right arm ECG lead of monitor/defibrillators (n = 60) were swabbed using a sterile cotton-tipped applicator saturated in a 0.85% Sodium Chloride solution. These cotton-tipped applicators were then inserted, scored, and released into Banana Broth vials. The vials were then sealed tightly and immediately transported to the laboratory, where they were incubated at 36°C for 72 hours. Colorimetric change from red to yellow was considered a positive indication for the presence of C. diff. Of 20 blood pressure cuffs, 15 had C. diff contamination (75%); C. diff was also present on 19 of 20 fingertip pulse oximeter sensors (95%) and 20 of 20 ECG right arm monitor leads (100%). Prehospital monitor/defibrillators may represent a significant reservoir of C. diff and other pathogenic bacteria. Improved disinfection protocols for reusable monitoring equipment and transition to disposable monitoring equipment used in the prehospital setting may reduce the risk of patient and EMS provider infection.

Patient Safety Related to Microbiological Contamination of the Environment of a Multi-Profile Clinical Hospital.

Nosocomial infections pose a serious burden for hospitals, patients, and the entire society. The aim of the study was to assess the microbiological cleanliness of the hospital environment through quantitative and qualitative analysis of microbiological contamination of air and surfaces in inpatient treatment facilities, based on the example of a large clinical hospital in Poland. Data were collected between 2012 and 2018 in premises of a large teaching hospital in Gdansk using the sedimentation method and the impact method using the Aerideal apparatus (Biomerieux). In the analyzed clinical center, the microbiological cleanliness tests in most of the hospital rooms in the analyzed period showed an acceptable number of saprophytic microorganisms. Of all the tested samples, 1159 (21.8%) were positive, indicating the presence of microorganisms in the tested sample. Species potentially pathogenic for hospital patients were identified, constituting 20.8% of all positive samples (4.6% of all samples). Significantly higher proportion of microorganisms potentially dangerous to patients were isolated from sanitary facilities. Due to the potentially pathogenic microorganisms detected in the tested samples, the authors suggest that in the analyzed hospital, the areas requiring a specific level of microbiological purity should be designated and described, with [specifically] defined cleaning and disinfection protocols.

Elastomeric Silicone Sponges for Bleach Delivery

Topical disinfection protocols to inactivate organisms, particularly on high contact surfaces, have become increasingly important. A classical oxidative agent, sodium hypochlorite (bleach), has many benefits, but can be problematic during applications because of its ability to oxidize the organic polymers in which it is contained. We demonstrate that bleach-containing elastomeric sponges are readily created in one step at room temperature from thiopropyl-modified silicone oils; sodium hypochlorite induces disulfide cross-linking and a foam structure due, in part, to the concomitant formation of sulfonates. No surfactants are required. The morphology of the bleach-containing silicone sponge is tunable by the aqueous bleach solution concentration and the water/silicone ratio used. The resulting silicone sponge contains excess bleach that can be released gradually, as shown by its ability to oxidize organic molecules in aqueous solution, either directly or after dehydration/rehydration; the latter process provides a way to store the bleach-containing material in dry form. Such foams exhibit enhanced sustainability as, we show, they can be converted back to thiopropylsilicone oils by reduction using hydrosilicones. The resulting oils can be re-cross-linked, completing the life cycle.

How Can We Handle Pandemic in the Dentistry and Prosthetic Clinic? Recommendations and New Approaches

To display an overall review of present literature concerning coronavirus disease and dentistry as it is a matter of global concern, necessitate an alteration in dental and laboratory fields; and suggested sterilization schedules in current issue. Many recommendations have been suggested to handle many prosthodontic measures and effects of currently pandemic on prosthodontic applications, research, and learning. Comprehensive electronic search of literature related to Covid-19 and dentistry was inspected including different database articles. Various guidelines recommended by several international and national institutions and organizations such as World Health organization (WHO), and different Prosthodontics societies were included to gather the required information pertaining to possible source of spread of Covid-19 in Prosthodontics order regarding patient management and clinical strategies. The Covid-19 initiates the need to arrange a balanced program during protecting the dental professionals and treating patients at the same time. Strict application of guidelines and disinfection protocols should be evaluated with risk/advantages ratio assessment to conflict such un-matched pandemic disease.

In Vitro Preformed Biofilms of Bacillus safensis Inhibit the Adhesion and Subsequent Development of Listeria monocytogenes on Stainless-Steel Surfaces.

Listeria monocytogenes continues to be one of the most important public health challenges for the meat sector. Many attempts have been made to establish the most efficient cleaning and disinfection protocols, but there is still the need for the sector to develop plans with different lines of action. In this regard, an interesting strategy could be based on the control of this type of foodborne pathogen through the resident microbiota naturally established on the surfaces. A potential inhibitor, Bacillus safensis, was found in a previous study that screened the interaction between the resident microbiota and L. monocytogenes in an Iberian pig processing plant. The aim of the present study was to evaluate the effect of preformed biofilms of Bacillus safensis on the adhesion and implantation of 22 strains of L. monocytogenes. Mature preformed B. safensis biofilms can inhibit adhesion and the biofilm formation of multiple L. monocytogenes strains, eliminating the pathogen by a currently unidentified mechanism. Due to the non-enterotoxigenic properties of B. safensis, its presence on certain meat industry surfaces should be favored and it could represent a new way to fight against the persistence of L. monocytogenes in accordance with other bacterial inhibitors and hygiene operations.

Bonding of an ion-releasing restorative material to caries-affected dentin disinfected with photodynamic therapy, Er,Cr:YSGG laser, and chemical disinfectants.

The study aimed to evaluate the microtensile bond strength (μTBS) of giomer, an ion-releasing restorative material, to caries-affected dentin (CAD) when different cavity disinfectant protocols were applied before the restoration. Thirty extracted non-carious human third molars were embedded in acrylic resin. The occlusal portions of the samples were excised using an IsoMet saw. After creating artificial caries, samples were divided into six groups (n = 12): sound dentin with no disinfection (Group SD), CAD with no disinfection (Group CAD), CAD disinfected with 2% chlorhexidine gluconate (Group CHX), CAD disinfected with 6% NaOCl (Group NaOCl), CAD disinfected with photodynamic therapy with methylene blue photosensitizer (Group PDT), and CAD disinfected with Er,Cr:YSGG (Group ECYL). Following disinfection protocols, the universal adhesive was applied, and all samples were restored using giomer. Subsequently, μTBS analyses were performed, and data were analyzed statistically. The highest μTBS values were obtained from the SD and CAD groups, which exhibited no statistical differences (p > 0.05). The PDT and ECYL groups had higher μTBS values compared with the CHX and NaOCl groups (p < 0.05), and all disinfection protocols decreased the bond strength to CAD (p < 0.05). The microtensile bond strength of disinfected CAD was greater with Er,Cr:YSGG laser and photodynamic therapy treatment than with chemical disinfectants. Giomer may enhance the bond strength to CAD, which has a weaker bonding potential than sound dentin due to structural differences. However, disinfection protocols adversely affect adhesion between the restorative material and CAD.

Antimicrobial resistance in commensal Escherichia coli and Enterococcus spp. is influenced by production system, antimicrobial use, and biosecurity measures on Spanish pig farms

BackgroundAntimicrobial resistance (AMR) is a global public health threat consequence of antimicrobial use (AMU) in human and animal medicine. In food-producing animals factors such as management, husbandry or biosecurity may impact AMU. Organic and extensive Iberian swine productions are based on a more sustainable and eco-friendly management system, providing an excellent opportunity to evaluate how sustained differences in AMU impact the AMR in indicator bacteria. Here, we evaluate the usefulness of commensal Escherichia coli and Enterococcus spp. isolates as AMR bioindicators when comparing 37 Spanish pig farms from both intensive and organic-extensive production systems, considering the effect of AMU and biosecurity measures, the last only on intensive farms.ResultsThe production system was the main factor contributing to explain the AMR differences in E. coli and Enterococcus spp. In both bacteria, the pansusceptible phenotype was more common (p < 0.001) on organic-extensive farms when compared to intensive herds. The microbiological resistance in commensal E. coli was, for most of the antimicrobials evaluated, significantly higher (p < 0.05) on intensive farms. In enterococci, the lincosamides usage revealed the association between AMR and AMU, with an increase in the AMR for erythromycin (p < 0.01), quinupristin-dalfopristin (p < 0.01) and the multidrug-resistant (MDR) phenotype (p < 0.05). The biosecurity measures implemented on intensive farms influenced the AMR of these bioindicators, with a slightly lower resistance to sulfamethoxazole (p < 0.01) and the MDR phenotype (p < 0.05) in E. coli isolated from farms with better cleaning and disinfection protocols. On these intensive farms, we also observed that larger herds had a higher biosecurity when compared to smaller farms (p < 0.01), with no significant associations between AMU and the biosecurity scores.ConclusionsOverall, this study evidences that the production system and, to a lesser extent, the biosecurity measures, contribute to the AMR development in commensal E. coli and Enterococcus spp., with antimicrobial usage as the main differential factor, and demonstrates the potential value of these bacteria as bioindicators on pig farms in AMR surveillance programs.

Colloidal Iron Oxide Formulation for Equine Hoof Disinfection.

Simple SummaryHorse hoof possesses a micro-flora that may promote the development of secondary infections following wounds or surgery. For this reason, in vitro and in vivo experiments were used to verify and compare the bactericidal power of two well-known disinfectants, Povidone-iodine (PI) and Chlorhexidine (CHx), and a new stable colloidal suspension of iron oxide, called Iron Animals (IA). In vitro, IA was able to completely suppress the bacterial growth on all of the tested microorganisms. In vivo, PI alone possessed the lowest efficacy for hoof disinfection; CHx resulted as the best treatment in 18% of cases. CHx + IA emerged as the best disinfection protocol for equine hoof achieving the lowest bacterial load in 55% of cases. The addition of IA, after PI or CHx, improved both disinfectants’ effectiveness, leading to the highest bactericidal activity in 82% of cases. IA would deserve a chance as a possible solution in pre-surgical disinfection of the equine hoof, reducing the risk of infection. The presence of bacteria of various origins on horse hoofs enables the onset of infections following trauma or even post-surgical wounds. Thus, the analysis of new antibacterial substances is of fundamental importance. In this study, the antibacterial efficacy of Iron Animals (IA), a stable colloidal suspension of iron oxide, organic acids, and detergents, was tested in vitro and in vivo. In vitro assays were performed to test the unspecific inhibitory effect of IA on both gram-positive and gram-negative bacteria monitoring the microorganism growth by spectrophotometry (optical density OD600) at 37 °C for 24 h. In vivo test consists on the quantification of the bacterial load in colony forming units per gram (CFU/g) of specimens collected from the frog region of the anterior hooves of 11 horses. Sampling followed the application of four disinfectant protocols consisting of two consecutive 3 min scrubs with 50 mL of 10% Povidone-iodine (PI) or 4% Chlorhexidine (CHx), with or without an additional application for 15 min of 10 mL of Iron Animals (PI+IA and CHx+IA). In vitro, IA completely suppressed the bacterial growth of all the tested microorganisms, resulting in effectiveness also against CHx-resistant bacteria, such as Staphylococcus aureus. In vivo, PI emerged as an ineffective protocol; CHx was effective in 18% of cases, but with the addition of IA (CHx + IA) its use emerged as the best disinfectant protocol for horse hoof, achieving the lowest bacterial load in 55% of cases. The addition of IA, after PI or CHx, improves the effectiveness of both disinfectants leading to the highest bactericidal activity in 82% of cases.

Risk assessment of arterial allograft contamination from tissue donors colonized by Candida auris

Microbiological contamination is one of the main risks that must be controlled in tissue banking practices. For this reason, strict donor selection criteria are applied, disinfection protocols are used, and microbiological monitoring is performed at various stages. To detect Candida auris in arterial allografts and assess its origin. Data on two multi-tissue donations with positive microbiological cultures for C.auris were analysed. Risk factors for microbiological contamination were assessed at procurement, processing and post storage. C.auris was only isolated in cultures from arteries, and was not detected in cultures from cornea, musculoskeletal tissue or skin (even in the axillary-rectal sample taken from one donor). The donor's own skin was identified as the most likely source to explain the contamination of arteries by C.auris. Due to the pathogenicity of this fungus and difficulties associated with its correct identification, the implementation of measures for its detection in tissue donations is recommended.

AIUM Practice Parameter for the Performance of Ultrasound Evaluations of the Prostate (and Surrounding Structures).

AIUM Practice Parameter for the Performance of Ultrasound Evaluations of the Prostate (and Surrounding Structures).

Disinfection protocols during COVID-19 pandemic and their effects on prosthetic surfaces: a systematic review.

To describe the possible adverse effects of sodium hypochlorite (NaOCl) solutions, high-concentration alcohol solutions, and povidone-iodine products, which are indicated for disinfection of inanimate surfaces against human coronavirus of the severe acute respiratory syndrome (SARS-CoV), on prosthesis materials, including zirconia, lithium disilicate, and acrylic resin. A systematic literature research for articles published between January 2010 and February 2020 was conducted in Scopus, PubMed/Medline, Web of Science, Embase, and Science Direct using a combination of the following MeSH/Emtree terms and keywords: sodium hypochlorite, alcohol, ethanol, povidone-iodine, dental ceramic, zirconia, lithium disilicate, and acrylic resin. A total of 538 studies were identified in the search during initial screening, of which 44 were subject to full-text evaluation, and 24 fulfilled the inclusion criteria. Seven articles on zirconia and lithium disilicate investigated the effect of NaOCl (0.5% and 1%), 96% isopropanol, and 80% ethanol on bond strength after saliva contamination. The remaining articles evaluated color alteration, surface roughness modifications, decrease in flexural strength, and bonding strength of all cleaning agents on acrylic resin. NaOCl (1%) solution for 1 minute is recommended to reduce SARS-CoV infectivity and to minimize the risk of cross-contamination through prosthetic materials. The increase in surface roughness and color alteration were recorded using 1% NaOCl on acrylic resin, but this increase was not clinically significant. A decrease in bonding strength was determined after using 1% NaOCl, 96% isopropanol, and 80% ethanol solutions on lithium disilicate. Silanization before the try-in procedure and the application of the second layer of silane after cleaning methods are recommended to improve the bonding strength.

Effect of Full-mouth Disinfection Protocol on Glycaemic Control and Subgingival Microbiota in Patients with Type 1 and Type 2 Diabetes.

To evaluate the effect of a full-mouth disinfection protocol (FMD) on periodontal parameters, glycaemic control and subgingival microbiota of periodontal patients with type 1 and type 2 diabetes, as well as those without diabetes. This study included 33 patients with periodontitis. Eleven of them were type 1 diabetes patients, 11 were type 2 diabetes patients, and 11 were non-diabetics. At baseline and 3 months after the FMD, the periodontal parameters of each patient were recorded, samples of capillary blood for the chairside assessment of HbA1c were taken, and plaque samples from the two deepest periodontal pockets were collected to test for the presence of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythia (Tf) and Treponema denticola (Td). Bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL) and glycated haemoglobin (HbA1c) decreased statistically significantly (p < 0.05) in all three groups 3 months after FMD. Only the proportion of Pg in the control group decreased statistically significantly (p < 0.05), while the proportion of other bacteria decreased or remained the same, whereby the differences were not statistically significant. Moreover, the proportion of Aa in type 1 diabetics increased statistically significantly (p < 0.05). The FMD protocol improves periodontal parameters and glycaemic control of type 1 and type 2 diabetes patients with periodontitis.

Optimization of treatment and prevention of generalized periodontal diseases with the use of transgingival photoactived disinfection

The aim of the study is to develop protocols for the treatment and prevention of generalized periodontal disease using a nozzle that designed for transgingival photosensitizer activation.&#x0D; Methods. Analysis of available variants of irradiation nozzles for photoactivated disinfection. Circuit design and construction of authors’ irradiation nozzle for transgingival photosensitizer activation.&#x0D; Results. Based on the analysis of data, there was developed a nozzle design that allows treating periodontium areas within 4-6 teeth, evenly distributes the required power of laser radiation, and can be used in hard-to-reach areas of the oral cavity. Based on the above calculations, a nozzle for transgingival photosensitizer activation was created (jointly with Fotonika Plus, PE). To optimize the PAD procedure, there was created a protocol of transgingival photoactivated disinfection to be applied at the stage of professional oral hygiene, using the created irradiation nozzle NOU-9 of authors’ design, and diode 2 W laser LIKA-surgeon with a wavelength of 660 nm. The result is the accelerated procedure of transgingival photoactivated disinfection.&#x0D; Conclusions. The development of photoactivated disinfection technology allows supplementing the traditional treatment of generalized periodontal diseases. Studies of non-invasive, transgingival method of photosensitizer activation have recently become popular. This, in turn, carries a lower probability of cross-infection and less traumatization of periodontal tissues during the manipulation. The use of PAD cannot lead to resistance of the microflora in contrast to pharmacological antibacterial preparations. Carrying out PAD does not require any complex manual skills, the purchase of expensive equipment, provides an opportunity for widespread introduction of technology. The use of the therapeutic complex and protocols of PAD that were developed can significantly reduce the duration of the procedure, resulting in improved comfort for both the doctor and the patient. The NOU-9 irradiation nozzle allows reaching hard-to-reach areas of the oral cavity, distributing laser radiation efficiently and evenly on periodontal tissues. The LIKA-surgeon 2 W laser with a wavelength of 660 nm provides the operating parameters required to activate the photosensitizer. Due to low-intensity radiation, it is possible to enhance regenerative processes in the periodontium after traumatic intervention. Clinical studies on the antibacterial efficacy of the technology are ongoing

Microbial Contamination Risk and Disinfection of Radiation Protective Garments.

Healthcare-associated infections are a major public health concern for both patients and medical personnel. This has taken on greater urgency during the current COVID-19 pandemic. Radiation Personal Protective Equipment (RPPE) may contribute to risks of microbial contamination. This possibility was tested in 61 personal or shared-use lead aprons and thyroid collars at Columbia Presbyterian Irving Medical Center. Fifty percent tested positive for either bacterial or fungal contamination, mostly around the neckline of lead vests and thyroid collars. Repeated testing of garments some weeks to months later confirmed continued presence of microbial contamination. The possibility that hospital-approved disinfection agents could degrade the radio-protective features of these garments was also examined. Samples of identical construction to garments in regular use were subjected to either daily or weekly wipes with hypochlorite or alcohol-based hospital-approved cleaning agents for 6 mo. A third group of samples was maintained in contact with the cleaning agents for 6 mo. All samples were fluoroscoped four times during the study. None demonstrated any degradation in radioprotection. All samples were photographed monthly. Physical degradation of the outer plastic covering by concentrated hypochlorite and limited mechanical damage around stitched seams of the samples cleaned daily with alcohol was noted. Based on the high prevalence of microbial contamination, regular cleaning and disinfection protocols should be implemented. Regular cleaning with medical-facility-approved cleaning and disinfecting agents is likely to be effective at reducing the microbial load and unlikely to result in significant reduction in radioprotective properties of these garments.

Youth Experiencing Homelessness During the COVID-19 Pandemic: Unique Needs and Practical Strategies From International Perspectives

Youth Experiencing Homelessness During the COVID-19 Pandemic: Unique Needs and Practical Strategies From International Perspectives