Hand Disinfection Research Articles

Staphylococcus aureus, Escherichia coli, and Klebsiella spp. prevalence in bulk tank milk of Colombian herds and associated milking practices.

Bovine mastitis is one of the most costly and prevalent diseases in dairy herds, which can be prevented and controlled through proper milking practices, diagnosis, and elimination of chronic animals, among others. Contagious pathogens such as Staphylococcus aureus and environmental pathogens such as Escherichia coli and Klebsiella spp. can affect cows and milk for human consumption, generating a public health risk. This study aimed to estimate the prevalence of herds with somatic cell count (SCC) ≥200,000 cells/mL, S. aureus, E. coli, and Klebsiella spp., in bulk tank milk (BTM) and its associated risk factors in Colombian dairy cow herds. A cross-sectional probabilistic study was carried out in 150 dairy herds located in the north of the Antioquia province. A single visit per herd was conducted, during which three BTM samples were aseptically collected. General data and milking practices were collected through an epidemiological survey applied in each herd. The prevalence of S. aureus, E. coli, and Klebsiella spp. were 14% (21/150), 2% (3/150), and 8% (12/150), respectively. Moreover, 95% of the herds presented an SCC of ≥200,000 cells/mL. Practices such as in-paddock milking, change of milker during the last month, use of disposable gloves, and hand disinfection were associated with increased prevalence of S. aureus, whereas proper dipping was a protective factor. Proper washing and disinfection of the milking machine, use of chlorinated disinfectants for hand hygiene, and use of disposable gloves decreased the prevalence of E. coli and Klebsiella spp. Bulk tank SCC increased in herds with 30-60 milking cows, herds with >60 milking cows, and herds with a change of milker during the last month. Hand disinfection and dipping decreased the SCC. Staphylococcus aureus, E. coli, and Klebsiella spp. were prevalent in BTM from dairy cow herds. The risk of S. aureus isolation was higher in herds with an in-paddock milking system. The risk of E. coli and Klebsiella spp. isolation were higher in herds with >60 milking cows, with a change of milker during the last month. Processes such as avoiding changing the milker and greater control in medium and large herds could improve the SCC in BTM.

Salmonellosis in Poland in 2020.

The aim of the study is to assess the epidemiological situation of salmonellosis in Poland in 2020 compared with previous years. The epidemiological situation was assessed on the basis of data provided to the Department of Epidemiology of Infectious Diseases and Surveillance of the NIPH NIH-NRI by sanitary-epidemiological stations through the EpiBaza System and the Registry of Epidemic Outbreaks System (ROE), as well as on the basis of data published in the annual bulletin "Infectious Diseases and Poisoning in Poland in 2020" (NIPH NIH-NRI, GIS, Warsaw, 2021) and from information received from laboratories of sanitary-epidemiological stations and data from the Demographic Research Department of the Statistics Poland. In Poland in 2020, in the sanitary-epidemiological surveillance registered a total of 5,470 cases of salmonellosis, 5,302 cases of intestinal salmonellosis, and the remaining 168 cases of extra-intestinal salmonellosis. The incidence per 100,000 population was 14.3 for total salmonellosis, 13.8 for intestinal salmonellosis and 0.44 for extra-intestinal salmonellosis. Sanitary-epidemiological stations registered 5,349 confirmed cases and 121 probable cases of salmonellosis. Due to intestinal salmonellosis, 63.9% of all patients were hospitalized, while for extra-intestinal salmonellosis 153 patients or 91.1% of cases, were hospitalized. The increase in the number of salmonellosis cases in 2020 started in June, while the peak of the incidence was in August. Among the voivodeships, the highest incidence of salmonellosis was registered in the Podkarpackie voivodeship 33.3/100,000 population, the lowest in Zachodniopomorskie 6.1/100,000 population. Cases in the 0-4 age group accounted for 45.2% of all salmonellosis cases in 2020. Among extra-intestinal salmonellosis, 63.1% were people aged 60+. Sanitary-epidemiological stations registered 131 food poisoning outbreaks caused by Salmonella bacilli in the ROE system, 108 of these outbreaks were caused by the Enteritidis serotype. In 2020, the most common serotypes were S. Enteritidis 70% of all recorded salmonellosis, S. Typhimurium 1.9%, and S. Infantis 0.54%. There were 9 deaths due to Salmonella infection. The COVID-19 pandemic and the associated restrictions introduced in the country, as well as increased hygiene through more frequent washing and disinfection of hands, could have contributed to a reduction of almost 69% in the number of salmonellosis cases registered in 2020, in Poland, compared to 2019. This is a 82% decrease in relation to 2018. There was also a decrease in the number of food poisoning outbreaks caused by Salmonella bacilli, while at the same time their percentage in the total number of outbreaks increased. On the one hand, the implemented restrictions could have had an impact on the decrease in the number of cases and outbreaks, on the other hand, worse access to medical care and diagnostics, most likely deepened the underestimation of these cases in the country observed for years, and distorted the real picture of the situation.

Recognition of hand disinfection by an alcohol-containing gel using two-dimensional imaging in a clinical setting

Hand hygiene compliance is important for the prevention of healthcare-associated infections. The conventional method of measuring hand disinfection guidelines involves an external observer watching the staff personnel, which introduces bias, and observations are only made for a set period of time. An unbiased, non-invasive automated system for assessing hand sanitisation actions can provide a better estimate of compliance. To develop an automated detector to assess hand hygiene compliance in hospitals, without bias from an external observer, capable of making observations at different times of the day, as non-invasive as possible by using only one camera, and collecting as much information as possible from 2D video footage. Video footage with annotations from various sources was collected to determine when staff performed hand disinfection with gel-based alcohol. The frequency response of wrists movement was used to train a Support Vector Machine to identify hand sanitisation events. Our system detected sanitisation events with an accuracy of 75.18 %, precision of 72.89 %, and recall of 80.91 %. These metrics provide an overall estimate of hand sanitisation compliance without bias due to the presence of an external observer while collecting data over time. Investigation of these systems is important because they are not constrained by time-limited observations, are non-invasive, and eliminate observer bias. Although there is room for improvement, the proposed system provides a fair assessment of compliance that the hospital can use as a reference to take appropriate action.

Feasibility and effectiveness of disinfection of gloves during routine care: a scoping review protocol

IntroductionDisinfecting gloves during patient care has potential benefits and risks. In recent years, disinfection of disposable medical gloves for prolonged use has occurred in clinical practice. However, there is limited...

Risperidone and fluvoxamine; two directions of augmentation: a case report

IntroductionOnly 40%–70% of patients have an adequate response to the first-line treatment of OCD with SSRIs. Antipsychotic augmentation is effective in the management of both obsessions and compulsions and these drugs are currently the first-line pharmacological augmenting agents for OCD. (Jaisoorya T, Thamby A. Antipsychotic augmentation in the treatment of obsessive-compulsive disorder. Indian Journal of Psychiatry. 2019;61(7):51)ObjectivesWe present the cases of a 31-year-old man and a 21- year-old girl. A 31 -year old man experienced hygienic obsessive and compulsive symptoms with excessive showering for one year (YBCOS 20). First, he was treated with 100 mg of fluvoxamine daily which helped him gain partial remission of symptoms. After a stressful period at work and his showering compulsions got worse. Our female patient suffered from compulsive hand washing and disinfection with fear of getting contaminated by other people (YBCOS 24). She was also treated for anorexia nervosa. At the moment of referral to our outpatient clinic, she had already been taking 2 mg of risperidone daily, but still, her compulsions persisted.MethodsBoth patients were included in outpatient service treatment. They were followed up weekly, psychotherapeutically supported and their psychopharmacotherapy was titrated. In the case of our male patient, risperidone of 1 mg/day was added to the ongoing fluvoxamine of 100 mg/day. Our female patient was given fluvoxamine 50 mg/a day and gradually increased to 100 mg/day with an ongoing 2 mg/day of risperidone.ResultsAfter two weeks, the hygiene compulsions of the 31-year-old-man completely remitted (YBCOS 6). He stopped excessive showering and became fully functional at work and in family relations. Our female patient also continued to take risperidone in augmentation with fluvoxamine as recommended. Her compulsions improved, and she returned to her hobbies and her college lectures (YBCOS 8). They have both been advised to continue outpatient psychiatric treatment and to regularly use pharmacotherapy.ConclusionsThe condition of both of our patients improved after adding an augmentative agent to the therapy. In the first case, it was risperidone as a fluvoxamine augmentation, and in the second, fluvoxamine was added as a risperidone augmentation. The combination of these two drugs, rather than each other being used on its own, proved to be a powerful therapeutic tool in the treatment of OCD. Further clinical studies are required for a better understanding of the underlying neurobiological mechanism of this effective combination.Disclosure of InterestNone Declared

WEO Newsletter.

WEO Newsletter.

The Soaring Increase of Resistant Microorganisms Demands Immediate Action Solutions are Available

Clinical environments provide an ideal reservoir for the growth, proliferation, and transmission of pathogenic organisms. Surfaces in hospitals e.g. hospital furniture, ECG lead wires and other cables, push buttons of infusion pumps, control knobs of ventilation machines, textiles as well as implantable biomaterials like central venous catheters, urologic catheters, endotracheal tubes are contaminated increasingly frequent with multiresistant microorganisms. These microorganisms are distributed by the hands of the nursing personnel throughout the hospital with serious, life threatening consequences. 1.8 million patients suffer from a nosocomial infection per year in Europe; approximately 180,000 deaths are attributed to these infections. The Centers for Disease Control (CDC) estimates that 2 million U.S. patients per year acquire a hospital-related infection. These infections cause 90,000 deaths each year and cost an average of $47,000 per patient to treat. The added cost to hospitals is $4.8 billion anually for extended care treatment. Microorganisms show an increasing rate of resistance against the majority of antibiotics including carbapenems as last available antibiotic. 700,000 deaths have been rеρorted worldwide, 30 000 deaths alone in Europe during the last year due to infections where no effective antimicrobial substance was available. The use of disinfectants is ostensibly intended to remove/kill pathogens on surfaces. However studies have shown that more than one-half the time, surfaces are not adequately cleaned or are re-contaminated within minutes. Much emphasis has been put therefore on hand disinfection. However there are also rеρorts of the emergence of alcohol tolerant/insensitive microorganisms e.g., vancomycin resistant enterococci. This phenomenon has the potential to undermine the effectiveness of alcohol based disinfectant standard precautions. The reason for this dramatic development of resistant microorganisms is still in debate. The indiscriminate use of antibiotics for prevention of a bacterial superinfections e.g. sinusitis, otitis media after a viral infections is frequently incriminated, however this seems to have little impact on the occurrence of multi-resistant hospital pathogens in general. However individual patients are seriously affected by the selection of multi-resistant pathogens. In contrast there is increasing evidence that the widespread use of disinfectants is responsible: disinfectants - analogous to antibiotics - must be incorporated into the metabolism of microorganisms. This is inevitably associated with induction of resistance by transfer of resistance plasmids e.g. induction of efflux pumps. 10 167 рublications (PUBMed Jan. 2023) are available in the international literature which document the resistance of microorganisms against disinfectants; 649 рublications describe the cross resistance with antibiotics, at the same time there are 11 237 publications on the toxicity of disinfectants.

Mobile Phones: Reservoirs of Resistant Bacteria during the COVID-19 Pandemic in Abu Dhabi, United Arab Emirates.

Mobile phones are excessively used even though microbes' ability to survive on phone surfaces was confirmed. During the COVID-19 pandemic, heavy hygiene practices have been applied to mobile surfaces. Therefore, it is interesting to evaluate the emergence of antimicrobial-resistant bacteria on mobile phone surfaces. A random sampling technique was utilized on residents in Abu Dhabi, UAE between May and June 2021. A swab sample from each participant's mobile phone was collected and transported to the microbiology laboratory for bacterial culture and antimicrobial susceptibility tests. Furthermore, a cross-sectional study was conducted via a self-administered questionnaire filled by participants. The questionnaire was used to collect sociodemographic data, phone frequency usage and cleaning methods. One hundred two-sample swabs and data have been included in the study. The majority of participants (91.1%) reported cleaning their mobile phones with wipes and alcohol. However, 100% of participants had a mobile phone contaminated by bacteria such as S. aureus, E. coli, Coagulase-negative staphylococci, Micrococcus, Bacillus, Streptococcus, Citrobacter, Proteus, Enterococcus, klebsiella, Pseudomonas and Actinobacteria. Interestingly, most of these potentially pathogenic bacteria were found to be resistant to ampicillin, ceftazidime and cefotaxime. The continuous hand and mobile disinfectant have contributed to the emergence of resistant bacteria.

Non-Alcohol Hand Sanitiser Gels with Mandelic Acid and Essential Oils.

Antimicrobial hand gels have become extremely popular in recent years due to the COVID-19 pandemic. Frequent use of hand sanitising gel can lead to dryness and irritation of the skin. This work focuses on the preparation of antimicrobial acrylic acid (Carbomer)-based gels enhanced by non-traditional compounds-mandelic acid and essential oils-as a substitute for irritating ethanol. Physicochemical properties (pH and viscosity), stability and sensory attributes of the prepared gels were investigated. Antimicrobial activity against representative Gram-positive and Gram-negative bacteria and yeasts was determined. The prepared gels with mandelic acid and essential oil (cinnamon, clove, lemon, and thyme) proved to have antimicrobial activity and even better organoleptic properties than commercial ethanol-based antimicrobial gel. Further, results confirmed that the addition of mandelic acid had a desirable effect on gel properties (antimicrobial, consistency, stability). It has been shown that the essential oil/mandelic acid combination can be a dermatologically beneficial hand sanitiser compared to commercial products. Thus, the produced gels can be used as a natural alternative to alcohol-based daily hand hygiene sanitisers.

Microbiota shaping and bioburden monitoring of indoor antimicrobial surfaces

Indoor residents are constantly exposed to dynamic microbiota that have significant health effects. In addition to hand hygiene, cleaning, and disinfection, antimicrobial coatings (AMCs) can prevent the spread of infectious diseases in public areas. The sustainable use of antimicrobial-coated products requires an assessment of their pros and cons for human health and the environment. The toxicity and resistance risks of AMCs have been considered, but large-scale genetic studies on the microbial community compositions and resistomes of AMCs are scarce. The use of an AMC can reduce the total number of microbes on a surface but poses the risk of dysbiosis, microbial imbalance, such as the polarized growth of metallophilic, metal- and antimicrobial-resistant, and other survivor bacteria, and the overall reduction of microbial diversity. Loss of diversity may lead to the enrichment of harmful bacteria and an increased risk of communicable or immunological non-communicable inflammatory diseases (NCDs). In public buildings, such as kindergartens and nursing homes for the elderly, the use of AMCs is likely to increase due to epidemics and pandemics in recent years. Therefore, comprehensive metagenomic research is needed to monitor the effects of AMCs on indoor microbial community compositions and functions. Although the determination of good indoor microbiota and homeostasis is difficult, microbial communities that have health-protective or harmful effects can and should be identified using a metagenomic sequencing approach before the large-scale implementation of AMCs.

The ETA-ESE statement on the European Chemicals Agency opinion on iodine as an endocrine disruptor.

In 2022, the European Chemicals Agency (ECHA) made a statement concluding that iodine is an endocrine disruptor (ED). "We stress the fact that the ECHA opinion ECHA/BPC/357/2022 is based on their misguidedly zooming in on exclusively the biocidal products (e.g., hand disinfectants, disinfection of animals' teats/udder, embalming fluids before cremation, etc.) that contain molecular iodine (I2), entirely neglecting [see the 2013 ECHA Regulation (EU) n°528/2012 describing iodine as being of "great importance for human health". Clearly, the current sweeping and erroneous classification of "iodine" as an endocrine disruptor is ill-advised. We moreover call upon the scientific and medical community at large to use the accurate scientific nomenclature, i.e., iodide or iodate instead of "iodine" when referring to iodized salts and food prepared there with. Drugs, diagnostic agents, and synthetic chemicals containing the element iodine in the form of covalent bonds must be correctly labelled ''iodinated'', if possible, using each time their distinctive and accurate chemical or pharmacological name.

Results of the Cologne Corona Surveillance (CoCoS) study – a cross-sectional study: survey data on risk factors of SARS-CoV-2 infection in adults

BackgroundThe personal, environmental, and behavioral risk factors that play an important role in the spread of SARS-CoV-2 are still largely unclear. At the same time, there is limited evidence on the effectiveness of specific countermeasures for SARS-CoV-2. As a first approach to these questions, we use data from the Cologne Corona Surveillance (CoCoS) study, a large cross-sectional study conducted in Cologne, Germany, in June 2021.MethodsThis study was conducted in Cologne, Germany. Six thousand randomly selected Cologne residents who were 18 years of age or older were invited to participate in this study. Participant information was obtained via an online survey. Previous SARS-CoV-2 infections were recorded using self-reports. Sociodemographic and environmental information such as age, sex, living situation were collected. Potential SARS-CoV-2 risk behaviors were captured (workplace situation, adherence to hygiene regulations, and regular use of public transportation). Adherence to hygiene regulations was surveyed by determining the compliance with the ‘AHA’-rules (German acronym that stands for keeping a distance of 1.5 m from fellow citizens, hand disinfection, and wearing a face mask). Binary logistic regression analysis was used to identify risk factors for SARS-CoV-2 infection.ResultsA sample of 2,433 study participants provided information. Comparison of the sample with the general population showed representativeness for most sociodemographic characteristics with a preference for higher level of education in the study sample. Younger age, as well as living with minor children (under 18 years) in the same household were associated with a higher number of self-reported SARS-CoV-2 infections. Adherence to hygiene regulations was associated with fewer self-reported SARS-CoV-2 infections in adults. Gender, size of living space per person, workplace situation (work from home versus working with contact to colleagues/customers), and regular use of public transportation showed no significant association with self-reported SARS-CoV-2 infections in multivariable analysis.ConclusionThe presented results provide initial indications of which sociodemographic and behavioral factors may be associated with SARS-CoV-2 infection. However, the fact that these factors were recorded without exact dates and could have changed accordingly during the pandemic or after infection limits the strength of the results.Trial registrationDRKS.de, German Clinical Trials Register (DRKS), Identifier: DRKS00024046, Registered on 25 February 2021.

Impact of concentration, temperature and pH on the virucidal activity of alcohols against human adenovirus

Adenoviruses belong to the stable nonenveloped viruses playing an important role in healthcare-associated infections mainly causing respiratory infections and epidemic keratoconjunctivitis. Hand disinfection with alcoholic preparations is therefore one of the most important measures to prevent such viral infections in hospitals and other medical settings. The inactivation of adenovirus type 5 by ethanol, 1- and 2-propanol, and 2 commercially available hand disinfectants was examined at different concentrations, temperatures, and pH-values. For ethanol and 1-propanol the maximum virus-inactivating properties after 30 seconds exposure were found at a concentration of 60%-70% and 50%-60%, respectively, whereas with 2-propanol no activity was observed. The virucidal activity of all alcohols and the 2 hand disinfectants examined was increased when raising the temperature from 20°C to 25°C. By increasing the pH value to 9, a strong improvement of the activity of ethanol, 1-propanol and 1 hand disinfectant was observed, whereas pH lowering resulted in decrease of activity. These results demonstrate the importance of physical parameters in the inactivation of adenoviruses by alcohols and will help to improve measures to reduce adenovirus transmission in healthcare settings.

Factors associated with acceptance of a digital contact tracing application for COVID-19 in the Japanese working-age population.

The working-age population is at the epicenter of coronavirus disease 2019 (COVID-19) infections. Therefore, it is important to increase the acceptance of digital contact tracing apps in this population. Contact-Confirming Application (COCOA) is the only digital contact tracing app in Japan. This study aimed to determine factors associated with acceptance of the COCOA for COVID-19 in the Japanese working-age population. A cross-sectional study was performed for 27,036 full-time workers registered with an internet survey company during December 2020 in Japan. Factors associated with COCOA adoption were evaluated by multivariate logistic regression analysis. The rate of downloading the COCOA was 25.1%. The COCOA was more likely to be accepted by people with married status, university graduation or above, higher income, and occupations involving desk work. Fear of COVID-19 transmission, wearing a mask, using hand disinfection, willingness to be vaccinated against COVID-19, and presence of an acquaintance infected with COVID-19 were also associated with a greater likelihood of adopting the app. The rate of downloading the COCOA in Japan was not very high. The present findings have important implications for widespread adoption of digital contact tracing apps in working-age populations in Japan and elsewhere.

Simultaneous determination of triclosan，triclocarban and p-chloro-m-xylenol in disinfectant，personal care products and oiltment by nonaqueous capillary electrophoresis

Triclosan （TCS）， triclocarban （TCC）， and p-chloro-m-xylenol （PCMX） are some of the most widely used antibiotics because of their broad-spectrum and highly-efficient bactericidal effects. In the context of disinfection， the National Standard GB 38598-2020 stipulates that the contents of the effective ingredients present in a disinfectant must be specified， wherein their range must fall within 90%-110% of the specified central value. To ensure a suitable product quality， analysis by high performance liquid chromatography （HPLC） is recommended by both the GB/T 27947-2020 and GB/T 34856-2017. However， the results analyzed according to the National Standard method often exceed the declared contents， thereby indicating the necessity to establish a new method based on a completely different principle （e. g.， capillary electrophoresis）， especially since it was not possible to analyze TCS， TCC， and PCMX in a single injection using the National Standard method. Moreover， using this method， large amounts of methanol were consumed， which could be potentially harmful to both operators and the environment. In terms of their water solubilities， this decreases in the order of PCMX>TCS>TCC， wherein TCC is insoluble in water. As such， the use of nonaqueous capillary electrophoresis （NACE） based on running buffer solutions prepared in pure organic solvents （e. g.， methanol or acetonitrile） is necessary. In this paper， a new NACE approach combined with an ultraviolet detection method was developed for the simultaneous analysis of TCS， TCC， and PCMX in disinfectants， personal care products， and ointments. For this purpose， an uncoated fused silica capillary （20 cm×50 μm， total length=30.2 cm） was used as the separation column with a separation buffer composed of 14 mmol/L sodium borate， 2 g/L polyethylene glycol （PEG） 20000， and 0.5 mmol/L dodecyltrimethylammonium bromide （DTAB） in methanol. Following optimization of the separation parameters， the complete and simultaneous separation of TCS， TCC， and PCMX was achieved when the sample solution was prepared using 5 g/L PEG 20000 in methanol-acetonitrile （50∶50， v/v）. It was possible to directly inject the sample into the analysis system after a simple dilution with the sample medium， and no interference was observed in any of the sample electropherograms when a separation voltage and detection wavelength of -12 kV and 214 nm were employed， respectively. Furthermore， TCS， TCC， and PCMX showed good linear relationships with their corrected peak areas within a mass concentration range of 1-100 mg/L， and the correlation coefficients （r） were all greater than 0.99. Moreover， the limits of detection （LODs， S/N=3） and limits of quantification （LOQs， S/N=10） were determined to be 0.2 and 1 mg/L， respectively. The spiked recoveries ranged from 94.5% to 104.4% with relative standard deviations of ≤4.8% in all cases. Subsequently， the established method was used to analyze 31 commercial samples， including hand sanitizer， disinfectant， baby powder， and antibacterial cream. A comparative analysis of HPLC， the developed NACE method， and our previously reported micellar electrokinetic chromatographic （MEKC） method was also carried out for the quantitative determination of TCS， TCC， and PCMX. Although no statistically significant differences were observed among the three methods， the results determined for 16 out of the 31 samples did not match the claimed contents. These results therefore indicate the necessity to further control the compositions of disinfectant products. Our results indicate that the newly established NACE method can be an important alternative to HPLC for routine laboratory analyses， especially considering that it minimizes waste generation， requires only a simple sample pretreatment process， and exhibits a good selectivity to the target compounds. It is therefore hoped that the NACE method will be incorporated into the National Standard method in the near future.

Far-UVC Radiation for Disinfecting Hands or Gloves?

(1) Background: Far-UVC radiation in the spectral range 200-230 nm has, according to previous findings, a strong antimicrobial effect on pathogens, but exhibits hardly any harmful effect on human skin. Therefore, the present study will discuss whether such radiation could also be suitable for hand disinfection in the healthcare sector. (2) Methods: Hands and gloves were microbially contaminated and exposed to radiation from a 222 nm krypton-chloride-excimer lamp. The applied doses were 23 mJ/cm2 and 100 mJ/cm2, respectively. Irradiated and non-irradiated hands and gloves were pressed onto agar plates and colonies were counted and compared after 24 h of incubation. For comparison, we also treated hands and gloves with a commercial liquid alcohol-based disinfectant. (3) Results: On the hand, the 23 mJ/cm2 resulted in the reduction of the observed colonies on the agar plates by one log level. For the gloves irradiated with 100 mJ/cm2, a colony reduction of 1.3 log levels was recorded. In the comparative experiments with the commercial disinfectant, a colony reduction of 1.9 and approximately one log level was observed on hand and gloves, respectively. (4) Conclusion: In both cases, far-UVC radiation provided a considerable reduction in microorganisms. However, compared to published far-UVC irradiation results in suspensions, the disinfection success on hands and gloves was rather low. With regard to the irradiation limits currently existing in the European Union, multiple daily hand disinfection with far-UVC radiation is actually legally not possible at present, but the thresholds are currently under discussion and could change in the future. Far-UVC disinfection of hands in gloves seems theoretically possible if attention is paid to potential perforations in the gloves.

AIUM Official Statement: Guidelines for Cleaning and Preparing External- and Internal-Use Ultrasound Transducers and Equipment Between Patients as Well as Safe Handling and Use of Ultrasound Coupling Gel.

AIUM Official Statement: Guidelines for Cleaning and Preparing External- and Internal-Use Ultrasound Transducers and Equipment Between Patients as Well as Safe Handling and Use of Ultrasound Coupling Gel.

Failure of sodium hypochlorite to meet the EN 1500 efficacy requirement for hygienic hand disinfection

This study evaluated the bactericidal efficacy of two alternative hand antiseptics, based on sodium hypochlorite or sodium hypochlorite and hypochlorous acid, compared with isopropanol on the hands of volunteers artificially contaminated with Escherichia coli using EN 1500. The reference alcohol was applied according to the norm, and the study formulations were used as in common practice (3mL for 30s). The products showed mean log10 reductions of 1.63 and 1.89, both of which were inferior to the reference treatment (4.78). Due to the failure to achieve sufficient bactericidal efficacy within 30s, sodium hypochlorite (0.05-0.06%) should not be considered for hand disinfection.

Indications for hand and glove disinfection in Advanced Cardiovascular Life Support: A manikin simulation study.

There are no investigations on hand hygiene during cardiopulmonary resuscitation (CPR), even though these patients are at high risk for healthcare-associated infections. We aimed to evaluate the number of indicated hand hygiene per CPR case in general and the fraction that could be accomplished without delay for other life-saving techniques through standardized observations. In 2022, we conducted Advanced Cardiovascular Life Support (ACLS) courses over 4 days, practicing 33 ACLS case vignettes with standard measurements of chest compression fractions and hand hygiene indications. A total of nine healthcare workers (six nurses and three physicians) participated. A total of 33 training scenarios resulted in 613 indications for hand disinfection. Of these, 150 (24%) occurred before patient contact and 310 (51%) before aseptic activities. In 282 out of 310 (91%) indications, which have the highest impact on patient safety, the medication administrator was responsible; in 28 out of 310 (9%) indications, the airway manager was responsible. Depending on the scenario and assuming 15 s to be sufficient for alcoholic disinfection, 56-100% (mean 84.1%, SD ± 13.1%) of all indications could have been accomplished without delaying patient resuscitation. Percentages were lower for 30-s of exposure time. To the best of our knowledge, this is the first study investigating the feasibility of hand hygiene in a manikin CPR study. Even if the feasibility is overestimated due to the study setup, the fundamental conclusion is that a relevant part of the WHO indications for hand disinfection can be implemented without compromising quality in acute care, thus increasing the overall quality of patient care.

Changes in Infection Prevention Practices and Occurrence of Skin Symptoms among Healthcare Workers, Cleaners and Day-care Workers in Norway during the COVID-19 Pandemic

The COVID-19 pandemic has resulted in increased attention on infection prevention measures. This study aims to assess whether changes in hand hygiene procedures, use of personal protective equipment and moisturizers during the first year of the COVID-19 pandemic were associated with changes in the occurrence of skin symptoms among healthcare workers, cleaners, and day-care workers. A total of 602 participants (40%) responded to an electronic questionnaire, including questions on previous and current occupational exposure and skin problems. Increased frequency of hand washing, use of hand disinfectants, use of disposable gloves and moisturizers were all associated with an increased symptom score on the hands, wrists, forearms. Participants who increased their use of masks or respirators had a higher risk of facial skin symptoms, compared with those with non-increased occupational exposure. In conclusion, a change of behaviour among healthcare workers, cleaners and day-care workers during the first year of the COVID-19 pandemic, with an increase in occupational exposures and use of moisturizers, was associated with higher occurrence of facial skin symptoms and symptoms on the hands, wrists and forearms.