Investigations into the efficacy of different procedures for surgical hand disinfection between consecutive operations.

PubMed

Rehork, B; Rüden, H

1991-10-01

In order to examine whether thorough surgical hand disinfection (handwashing plus hand disinfection) between consecutive operations is necessary, tests were carried out simulating normal clinical conditions. The tests were performed according to the guidelines for the evaluation of disinfection procedures of the German Society for Hygiene and Microbiology. Surgical hand disinfection was as follows: handwashing with soap without antimicrobial additives and subsequent 5-min disinfection with 60% n-propanol. This was followed by simulated operations of 30 or 120 min duration with a 30-min break between operations, during which half of the test group kept on the surgical gloves, while the other half removed them. The second surgical hand disinfection was done without prior handwashing by 50% of the test group. The disinfection time was reduced from 5 to 1 min by 50% of the test group. The results were evaluated by means of explorative data analysis and inductive statistical methods. Removing the surgical gloves during the interoperative break did not result in significantly higher numbers of colony forming units (cfu) compared with retaining the gloves. This was also the case after a subsequent handwashing. At the second surgical hand disinfection, after a simulated operation of 60 min duration (including break), there was no significant difference in the numbers of cfus between the test group who had washed their hands and those who had not. Reducing the disinfection time from 5 min to 1 min was not associated with a significant increase in the number of cfus. However, after a simulated operating time of 150 min (including the break), the second surgical hand disinfection with handwashing resulted in a significantly lower number of microorganisms than disinfection alone. In half the tests, the numbers of cfu were significantly lower when the test group disinfected their hands for 5 min rather than 1 min.

The Effect of Alcohol-Based Hand Sanitizer Vapors on Evidential Breath Alcohol Test Results.

PubMed

Strawsine, Ellen; Lutmer, Brian

2017-11-16

This study was undertaken to determine if the application of alcohol-based hand sanitizers (ABHSs) to the hands of a breath test operator will affect the results obtained on evidential breath alcohol instruments (EBTs). This study obtained breath samples on three different EBTs immediately after application of either gel or foam ABHS to the operator's hands. A small, but significant, number of initial analyses (13 of 130, 10%) resulted in positive breath alcohol concentrations, while 41 samples (31.5%) resulted in a status code. These status codes were caused by ethanol vapors either in the room air or their inhalation by the subject, thereby causing a mouth alcohol effect. Replicate subject samples did not yield any consecutive positive numeric results. As ABHS application can cause a transitory mouth alcohol effect via inhalation of ABHS vapors, EBT operators should forego the use of ABHS in the 15 min preceding subject testing. © 2017 American Academy of Forensic Sciences.

Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 10. Alcohol-based antiseptics for hand disinfection and a comparison of their effectiveness with soaps.

PubMed

Todd, Ewen C D; Michaels, Barry S; Holah, John; Smith, Debra; Greig, Judy D; Bartleson, Charles A

2010-11-01

Alcohol compounds are increasingly used as a substitute for hand washing in health care environments and some public places because these compounds are easy to use and do not require water or hand drying materials. However, the effectiveness of these compounds depends on how much soil (bioburden) is present on the hands. Workers in health care environments and other public places must wash their hands before using antiseptics and/or wearing gloves. However, alcohol-based antiseptics, also called rubs and sanitizers, can be very effective for rapidly destroying some pathogens by the action of the aqueous alcohol solution without the need for water or drying with towels. Alcohol-based compounds seem to be the most effective treatment against gram-negative bacteria on lightly soiled hands, but antimicrobial soaps are as good or better when hands are more heavily contaminated. Instant sanitizers have no residual effect, unlike some antimicrobial soaps that retain antimicrobial activity after the hygienic action has been completed, e.g., after hand washing. Many alcohol-based hand rubs have antimicrobial agents added to them, but each formulation must be evaluated against the target pathogens in the environment of concern before being considered for use. Wipes also are widely used for quick cleanups of hands, other body parts, and surfaces. These wipes often contain alcohol and/or antimicrobial compounds and are used for personal hygiene where water is limited. However, antiseptics and wipes are not panaceas for every situation and are less effective in the presence of more than a light soil load and against most enteric viruses.

Candida auris: Disinfectants and Implications for Infection Control

PubMed Central

Ku, Tsun S. N.; Walraven, Carla J.; Lee, Samuel A.

2018-01-01

Candida auris is a rapidly emerging pathogen and is able to cause severe infections with high mortality rates. It is frequently misidentified in most clinical laboratories, thus requiring more specialized identification techniques. Furthermore, several clinical isolates have been found to be multidrug resistant and there is evidence of nosocomial transmission in outbreak fashion. Appropriate infection control measures will play a major role in controlling the management and spread of this pathogen. Unfortunately, there are very few data available on the effectiveness of disinfectants against C. auris. Chlorine-based products appear to be the most effective for environmental surface disinfection. Other disinfectants, although less effective than chlorine-based products, may have a role as adjunctive disinfectants. A cleaning protocol will also need to be established as the use of disinfectants alone may not be sufficient for maximal decontamination of patient care areas. Furthermore, there are fewer data on the effectiveness of antiseptics against C. auris for patient decolonization and hand hygiene for healthcare personnel. Chlorhexidine gluconate has shown some efficacy in in vitro studies but there are reports of patients with persistent colonization despite twice daily body washes with this disinfectant. Hand hygiene using soap and water, with or without chlorhexidine gluconate, may require the subsequent use of alcohol-based hand sanitizer for maximal disinfection. Further studies will be needed to validate the currently studied disinfectants for use in real-world settings. PMID:29706945

Hand coverage by alcohol-based handrub varies: Volume and hand size matter.

PubMed

Zingg, Walter; Haidegger, Tamas; Pittet, Didier

2016-12-01

Visitors of an infection prevention and control conference performed hand hygiene with 1, 2, or 3 mL ultraviolet light-traced alcohol-based handrub. Coverage of palms, dorsums, and fingertips were measured by digital images. Palms of all hand sizes were sufficiently covered when 2 mL was applied, dorsums of medium and large hands were never sufficiently covered. Palmar fingertips were sufficiently covered when 2  or 3 mL was applied, and dorsal fingertips were never sufficiently covered. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Preoperative Disinfection of Surgeons' Hands: Use of Alcoholic Solutions and Effects of Gloves on Skin Flora

PubMed Central

Lowbury, E. J. L.; Lilly, H. A.; Ayliffe, G. A. J.

1974-01-01

A single application of about 10 ml of 95% alcoholic chlorhexidine (0·5%) or tetrabrom-o-methyl phenol (0·1%) rubbed on to the hands until they were dry led to mean reduction in viable bacterial counts from standard handwashings of 97·9 ± 1·09% and 91·8 ± 4·63% respectively. After six of such treatments, three on each of two successive days, the mean reductions in relation to viable counts before the first treatment were 99·7 ± 0·09% for alcoholic chlorhexidine and 99·5 ± 0·17% for tetrabrom-o-methyl phenol. These reductions were greater than those obtained with 4% chlorhexidine detergent solution— 87·1 ± 3·5% and 98·2 ± 1·6%, and with 95% or 70% ethyl alcohol and with aqueous 0·5% chlorhexidine. Preoperative washing of the surgeon's hands with alcoholic chlorhexidine used without addition of water is more effective and less expensive than handwashing with antiseptic detergent preparations and running water. The viable counts of washings from hands treated with various antiseptics, including ethyl alcohol, were lower in relation to the pretreatment levels when gloves had been worn for three hours than when samples for counts were taken immediately after the antiseptic treatment. No such difference was found in samplings from hands washed with unmedicated soap. Tests for residual action of antiseptics on the skin showed a greater effect with alcoholic chlorhexidine than with tetrabrom-o-methyl phenol, though both showed greater residual activity than an Irgasan DP 300 detergent preparation. No residual action was shown after 70% ethyl alcohol. PMID:4609555

Hand Hygiene – Evaluation of Three Disinfectant Hand Sanitizers in a Community Setting

PubMed Central

Babeluk, Rita; Jutz, Sabrina; Mertlitz, Sarah; Matiasek, Johannes; Klaus, Christoph

2014-01-01

Hand hygiene is acknowledged as the single most important measure to prevent nosocomial infections in the healthcare setting. Similarly, in non-clinical settings, hand hygiene is recognised as a key element in helping prevent the spread of infectious diseases. The aim of this study was to evaluate the efficacy of three different disinfectant hand sanitizers in reducing the burden of bacterial hand contamination in 60 healthy volunteers in a community setting, both before and after education about the correct use of hand sanitizers. The study is the first to evaluate the efficacy and ease of use of different formulations of hand rubs used by the general population. The products tested were: Sterillium (perfumed, liquid), desderman pure gel (odorless, gel) and Lavit (perfumed, spray). Sterillium and desderman are EN1500 (hygienic hand rub) certified products (available in pharmacy) and Lavit is non EN1500 certified and available in supermarkets. The two EN1500 certified products were found to be significantly superior in terms of reducing bacterial load. desderman pure gel, Sterillium and Lavit reduced the bacterial count to 6.4%, 8.2% and 28.0% respectively. After education in the correct use of each hand rub, the bacterial load was reduced even further, demonstrating the value of education in improving hand hygiene. Information about the testers' perceptions of the three sanitizers, together with their expectations of a hand sanitizer was obtained through a questionnaire. Efficacy, followed by skin compatibility were found to be the two most important attributes of a hand disinfectant in our target group. PMID:25379773

Reported Adverse Health Effects in Children from Ingestion of Alcohol-Based Hand Sanitizers - United States, 2011-2014.

PubMed

Santos, Cynthia; Kieszak, Stephanie; Wang, Alice; Law, Royal; Schier, Joshua; Wolkin, Amy

2017-03-03

Hand sanitizers are effective and inexpensive products that can reduce microorganisms on the skin, but ingestion or improper use can be associated with health risks. Many hand sanitizers contain up to 60%-95% ethanol or isopropyl alcohol by volume, and are often combined with scents that might be appealing to young children. Recent reports have identified serious consequences, including apnea, acidosis, and coma in young children who swallowed alcohol-based (alcohol) hand sanitizer (1-3). Poison control centers collect data on intentional and unintentional exposures to hand sanitizer solutions resulting from various routes of exposure, including ingestion, inhalation, and dermal and ocular exposures. To characterize exposures of children aged ≤12 years to alcohol hand sanitizers, CDC analyzed data reported to the National Poison Data System (NPDS).* The major route of exposure to both alcohol and nonalcohol-based (nonalcohol) hand sanitizers was ingestion. The majority of intentional exposures to alcohol hand sanitizers occurred in children aged 6-12 years. Alcohol hand sanitizer exposures were associated with worse outcomes than were nonalcohol hand sanitizer exposures. Caregivers and health care providers should be aware of the potential dangers associated with hand sanitizer ingestion. Children using alcohol hand sanitizers should be supervised and these products should be kept out of reach from children when not in use.

Preoperative Hand Decontamination in Ophthalmic Surgery: A Comparison of the Removal of Bacteria from Surgeons' Hands by Routine Antimicrobial Scrub versus an Alcoholic Hand Rub.

PubMed

Forer, Yaara; Block, Colin; Frenkel, Shahar

2017-09-01

The goal of this experiment was to evaluate and compare the antimicrobial efficacy of routine preoperative hand washing using commercial medicated sponge brushes versus an alcoholic hand rub, by comparing bacterial growth on ophthalmic surgeons' hands after application of each of these methods. Twenty ophthalmic surgeons were recruited at the Hadassah-Hebrew University Medical Center in Jerusalem, Israel. Samples were collected twice from the hands of each surgeon after hand decontamination using two different protocols during routine surgical practice. The routine preparation consisted of a 3-minute surgical scrub using commercial brush-sponges incorporating either 4% chlorhexidine gluconate (CHG) or 1% povidone-iodine (PVP-I) formulations with detergent, followed by drying the hands with a sterile towel, while the 70% ethanol solution was applied for 60-seconds and allowed to air dry. Half of the group was randomly assigned to provide samples first after the routine method and the alcoholic solution a week later, and the other half of the group was sampled in the reverse order. Viable counts of bacteria were evaluated using a modified glove juice method. Bacterial colonies were enumerated after incubation for 24 hours and expressed as colony forming units (CFU)/mL for each pair of hands. Geometric mean counts were 1310 and 39 CFU/mL, in the routine and alcohol rub groups, respectively, representing a mean log 10 reduction in 1.53. The difference between the paired bacterial counts for the routine versus the alcohol rub was statistically significant (p < 0.0001). There was no statistically significant difference between log 10 reductions for CHG and PVP-I (p = 0.97). This study provides evidence that an alcohol rub protocol is more effective in reducing bacterial counts on hands than routine surgical hand preparation with PVP-I and CHG in a population of practicing ophthalmic surgeons in the operative clinical setting. Thus, it provides a safe alternative as a

Comparative assessment of local tolerance of alcohols commonly used in alcohol-based hand rubs for hand hygiene.

PubMed

Manche, Monique; Foligné, Benoît; Sauty, Mathieu; Platel, Anne; Vercauteren, Eric; Rauwel, Gaétan; Catoire, Sophie; Ficheux, Hervé; Criquelion, Jacques; Nesslany, Fabrice

2017-10-01

Hand hygiene plays a key role in nosocomial infection prevention. To achieve users' adherence, products' dermal tolerance is essential. We aimed at making a comparative assessment of skin irritation and phototoxicity of the 3 alcohols commonly used in alcohol-based hand rubs (Ethanol, Propan-2-ol, Propan-1-ol) at 60, 70, 80 or 85% w/w in water or with co-formulates (hydrating, emollient and skin protective agents). In vitro validated OECD methods 439 and 432 were used. For irritation, EpiSkin™ Small Model was the chosen Reconstructed Human Epidermis (RhE). For phototoxicity, co-formulates alone or in mixture with and without alcohol were tested using BALB/c 3T3 cell cultures. Whilst Ethanol and Propan-2-ol could not be differentiated and displayed good skin tolerance profiles, Propan-1-ol based products lead to significant viability impairments of RhE at 60, 70 or 80% and at 60% in the presence of co-formulates. However, these results could not be reproduced in another RhE model. Taking also into account bibliographic data on Propan-1-ol, this suggests that our results are probably related to a lack of specificity of the used RhE. Therefore, it can be relevant in case of significant results to use two different RhE models before performing any classification and/or performing any complementary tests. Copyright © 2017 Elsevier Ltd. All rights reserved.

A test procedure for evaluating surgical hand disinfection.

PubMed

Babb, J R; Davies, J G; Ayliffe, G A

1991-06-01

A technique for assessing the immediate and prolonged efficacy of surgical scrubs and alcoholic hand rubs is described. A mean baseline count is obtained from all volunteers and logarithmic reductions in resident skin flora immediately after one or more applications, and after wearing gloves for 3 h, are measured. Loose-fitting surgical gloves are used for sampling resident flora. Preparations were applied using a standard technique for 2 min, apart from one test with 70% isopropanol (IPA) in which the application time was 30 s. Two studies are described, one of which compared four chlorhexidine scrubs, and the second 70% IPA, 7.5% povidone-iodine scrub, 2% triclosan cleanser and unmedicated bar soap. In spite of their constituent similarity, the four chlorhexidine scrubs varied considerably in efficacy and user acceptability. A 2 min application of 70% IPA was the most effective treatment, and gave log10 reductions of 1.65 for immediate and 1.58 for prolonged effect. This was marginally more effective than a 30 s application, but the difference was not significant. 'Hibiscrub' was the most effective aqueous formulation and gave reductions of 1.01 for immediate effect and 1.16 for prolonged effect. The test described could be used by reference centres and manufacturers to assess the efficacy of new and existing surgical hand disinfection formulations.

Efficacy and effectiveness of alcohol in the disinfection of semi-critical materials: a systematic review.

PubMed

Ribeiro, Maíra Marques; Neumann, Verena Ashley; Padoveze, Maria Clara; Graziano, Kazuko Uchikawa

2015-01-01

to assess the efficacy and the effectiveness of 60-80% alcohol (v/v) in the disinfection of semi-critical materials which were either previously cleaned or not. studies obtained from BIREME, IBECS, MEDLINE, ScIELO, PubMed, Ask Medline web portals, and references from other studies. Criteria were created to assess the methodological quality of articles. Out of the 906 studies found, 14 have been included. after materials were disinfected with alcohol, microorganisms were detected in 104/282 (36.9%) effectiveness tests and in 23/92 (25.0%) efficacy tests that were conducted. In the field studies, disinfection was not achieved for 74/218 (33.9%) of the products that were submitted to previous cleaning and for 30/64 (46.9%) of the ones which were not submitted to previous cleaning. In the experimental studies, alcohol disinfection was not efficacy in 11/30 (36.7%) and 12/62 (19.4%) of products, respectively. The studies were not found to have followed standardized methods. disinfection of semi-critical products with alcohol 70% - or in an approximate concentration - cannot be recommended to all health care products in an unrestricted way. However, according to the type of semi-critical product, disinfection can be attained with or without previous cleaning.

Efficacy and effectiveness of alcohol in the disinfection of semi-critical materials: a systematic review

PubMed Central

Ribeiro, Maíra Marques; Neumann, Verena Ashley; Padoveze, Maria Clara; Graziano, Kazuko Uchikawa

2015-01-01

Abstract Objective: to assess the efficacy and the effectiveness of 60-80% alcohol (v/v) in the disinfection of semi-critical materials which were either previously cleaned or not. Method: studies obtained from BIREME, IBECS, MEDLINE, ScIELO, PubMed, Ask Medline web portals, and references from other studies. Criteria were created to assess the methodological quality of articles. Out of the 906 studies found, 14 have been included. Results: after materials were disinfected with alcohol, microorganisms were detected in 104/282 (36.9%) effectiveness tests and in 23/92 (25.0%) efficacy tests that were conducted. In the field studies, disinfection was not achieved for 74/218 (33.9%) of the products that were submitted to previous cleaning and for 30/64 (46.9%) of the ones which were not submitted to previous cleaning. In the experimental studies, alcohol disinfection was not efficacy in 11/30 (36.7%) and 12/62 (19.4%) of products, respectively. The studies were not found to have followed standardized methods. Conclusion: disinfection of semi-critical products with alcohol 70% - or in an approximate concentration - cannot be recommended to all health care products in an unrestricted way. However, according to the type of semi-critical product, disinfection can be attained with or without previous cleaning. PMID:26444178

Association of hand and arm disinfection with asthma control in US nurses.

PubMed

Dumas, Orianne; Varraso, Raphäelle; Boggs, Krislyn M; Descatha, Alexis; Henneberger, Paul K; Quinot, Catherine; Speizer, Frank E; Zock, Jan-Paul; Le Moual, Nicole; Camargo, Carlos A

2018-05-01

To investigate the association between occupational exposure to disinfectants/antiseptics used for hand hygiene and asthma control in nurses. In 2014, we invited female nurses with asthma drawn from the Nurses' Health Study II to complete two supplemental questionnaires on their occupation and asthma (cross-sectional study, response rate: 80%). Among 4055 nurses (mean age: 59 years) with physician-diagnosed asthma and asthma medication use in the past year, we examined asthma control, as defined by the Asthma Control Test (ACT). Nurses were asked about the daily frequency of hand hygiene tasks: 'wash/scrub hands with disinfectants/hand sanitizers' (hand hygiene) and 'wash/scrub arms with disinfecting products' (surrogate of surgical hand/arm antisepsis). Analyses were adjusted for age, race, ethnicity, smoking status and body mass index. Nurses with partly controlled asthma (ACT: 20-24, 50%) and poorly controlled asthma (ACT ≤19, 18%) were compared with nurses with controlled asthma (ACT=25, 32%). In separate models, both hand and arm hygiene were associated with poorly controlled asthma. After mutual adjustment, only arm hygiene was associated with poorly controlled asthma: OR (95% CI) for <1 time/day, 1.38 (1.06 to 1.80); ≥1 time/day, 1.96 (1.52 to 2.51), versus never. We observed a consistent dose-response relationship between frequency of arm hygiene tasks (never to >10 times/day) and poor asthma control. Associations persisted after further adjustment for surfaces/instruments disinfection tasks. Frequency of hand/arm hygiene tasks in nurses was associated with poor asthma control. The results suggest an adverse effect of products used for surgical hand/arm antisepsis. This potential new occupational risk factor for asthma warrants further study. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Efficacy of alcohol-based hand sanitizer on hands soiled with dirt and cooking oil.

PubMed

Pickering, Amy J; Davis, Jennifer; Boehm, Alexandria B

2011-09-01

Handwashing education and promotion are well established as effective strategies to reduce diarrhea and respiratory illness in countries around the world. However, access to reliable water supplies has been identified as an important barrier to regular handwashing in low-income countries. Alcohol-based hand sanitizer (ABHS) is an effective hand hygiene method that does not require water, but its use is not currently recommended when hands are visibly soiled. This study evaluated the efficacy of ABHS on volunteers' hands artificially contaminated with Escherichia coli in the presence of dirt (soil from Tanzania) and cooking oil. ABHS reduced levels of E. coli by a mean of 2.33 log colony forming units (CFU) per clean hand, 2.32 log CFU per dirt-covered hand, and 2.13 log CFU per oil-coated hand. No significant difference in efficacy was detected between hands that were clean versus dirty or oily. ABHS may be an appropriate hand hygiene method for hands that are moderately soiled, and an attractive option for field settings in which access to water and soap is limited.

Hand hygiene for the prevention of nosocomial infections.

PubMed

Kampf, Günter; Löffler, Harald; Gastmeier, Petra

2009-10-01

The WHO regards hand hygiene as an essential tool for the prevention of nosocomial infection, but compliance in clinical practice is often low. The relevant scientific literature and national and international evidence-based recommendations (Robert Koch Institute [Germany], WHO) were evaluated. Hygienic hand disinfection has better antimicrobial efficacy than hand-washing and is the procedure of choice to be performed before and after manual contact with patients. The hands should be washed, rather than disinfected, only when they are visibly soiled. Skin irritation is quite common among healthcare workers and is mainly caused by water, soap, and prolonged wearing of gloves. Compliance can be improved by training, by placing hand-rub dispensers at the sites where they are needed, and by physicians setting a good example for others. Improved compliance in hand hygiene, with proper use of alcohol-based hand rubs, can reduce the nosocomial infection rate by as much as 40%.

Less and less-influence of volume on hand coverage and bactericidal efficacy in hand disinfection.

PubMed

Kampf, Günter; Ruselack, Sigunde; Eggerstedt, Sven; Nowak, Nicolas; Bashir, Muhammad

2013-10-10

Some manufacturers recommend using 1.1 mL per application of alcohol-based handrubs for effective hand disinfection. However, whether this volume is sufficient to cover both hands, as recommended by the World Health Organization, and fulfills current efficacy standards is unknown. This study aimed to determine hand coverage for three handrubs (two gels based on 70% v/v and 85% w/w ethanol and a foam based on 70% v/v ethanol) applied at various volumes. Products were tested at product volumes of 1.1 mL, 2 mL, 2.4 mL as well as 1 and 2 pump dispenser pushes; the foam product was tested in addition at foam volumes of 1.1 mL, 2 mL, and 2.4 mL. Products were supplemented with a fluorescent dye and 15 participants applied products using responsible application techniques without any specific steps but the aim of completely covering both hands. Coverage quality was determined under ultraviolet light by two blinded investigators. Efficacy of the three handrubs was determined according to ASTM E 1174-06 and ASTM E 2755-10. For each experiment, the hands of 12 participants were contaminated with Serratia marcescens and the products applied as recommended (1.1 mL for 70% v/v ethanol products; 2 mL for the 85% w/w ethanol product). Log10-reduction was calculated. Volumes < 2 mL yielded high rates of incomplete coverage (67%-87%) whereas volumes ≥ 2 mL gave lower rates (13%-53%). Differences in coverage were significant between the five volumes tested for all handrubs (p < 0.001; two-way ANOVA) but not between the three handrubs themselves (p = 0.796). Application of 1.1 mL of 70% v/v ethanol rubs reduced contamination by 1.85 log10 or 1.60 log10 (ASTM E 1174-06); this failed the US FDA efficacy requirement of at least 2 log10. Application of 2 mL of the 85% w/w ethanol rub reduced contamination by 2.06 log10 (ASTM E 1174-06), fulfilling the US FDA efficacy requirement. Similar results were obtained according to ASTM E 2755-10. Our data indicated that

Less and less–influence of volume on hand coverage and bactericidal efficacy in hand disinfection

PubMed Central

2013-01-01

Background Some manufacturers recommend using 1.1 mL per application of alcohol-based handrubs for effective hand disinfection. However, whether this volume is sufficient to cover both hands, as recommended by the World Health Organization, and fulfills current efficacy standards is unknown. This study aimed to determine hand coverage for three handrubs (two gels based on 70% v/v and 85% w/w ethanol and a foam based on 70% v/v ethanol) applied at various volumes. Methods Products were tested at product volumes of 1.1 mL, 2 mL, 2.4 mL as well as 1 and 2 pump dispenser pushes; the foam product was tested in addition at foam volumes of 1.1 mL, 2 mL, and 2.4 mL. Products were supplemented with a fluorescent dye and 15 participants applied products using responsible application techniques without any specific steps but the aim of completely covering both hands. Coverage quality was determined under ultraviolet light by two blinded investigators. Efficacy of the three handrubs was determined according to ASTM E 1174-06 and ASTM E 2755-10. For each experiment, the hands of 12 participants were contaminated with Serratia marcescens and the products applied as recommended (1.1 mL for 70% v/v ethanol products; 2 mL for the 85% w/w ethanol product). Log10-reduction was calculated. Results Volumes < 2 mL yielded high rates of incomplete coverage (67%–87%) whereas volumes ≥ 2 mL gave lower rates (13%–53%). Differences in coverage were significant between the five volumes tested for all handrubs (p < 0.001; two-way ANOVA) but not between the three handrubs themselves (p = 0.796). Application of 1.1 mL of 70% v/v ethanol rubs reduced contamination by 1.85 log10 or 1.60 log10 (ASTM E 1174-06); this failed the US FDA efficacy requirement of at least 2 log10. Application of 2 mL of the 85% w/w ethanol rub reduced contamination by 2.06 log10 (ASTM E 1174-06), fulfilling the US FDA efficacy requirement. Similar results were obtained according to ASTM E 2755

Quality of alcohol-based hand disinfectants and their regulatory status. Development and marketing authorisation.

PubMed

Stengele, Michael

2008-10-01

A 2005 survey showed that there are at least four legal product classifications for hand disinfectants in the European Union: medicinal products, biocidal products, cosmetics and medical devices. An internationally harmonized classification does not exist. The regulatory status of those products is defined at national level. In order to assure compliance with the regulations these four classifications provide different levels of official surveillance varying from product-specific marketing authorisations and production site audits to the obligation to just work in accordance with certain general guidelines. Biocidal product regulations cover eco-toxicological and toxicological aspects, but do not very much address to the customers' quality and efficacy expectations. In contrast, the medicinal product legislation is the most ambitious one claiming quality, safety, efficacy, and an independent benefit risk-assessment by an authority. In respect of ambition, the two remaining product categories--cosmetics and medical devices--rank between the both classifications mentioned above. For medical devices, it is the responsibility of the manufacturer to make sure the products meet defined essential requirements regarding quality, safety and performance and to have an appropriate quality assurance system implemented under third party control. For cosmetics there are some legal restrictions, but within these it is the sole responsibility of the manufacturer to ensure that the products are safe and fulfil their claims. This paper describes one way out of this increasingly complex situation, the definition of a single quality standard meeting the users' expectations as well as all legal requirements regardless of the specific sales country. This international quality standard for products would take priority over any individual national standard, to the benefit of users.

[Development of alternative to animal experiment in evaluation of skin irritation caused by alcohol-based hand rubs].

PubMed

Yamamoto, Nobuyuki; Miyamoto, Koji; Katoh, Masakazu

2010-08-01

Alcohol-based hand rubs are widely used for infection control in clinical practice. However, it is known that frequent use of the alcohol-based hand rubs may cause skin irritation. To predict the skin irritation in human, animal experiments are quite useful. Especially, the Draize Test using rabbits is suitable for this purpose because their skin is highly sensitive. On the other hand, the development of alternative to animal experiments is important not only from the viewpoint of ethical aspects but also from the efficient research and development. Reconstructed human epidermis (RhE) was developed as a human skin equivalent model in vitro, and has been applied to the evaluation of skin irritation. But the RhE has not been utilized for the evaluation of alcohol-based hand rubs because of the high skin permeability and cytotoxicity of alcohols. The aim of this study was to develop a new method using the RhE in evaluation of skin irritation caused by alcohol-based hand rubs. The authors propose an experimental technique named "Skin model blowing method (SMBM)" consisting of the sequential procedure as follows; applying small amount of testing sample on RhE, blow-dry, post incubation, and cell viability measurement. According to the SMBM, the skin irritation caused by alcohol-based hand rubs could be evaluated under the similar condition of their actual use. It was found that a high correlation existed between the cell viability obtained from SMBM and the skin irritation index in rabbit which had been reported previously.

Video-based instructions for surgical hand disinfection as a replacement for conventional tuition? A randomised, blind comparative study.

PubMed

Weber, Uwe; Constantinescu, Mihai A; Woermann, Ulrich; Schmitz, Felix; Schnabel, Kai

2016-01-01

Various different learning methods are available for planning tuition regarding the introduction to surgical hand disinfection. These learning methods should help to organise and deal with this topic. The use of a video film is an alternative to conventional tuition due to the real presentation possibilities of practical demonstration. This study examines by way of comparison which form of communication is more effective for learning and applying surgical hand disinfection for medical students in their first year of studies: video-based instruction or conventional tuition. A total of 50 first-year medical students were randomly allocated either to the "Conventional Instruction" (CI) study group or to the "Video-based Instruction" (VI) study group. The conventional instruction was carried out by an experienced nurse preceptor/nurse educator for the operating theatre who taught the preparatory measures and the actual procedure in a two-minute lesson. The second group watched a two-minute video sequence with identical content. Afterwards, both groups demonstrated practically the knowledge they had acquired at an individual practical test station. The quality (a) of the preparation and (b) of the procedure as well as (c) the quality of the results was assessed by 6 blind experts using a check list. The acceptability of the respective teaching method was also asked about using a questionnaire. The group performance did not differ either in the preparation (t=-78, p<0.44) or in the quality (t=-99, p<0.34). With respect to performance, it was possible to demonstrate a strong treatment effect. In the practical (t=-3.33, p<0.002, d=0.943) and in the total score (t=-2.65, p<0.011, d=0.751), the group with video-based instruction achieved a significantly better result. In response to the question as to which of the two learning methods they would prefer, the significant majority (60.4%) of students stated video instruction. In this study, the use of the video-based

Why language matters: a tour through hand hygiene literature.

PubMed

Pires, Daniela; Tartari, Ermira; Bellissimo-Rodrigues, Fernando; Pittet, Didier

2017-01-01

Hand hygiene has evolved over the last decades and many terminologies emerged. We aimed to analyse the evolution in the frequency of utilization of key hand hygiene terms in the literature along the years. We identified keywords and Medical Subject Headings (MeSH) used in MEDLINE® indexation related to hand hygiene by searching international guidelines and the MeSH database. We performed a MEDLINE® search combining the selected keywords and MeSH and analysed the number of publications retrieved yearly. The literature search yielded 9019 publications when all hand hygiene related search terms were combined, between 1921 and November 2016. The total number of publications per year increased from a median of 4 (IQR 3, 6) in the 1950's to 554 (IQR 478, 583) between 2011 and 2015. The most frequently used keywords are hand disinfection, hand hygiene, hand washing, handrub, hand sanitizer and alcohol-based hand rub (ABHR). Until the 1990s, hand disinfection and hand washing were the most frequently used terms. Whilst the last decade has seen a remarkable increase in publications mentioning hand disinfection and hand hygiene and for the first time handrub, hand sanitizers and ABHR were introduced in the literature. Hand disinfection, hand hygiene and hand sanitizers are the main MeSH used by MEDLINE®. Since 2013 hand hygiene is the most frequently used MeSH and keyword. The change seen in literature in the last two decades, from hand washing and hand disinfection to hand hygiene, most probably reflect the paradigm shift favouring use of ABHR over soap and water promoted by international guidelines in the early 2000s.

Survey of attitudes and practices of Irish nursing students towards hand hygiene, including handrubbing with alcohol-based hand rub.

PubMed

Kingston, Liz M; O'Connell, Nuala H; Dunne, Colum P

2017-05-01

Hand hygiene is widely recognised as the most important measure a healthcare worker can take in preventing the spread of healthcare associated infections. As a member of the healthcare team, nursing students have direct patient contact during clinical practice; hence, good hand hygiene practice among nursing students is essential. Low to moderate levels of hand hygiene knowledge and poor attitudes and practices are reported among nursing students. However, less is known about their attitudes and practices of handrubbing with ABHR, even though handrubbing is the recommended optimum practice in most situations. The aim of this study was to explore attitudes and practices of hand hygiene, in particular handrubbing with alcohol-based hand rub, among nursing students in Ireland. This survey employed a descriptive, self-report design using a questionnaire to gather data. It was administered electronically to all undergraduate nursing students (n=342) in the Department of Nursing and Midwifery at the University of Limerick, Ireland in March and April 2015. Response rate was 66%. Attitudes towards hand hygiene were generally positive. Compliance with hand hygiene after contact with body fluid was high (99.5%) and before a clean or aseptic procedure (98.5%). However, suboptimal practices emerged, before touching a patient (85%), after touching a patient (87%) and after touching patients' surroundings (61%), with first year students more compliant than fourth year students. 16% of students were not aware of the clinical contraindications for using alcohol-based hand rub and 9% did not know when to use soap and water and when to use alcohol-based hand rub. Educators and practitioners play an important role in ensuring that nursing students develop appropriate attitudes towards hand hygiene and engage in optimal handrubbing practices. Raising awareness among nursing students of their responsibility in preventing the occurrence and reducing the transmission of HCAI as an on

Breath alcohol of anesthesiologists using alcohol hand gel and the "five moments for hand hygiene" in routine practice.

PubMed

Lindsay, Helen A; Hannam, Jacqueline A; Bradfield, Charles N; Mitchell, Simon J

2016-08-01

Appropriate hand hygiene reduces hospital-acquired infections. Anesthesiologists work in environments with numerous hand hygiene opportunities (HHOs). In a prospective observational study, we investigated the potential for an anesthesiologist to return a positive alcohol breath test during routine practice when using alcohol hand gel. We observed ten volunteer anesthesiologists over four hours while they implemented the World Health Organization (WHO) "five moments for hand hygiene" using our hospital's adopted standard 70% ethanol hand gel. We measured the expired alcohol concentration at shift start and every fifteen minutes thereafter with a fuel cell breathalyzer calibrated to measure the percentage of blood alcohol concentration (BAC). Blood alcohol specimens (analyzed with gas chromatography) were collected at shift start and, when possible, immediately after a participant's first positive breathalyzer test. Of the 130 breathalyzer tests obtained, there were eight (6.2%) positive breath alcohol results from six of the ten participants, all within two minutes of a HHO. The highest value breathalyzer BAC recorded was 0.064%, with an overall mean (SD) of 0.023 (0.017)%. Five (62.5%) of the positive breathalyzer tests returned to zero in less than seven minutes. All of three blood specimens obtained immediately after a positive breathalyzer reading tested negative for alcohol. Anesthesia practitioners using alcohol hand gel in a manner that conforms with recommended hand hygiene can test positive for alcohol on a breathalyzer assay. Positive tests probably arose from inhalation of alcohol vapour into the respiratory dead space following gel application. If workplace breath testing for alcohol is implemented, it should be completed more than 15 min after applying alcohol hand gel. Positive results should be verified with a BAC test.

Adequate disinfection of a split-septum needleless intravascular connector with a 5-second alcohol scrub.

PubMed

Rupp, Mark E; Yu, Stephanie; Huerta, Tomas; Cavalieri, R Jennifer; Alter, Roxanne; Fey, Paul D; Van Schooneveld, Trevor; Anderson, James R

2012-07-01

Define optimum vascular catheter connector valve disinfection practices under laboratory and clinical conditions. Prospective observational clinical survey and laboratory assessment of disinfection procedures. All adult inpatients at an academic healthcare center. In the clinical setting, contamination of needleless connectors was assessed in 6 weekly prevalence surveys in which the connector valves from central venous catheters (CVCs) in situ were cultured by pressing the connector diaphragm to an agar plate. Before culture, valves were disinfected by scrubbing the diaphragm with a 70% isopropyl alcohol pledget for 0, 5, 10, 15, or 30 seconds. In the laboratory, the diaphragms on 150 unused sterile connector valves were inoculated with 10(3), 10(5), or 10(8) colony-forming units of Staphylococcus epidermidis and allowed to dry. After disinfection of the diaphragms by scrubbing with a 70% isopropyl alcohol pledget for 0, 5, 10, 15, or 30 seconds, the valves were sampled by pressing the diaphragm to an agar plate. In the clinical setting, 363 connector valves from patients with CVCs were sampled, and 66.7% of nondisinfected valves revealed bacterial contamination. After 5-second disinfection with an alcohol pledget, only 1 (1.4%) of 71 yielded microbial growth (P < .005). In the laboratory, at the 10(3) and 10(5) inoculum, all connector valves yielded sterile cultures when scrubbed for 5 or more seconds (P < .001). At the 10(8) inoculum, 2 (20%) of 10 connector valves yielded minimal growth of S. epidermidis. A 5-second scrub with a 70% isopropyl alcohol pledget yields adequate disinfection of a split-septum intravascular catheter connector valve under clinical and laboratory conditions.

Disinfection of the Radiologist Workstation and Radiologist Hand Hygiene: A Single Institution Practice Quality Improvement Project.

PubMed

Quon, Jeffrey S; Dilauro, Marc; Ryan, John G

2017-08-01

The purpose of this study was to evaluate the workstation disinfection rates and hand hygiene of radiologists and trainees at shared departmental workstations and assess the impact of education and reminder placards on daily habits. A 10-question survey was administered to all staff radiologists, fellows, and residents at our institution. The questions pertained to workstation disinfection, hand hygiene habits, and accessibility to disinfectant wipes and hand sanitizer stations. Subsequently, a short educational PowerPoint presentation was emailed to the department and small reminder placards were placed at each workstation. A follow-up survey was administered. Chi-square and Wilcoxon signed-rank tests were used to analyse the results. The percentage of participants who disinfect their workstations 1-2 times/week, 3-4 times/week or everyday increased from 53.4% (45 of 84 participants) to 74.3% (55 of 74 participants; P = .01), while the number who disinfect their workstation <1 time/week or never decreased from 46.4% (39 of 84 participants) to 25.7% (19 of 74 participants; P = .01). Hand washing before working at the workstation increased from 41.6% (35 of 84 participants) to 48.7% (36 of 74 participants; P = .76) and hand washing after working at the workstation increased from 50.0% (42 of 84 participants) to 56.8% (42 of 74 participants; P = .49). At our institution, the implementation of daily reminder placards at each workstation and the administration of an educational PowerPoint presentation improved the rate of radiologist workstation disinfection. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

New formaldehyde base disinfectants.

NASA Technical Reports Server (NTRS)

Trujillo, R.; Lindell, K. F.

1973-01-01

Preparations of formaldehyde in various organic liquids - ethylene glycol, glycerol, and propylene glycol - serve as effective disinfectants towards microbial vegetative cells and spores. This disinfection is a temperature-dependent process and is manifest when these formaldehyde base disinfectants are dissolved in water. The irritating vapors associated with formaldehyde disinfection are not present in either of these new formaldehyde base disinfectants or in aqueous solutions of them.

Effectiveness of a nonrinse, alcohol-free antiseptic hand wash.

PubMed

Moadab, A; Rupley, K F; Wadhams, P

2001-06-01

This study evaluated the efficacy of a novel surfactant, allantoin, and benzalkonium chloride hand sanitizer using the US Food and Drug Administration's method for testing antiseptic hand washes that podiatric physicians and other health-care personnel use. The alcohol-free product, HandClens, was compared with an alcohol-based product, Purell. Independent researchers from the California College of Podiatric Medicine conducted the study using 40 volunteer students from the class of 2001. The results show that HandClens outperformed Purell and met the regulatory requirements for a hand sanitizer. Purell failed as an antimicrobial hand wash and was less effective than a control soap used in the study.

Disinfection of gloves: feasible, but pay attention to the disinfectant/glove combination.

PubMed

Scheithauer, S; Häfner, H; Seef, R; Seef, S; Hilgers, R D; Lemmen, S

2016-11-01

Compliance with hand hygiene is complicated by indications for hand disinfection in rapid succession during the care of one patient. In such situations, disinfection of gloves could facilitate better workflow and optimize compliance rates. We analysed the efficacy of disinfecting gloves by comparing an individual effect of five different hand disinfectant solutions in combination with three different glove types. The investigation was performed in accordance with DIN EN 1500:2013. For all combinations, ten analyses were performed, including (1) right/left-hand examination disinfection efficacy after the first and fifth contamination with E. coli K12 NCTC 10538, (2) recovery rates after contamination, (3) reduction efficacy, (4) fingertip immersion culture, and (5) check for tightness. Disinfection of the ungloved hands was taken as an additional benchmark. The disinfection efficacy for all disinfectant/glove combinations was better with rather than without gloves. For eight combinations, the disinfection efficacy was always >5.0 log 10 . There were significant differences within the gloves (P=0.0021) and within the disinfectant product (P=0.0023), respectively. In detail, Nitril Blue Eco-Plus performed significantly better than Vasco Braun (P=0.0017) and Latex Med Comfort (P=0.0493). Descoderm showed a significantly worse performance than Promanum pure (P=0.043). In the check for tightness, only the Vasco Braun gloves showed no leaks in all samples. There were relevant qualitative differences pertaining to the comfort of disinfecting gloves. The disinfection efficacy for the different disinfectant/glove combinations was greater than for the ungloved hands. However, various disinfectant/glove combinations produce relevant differences as regards disinfection efficacy. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Inefficacy of alcohol-based hand rub on mites in a patient with hyperkeratotic scabies.

PubMed

Cinotti, E; Perrot, J L; Labeille, B; Maguet, H; Couzan, C; Flori, P; Cambazard, F

2015-03-01

The World Health Organization is strongly promoting alcohol-based hand rubs to interrupt transmission of pathogens within the healthcare environment, and in some hospitals they are being recommended in cases of scabies. However, there are no studies that demonstrate the efficacy of such hand rubs against scabies. To evaluate the viability of Sarcoptes scabiei after the application of various topical antiseptics used for hand hygiene, and the effect of hand washing on the number of parasites present on the skin surface of a patient with scabies. We applied three different topical antiseptics (two alcohol-based and one povidone-iodine-based) to the skin of one hand that was affected by scabies, and took a skin scraping of each area to evaluate the viability of the mites over time. A skin scraping of a control area without antiseptic application was also taken. We also tested the antiseptics directly on the mites. Statistical comparison between the percentages of vital mites in the different samples was assessed using the χ(2) test. We also captured a dermoscopic image of the other hand before and after hand washing to count the number of parasites on the skin surface. Topical antiseptics did not reduce the number of living mites compared with control skin, and hand washing did not reduce the number of parasites on the skin surface. Application of topical antiseptics does not reduce the viability of S. scabiei, and is therefore unable to prevent the transmission of scabies. The usefulness of hand washing in preventing transmission of scabies to new subjects remains to be investigated. © 2014 British Association of Dermatologists.

Bactericidal Efficacy of Hydrogen Peroxide-Based Disinfectants Against Gram-Positive and Gram-Negative Bacteria on Stainless Steel Surfaces.

PubMed

Ríos-Castillo, Abel G; González-Rivas, Fabián; Rodríguez-Jerez, José J

2017-10-01

In order to develop disinfectant formulations that leverage the effectiveness of hydrogen peroxide (H 2 O 2 ), this study evaluated the bactericidal efficacy of hydrogen peroxide-based disinfectants against Gram-positive and Gram-negative bacteria on stainless steel surfaces. Low concentration of hydrogen peroxide as 0.5% with a cationic polymer, ethoxylated fatty alcohol, and ethyl alcohol had bactericidal efficacy (reductions ≥ 4 log 10 CFU/mL) against Escherichia coli, Staphylococcus aureus, Enterococcus hirae, and Pseudomonas aeruginosa. Hydrogen peroxide-based disinfectants were more effective against E. hirae and P. aeruginosa than to S. aureus. However, the efficacy of hydrogen peroxide against catalase positive bacteria such as S. aureus was increased when this compound was formulated with low concentrations of benzalkonium chloride or ethyl alcohol, lactic acid, sodium benzoate, cationic polymer, and salicylic acid. This study demonstrates that the use of hydrogen peroxide with other antimicrobial products, in adequate concentrations, had bactericidal efficacy in Gram-positive and Gram-negative bacteria on stainless steel surfaces, enabling to reduce the effective concentration of hydrogen peroxide. In the same way, the use of hydrogen peroxide-based disinfectants could reduce the concentrations of traditional disinfectants as quaternary ammonium compounds and therefore a reduction of their chemical residues in the environment after being used. The study of the bactericidal properties of environmentally nontoxic disinfectants such as hydrogen peroxide, sole or in formulations with other disinfectants against Gram-positive and Gram-negative bacteria can enhance the efficacy of various commonly used disinfectant formulations with the hygiene benefits that it entails. Also, the use of hydrogen peroxide formulations can reduce the concentration levels of products that generate environmental residues. © 2017 Institute of Food Technologists®.

Towards objective hand hygiene technique assessment: validation of the ultraviolet-dye-based hand-rubbing quality assessment procedure.

PubMed

Lehotsky, Á; Szilágyi, L; Bánsághi, S; Szerémy, P; Wéber, G; Haidegger, T

2017-09-01

Ultraviolet spectrum markers are widely used for hand hygiene quality assessment, although their microbiological validation has not been established. A microbiology-based assessment of the procedure was conducted. Twenty-five artificial hand models underwent initial full contamination, then disinfection with UV-dyed hand-rub solution, digital imaging under UV-light, microbiological sampling and cultivation, and digital imaging of the cultivated flora were performed. Paired images of each hand model were registered by a software tool, then the UV-marked regions were compared with the pathogen-free sites pixel by pixel. Statistical evaluation revealed that the method indicates correctly disinfected areas with 95.05% sensitivity and 98.01% specificity. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

[Experiments on disinfection of vaccinia virus embedded in scabs and/or at the hand].

PubMed

Schümann, K; Grossgebauer, K

1977-01-01

Vaccinia viruses embedded in rabbit dermal scabs were subjected to physical and chemical disinfection procedures. Scabs were suspended in vitro without saline or in physiological saline, and left for 1 hour at 70 to 90 degrees C. A complete inactivation was achived only in those scab samples which had been incubated at 90 degrees C for 1 hour and suspended in physiological saline. Scabs which had been placed in a disinfecting apparatus (Vacudes 4000) filled with mattrasses consistently proved to be free of infectious vaccinia viruses in each of the chosen programs. In addition scabs were subjected to disinfection by means of chemical disinfecting agents. The scabs had been placed in a chemical disinfecting suspension and left there for 90 minutes. Complete disinfection was obtained with glutaraldehyde 2%, formaldehyde 2%, Lysoformin 2% or 3%, phenol 5% and chloramine T 2%. Complete disinfection was likewise achieved after 3 hours treatment with some alchohols (ethylalcohol 80%, isopropylalcohol 7%, n-propylalcohol 60%), Amocid 5% and formaldehyde 1%.0.5% formaldehyde caused complete disinfection when applied for 6 hours. The only exception was a Quat which did not disinfect fully even after 18 hours application. Concerning the tests to disinfect the hands complete disinfection occurs when using chloramine T (1.5%) or isopropylalcohol (70%) in 2 to 5 minutes. Further tests were performed with scabs which were placed in sick rooms that were terminally disinfected with formaline vapor. It could be confirmed that the usual terminal disinfection with formaldehyde vapor was unable to completely disinfect the scabs. It is necessary to double the amount of formaldehyde (10 g formaldehyde per cubic metre of space) and prolong the period of treatment to 24 hours to achieve a greater degree of disinfection rate.

Ability of Hand Hygiene Interventions Using Alcohol-Based Hand Sanitizers and Soap To Reduce Microbial Load on Farmworker Hands Soiled during Harvest.

PubMed

de Aceituno, Anna Fabiszewski; Bartz, Faith E; Hodge, Domonique Watson; Shumaker, David J; Grubb, James E; Arbogast, James W; Dávila-Aviña, Jorgé; Venegas, Fabiola; Heredia, Norma; García, Santos; Leon, Juan S

2015-11-01

Effective hand hygiene is essential to prevent the spread of pathogens on produce farms and reduce foodborne illness. The U.S. Food and Drug Administration Food Safety Modernization Act Proposed Rule for Produce Safety recommends the use of soap and running water for hand hygiene of produce handlers. The use of alcohol-based hand sanitizer (ABHS) may be an effective alternative hygiene intervention where access to water is limited. There are no published data on the efficacy of either soap or ABHS-based interventions to reduce microbial contamination in agricultural settings. The goal of this study was to assess the ability of two soap-based (traditional or pumice) and two ABHS-based (label-use or two-step) hygiene interventions to reduce microbes (coliforms, Escherichia coli, and Enterococcus spp.) and soil (absorbance of hand rinsate at 600 nm [A600]) on farmworker hands after harvesting produce, compared with the results for a no-hand-hygiene control. With no hand hygiene, farmworker hands were soiled (median A600, 0.48) and had high concentrations of coliforms (geometric mean, 3.4 log CFU per hand) and Enterococcus spp. (geometric mean, 5.3 log CFU per hand) after 1 to 2 h of harvesting tomatoes. Differences in microbial loads in comparison to the loads in the control group varied by indicator organism and hygiene intervention (0 to 2.3 log CFU per hand). All interventions yielded lower concentrations of Enterococcus spp. and E. coli (P < 0.05), but not of coliforms, than were found in the control group. The two-step ABHS intervention led to significantly lower concentrations of coliforms and Enterococcus spp. than the pumice soap and label-use ABHS interventions (P < 0.05) and was the only intervention to yield significantly fewer samples with E. coli than were found in the control group (P < 0.05). All interventions removed soil from hands (P < 0.05), soap-based interventions more so than ABHS-based interventions (P < 0.05). ABHS-based interventions were

Effectiveness of liquid soap and hand sanitizer against Norwalk virus on contaminated hands.

PubMed

Liu, Pengbo; Yuen, Yvonne; Hsiao, Hui-Mien; Jaykus, Lee-Ann; Moe, Christine

2010-01-01

Disinfection is an essential measure for interrupting human norovirus (HuNoV) transmission, but it is difficult to evaluate the efficacy of disinfectants due to the absence of a practicable cell culture system for these viruses. The purpose of this study was to screen sodium hypochlorite and ethanol for efficacy against Norwalk virus (NV) and expand the studies to evaluate the efficacy of antibacterial liquid soap and alcohol-based hand sanitizer for the inactivation of NV on human finger pads. Samples were tested by real-time reverse transcription-quantitative PCR (RT-qPCR) both with and without a prior RNase treatment. In suspension assay, sodium hypochlorite concentrations of >or=160 ppm effectively eliminated RT-qPCR detection signal, while ethanol, regardless of concentration, was relatively ineffective, giving at most a 0.5 log(10) reduction in genomic copies of NV cDNA. Using the American Society for Testing and Materials (ASTM) standard finger pad method and a modification thereof (with rubbing), we observed the greatest reduction in genomic copies of NV cDNA with the antibacterial liquid soap treatment (0.67 to 1.20 log(10) reduction) and water rinse only (0.58 to 1.58 log(10) reduction). The alcohol-based hand sanitizer was relatively ineffective, reducing the genomic copies of NV cDNA by only 0.14 to 0.34 log(10) compared to baseline. Although the concentrations of genomic copies of NV cDNA were consistently lower on finger pad eluates pretreated with RNase compared to those without prior RNase treatment, these differences were not statistically significant. Despite the promise of alcohol-based sanitizers for the control of pathogen transmission, they may be relatively ineffective against the HuNoV, reinforcing the need to develop and evaluate new products against this important group of viruses.

In-vivo efficacy of hand sanitisers against feline calicivirus: a surrogate for norovirus.

PubMed

Lages, S L S; Ramakrishnan, M A; Goyal, S M

2008-02-01

Hand disinfection is considered important in preventing the transmission of viruses, including norovirus. We investigated the virucidal efficacy of nine hand sanitisers (four alcohol-based sanitisers, three non-alcoholic sanitisers and two triclosan-containing antimicrobial liquid soaps) against feline calicivirus, a surrogate for norovirus, on artificially contaminated fingertips for 30 s and 2 min contact periods. Among alcohol-based sanitisers, a product containing 99.5% ethanol was more effective than those containing 62% ethanol, 70% isopropanol or 91% isopropanol. A log(10) virus reduction factor of 1.00-1.30 was achieved with 99.5% ethanol but those containing a lower alcohol concentration only achieved a log(10) reduction factor of alcohol-based sanitisers, non-alcoholic sanitisers or antimicrobial soaps. The two antimicrobial soaps tested showed minimal virus reduction (a log(10) reduction factor of 0.17-0.50), which is similar to that obtained by washing hands without any soap (a log(10) reduction factor of 0.33-0.42). These results indicate that triclosan-containing antimicrobial soaps or alcohol-based hand rubs may be inadequate for preventing norovirus transmission. Further research on alternative hand sanitisers should continue for effective control of norovirus infections.

Clean and Green: Saving Water in the Operating Theatre

PubMed Central

Jehle, Karlheinz; Jarrett, Nick; Matthews, Shaun

2008-01-01

INTRODUCTION There is a growing trend to use alcohol-based hand disinfectants in clinical practice. In addition to their antibacterial efficacy, these disinfectants offer an alternative to traditional surgical hand disinfection agents that can save water in the operating theatre. MATERIALS AND METHODS The amounts of water and soap used during traditional surgical hand disinfection with antiseptic soap preparations were measured and water usage over a 1-year period was estimated. Costs of traditional disinfection agents were compared with alcohol-based agents. RESULTS One surgical hand disinfection episode with traditional agents used 18.5 l of water. During 15,500 procedures performed at our institution over a 1-year period, 931,938 l of water were used which could have been saved had alcohol-based agents been used. Cost per episode of hand disinfection depends on the amounts used and is not higher compared to traditional agents. CONCLUSIONS The benefits of using an alcohol-based surgical hand disinfectant may include significant water savings, in addition to previously published advantages of improved efficacy. When deciding on the method of surgical hand disinfection, careful thought should be given to the use of water as a resource. Surgeons should be aware of the environmental impact of their profession. PMID:18201493

Comparison of the antibacterial efficacy and acceptability of an alcohol-based hand rinse with two alcohol-based hand gels during routine patient care.

PubMed

Barbut, Frédéric; Maury, Eric; Goldwirt, Laurianne; Boëlle, Piérre-Yves; Neyme, Denis; Aman, Rubina; Rossi, Beatrice; Offenstadt, Georges

2007-06-01

The aims of this study were to compare the antibacterial efficacy of handrubbing with an alcoholic rinse (AHRR) and two different alcoholic gels (AHRG) in reducing hand contamination under practical use conditions. We wanted to assess the acceptability of the three products and to determine the effect of each product on overall hand hygiene compliance. A prospective alternating time-series clinical trial was performed in a medical intensive care unit. The study was divided into three six-week periods (P1, P2, P3). Handrubbing was achieved with Sterillium rinse (AHRR) during P1, sterillium gel(AHRG-1) during P2 and Manugel Plus (AHRG-2) during P3. Pre- and post-rubbing hand contaminations were assessed immediately after a direct contact with a patient, using the glove juice technique. Health care workers (HCWs) evaluated the acceptability of the products through a self-administered anonymous questionnaire. Compliance of HCWs with hand hygiene was assessed during the three periods. We studied 242 handrubbing opportunities. The mean reduction factor (expressed as the Log(10) CFU/mL) of the AHRR, AHRG-1 and AHRG-2 were 1.28+/-0.95, 1.29+/-0.84 and 0.51+/-0.73, respectively (p<0.001). Assessment of the three products by HCWs indicated that AHRR and AHRG-1 were significantly better accepted than AHRG-2. The overall compliance of HCWs to hand hygiene was better when gel was available. Under practical use conditions, AHRG-1 and AHRR were more effective than AHRG-2, although all were claimed to pass the European standard EN1500. In vivo trials are essential to compare the antimicrobial efficacy of products for handrubbing.

Recommendations and requirements for soap and hand rub dispensers in healthcare facilities.

PubMed

Assadian, Ojan; Kramer, Axel; Christiansen, Bärbel; Exner, Martin; Martiny, Heike; Sorger, Arno; Suchomel, Miranda

2012-01-01

chemicals and cleaning products. It must be possible to reprocess the dispenser and all of its permanent parts by applying machine based thermal disinfection at an A(0)-value of minimum 60 (e.g. 80°C/1 minute). Automatically portioning dispensers shall not fail during 200 hubs. The maximal allowed failure rate shall not exceed 1% (2 out of 200 consecutive hubs). A dispenser used for alcohol based hand rubs must allow keeping the alcohol concentration constant over a time period of 3 months. The maximum acceptable decrease in the concentration of the alcohol shall not exceed 5%. Liquid soap and hand rub dispensers with single-use pumps, ideally already mounted on the cartridge and to be discharged with the empty cartridge, are preferable. If pumps are used on the next consecutive cartridge, the manufacturer must provide the user with a detailed introduction for cleansing and reprocessing before further use. Because of forensic reasons it is recommended to place a good readable sign on the dispenser indicating e.g. "Apply alcohol based hand rubs only on the hand! Do not drink, avoid spraying into the eye or application on mucous membranes". It is regarded as an additional benefit, if the dispenser is able to document the consumption of hand rub or the frequency of hubs either mechanically or electronically.

A randomized, controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the home.

PubMed

Sandora, Thomas J; Taveras, Elsie M; Shih, Mei-Chiung; Resnick, Elissa A; Lee, Grace M; Ross-Degnan, Dennis; Goldmann, Donald A

2005-09-01

Good hand hygiene may reduce the spread of infections in families with children who are in out-of-home child care. Alcohol-based hand sanitizers rapidly kill viruses that are commonly associated with respiratory and gastrointestinal (GI) infections. The objective of this study was to determine whether a multifactorial campaign centered on increasing alcohol-based hand sanitizer use and hand-hygiene education reduces illness transmission in the home. A cluster randomized, controlled trial was conducted of homes of 292 families with children who were enrolled in out-of-home child care in 26 child care centers. Eligible families had > or =1 child who was 6 months to 5 years of age and in child care for > or =10 hours/week. Intervention families received a supply of hand sanitizer and biweekly hand-hygiene educational materials for 5 months; control families received only materials promoting good nutrition. Primary caregivers were phoned biweekly and reported respiratory and GI illnesses in family members. Respiratory and GI-illness-transmission rates (measured as secondary illnesses per susceptible person-month) were compared between groups, adjusting for demographic variables, hand-hygiene practices, and previous experience using hand sanitizers. Baseline demographics were similar in the 2 groups. A total of 1802 respiratory illnesses occurred during the study; 443 (25%) were secondary illnesses. A total of 252 GI illnesses occurred during the study; 28 (11%) were secondary illnesses. The secondary GI-illness rate was significantly lower in intervention families compared with control families (incidence rate ratio [IRR]: 0.41; 95% confidence interval [CI]: 0.19-0.90). The overall rate of secondary respiratory illness was not significantly different between groups (IRR: 0.97; 95% CI: 0.72-1.30). However, families with higher sanitizer usage had a marginally lower secondary respiratory illness rate than those with less usage (IRR: 0.81; 95% CI: 0.65-1.09). A

Illness transmission in the home: a possible role for alcohol-based hand gels.

PubMed

Lee, Grace M; Salomon, Joshua A; Friedman, Jennifer F; Hibberd, Patricia L; Ross-Degnan, Dennis; Zasloff, Eva; Bediako, Sitso; Goldmann, Donald A

2005-04-01

The widespread use of child care has altered the epidemiology of respiratory and gastrointestinal (GI) infection in the community. Our primary objective was to measure transmission of respiratory and GI illnesses among families with children enrolled in child care. We also sought to examine potential predictors of reduced illness transmission in the home in a secondary analysis. We performed an observational, prospective cohort study to determine transmission rates for respiratory and GI illnesses within families with at least 1 child between 6 months and 5 years of age enrolled in child care. A survey about family beliefs and practices was mailed at the beginning of the study. Symptom diaries were provided for families to record the timing and duration of respiratory and GI illnesses. To ensure the accuracy of symptom diaries, biweekly telephone calls were performed to review illnesses recorded by participants. Families with > or =4 weeks of data recorded were included in the analysis. Families were recruited from 5 pediatric practices in the metropolitan Boston area. Of 261 families who agreed to participate in the study, 208 were available for analysis. Secondary transmission rates for respiratory and GI illnesses were measured as illnesses per susceptible person-month. We observed 1545 respiratory and 360 GI illnesses in 208 families from November 2000 to May 2001. Of these, 1099 (71%) respiratory and 297 (83%) GI illnesses were considered primary illnesses introduced into the home. The secondary transmission rates for respiratory and GI illnesses were 0.63 and 0.35 illnesses per susceptible person-month, respectively. Only two thirds of respondents correctly believed that contact transmission was important in the spread of colds, and fewer than half believed that it was important in the spread of stomach flus. Twenty-two percent of respondents reported use of alcohol-based hand gels all, most, or some of the time; 33% reported always washing their hands after

Defining unnecessary disinfection procedures for single-dose and multiple-dose vials.

PubMed

Buckley, T; Dudley, S M; Donowitz, L G

1994-11-01

Recommendations in the literature conflict on the necessity of disinfecting single-use vials prior to aspiration of fluid. Interventions to disinfect the stopper surface on multiple-dose vials vary considerably. To determine the necessity of alcohol disinfection of the stopper on single-dose vials and to compare povidone-iodine and alcohol versus alcohol-only disinfection of the stopper prior to each needle penetration on multiple-dose vials. The rubber stopper surfaces of 100 single-dose vials were cultured for the presence of bacteria. To determine the efficacy of two procedures for disinfection of multiple-dose vials, 87 stopper surfaces routinely disinfected with both povidone-iodine and alcohol were cultured for bacteria. After a change in practice, 100 multiple-dose vials routinely disinfected with alcohol only were cultured for the presence of bacteria. Of the cultures done on single-dose vial stoppers, 99% were sterile. A comparison of the two disinfection techniques for multiple-dose vials revealed that 83 (95%) of the 87 vials prepped with both povidone-iodine and alcohol were sterile, compared with all stoppers disinfected with alcohol only. This study shows the lack of necessity of any disinfection procedure on the rubber stopper of single-dose vials and the efficacy of alcohol only for disinfecting the stopper of multiple-dose vials.

Does the use of alcohol-based hand gel sanitizer reduce travellers' diarrhea and gastrointestinal upset?: A preliminary survey.

PubMed

Henriey, Delphine; Delmont, Jean; Gautret, Philippe

2014-01-01

Use of alcohol-based hand sanitizer is recommended by the CDC to reduce the risk for travellers' diarrhoea, but its effectiveness has not been assessed. We investigated the potential protective effect of hand sanitizer use on the occurrence of diarrhoea and/or vomiting in 200 international travellers, who were returning home, at an international airport. We also conducted a knowledge, aptitude and practice survey about hand gel use among international travellers consulting for pre-travel advice at a specialized clinic. 200 returning travellers were included of which 32.5% declared having used alcohol-based hand sanitizer during travel. Travellers who used hand sanitizer reported diarrhoea and vomiting significantly less frequently than those who did not (17% vs. 30%, OR = 0.47; 95% CI [0.21-0.97], p = 0.04). A total of 257 travellers consulting for pre-travel advice were included. A majority of travellers knew that hand sanitizer may be used for hand hygiene and had already used hand sanitizer; 72% planned to bring hand sanitizer during their next travel. Use of hand sanitizer is highly acceptable by travellers and is associated with a reduction in the incidence of travellers' diarrhoea and/or vomiting. Copyright © 2014 Elsevier Ltd. All rights reserved.

Development and evaluation of a new alcohol-based surgical hand scrub formulation with persistent antimicrobial characteristics and brushless application.

PubMed

Hobson, D W; Woller, W; Anderson, L; Guthery, E

1998-10-01

Since the introduction in the 1970s of surgical hand scrub formulations that contain 4% chlorhexidine gluconate (CHG), new surgical scrub formulations that have improved efficacy, persistence, or significantly improved use characteristics have not been forthcoming. In addition, the manufacturer's labeling for popular hand scrub products generally requires scrub times in excess of 6 minutes, whereas current practical needs call for products with substantially shorter scrub times. A new alcohol-based surgical scrub formulation, which has ingredients that provide emollient, surfactant, and antimicrobial persistence characteristics to complement the rapid and broad-spectrum antiseptic qualities of alcohol, has been developed in an effort to address these current practical needs. The relative efficacy of a new alcohol-based surgical scrub formulation that contains ingredients that provide surfactant and antimicrobial persistence characteristics was compared with that of commercial 4% CHG and 7.5% povidone iodine (PVPI) formulations with use of human subjects. Hand antimicrobial count sampling was performed by using standardized "glove juice" methodology. The efficacy and persistence results of the new formulation showed statistically significant improvement over both CHG and PVPI at a substantially lessened scrub time (3 minutes). In addition, use of the new formulation without a scrub brush produced results statistically similar to 3-minute applications with either a brush or a sponge. The new alcohol-based formulation demonstrates promise as a new surgical hand scrub formulation with antimicrobial and use characteristics that are significantly improved over current CHG and PVPI formulations. These studies demonstrate the suitability of this formulation for use as a surgical hand scrub and for brushless application.

Moisturizing alcohol hand gels for surgical hand preparation.

PubMed

Jones, R D; Jampani, H; Mulberry, G; Rizer, R L

2000-03-01

With the use of novel formulary technology, unique moisturizing hand gels have been developed that offer significant advantages in perioperative and other health care settings. These advantages include the time-saving capabilities of a waterless formulation, the persistence and effectiveness of a surgical scrub, and the moisturization and protective properties of a lotion. Extensive laboratory and clinical studies, involving in vivo antimicrobial activity against resident and transient flora, skin moisturization on normal and dry skin, and compatibility with latex gloves, have supported these advantages. Nondrying alcohol hand gels can be used for antiseptic hand washing, hand scrubs between procedures (i.e., reentry scrubs), brushless surgical scrubs, moisturizers, and glove-donning aids.

Testing a new alcohol-free hand sanitizer to combat infection.

PubMed

Dyer, D L; Gerenraich, K B; Wadhams, P S

1998-08-01

Universal precautions require that perioperative health care personnel wash their hand before and after all patient contact. Time constraints, however, can make adhering to universal precautions, including proper hand washing, difficult. Some perioperative health care workers, therefore, routinely use rise-free hand sanitizers to supplement normal hand washing. This study evaluated immediate and persistent antimicrobial effectiveness of two alcohol--containing hand sanitizers and a novel surfactant, allantoin, benzalkonium chloride (SAB) hand sanitizer using a federally approved effectiveness protocol. Results indicate that all three products were equally effective after a single application. After repeated use, the alcohol-containing sanitizers did not meet federal performance standards, and the alcohol-free sanitizer did. These properties and others illustrated in this article indicate that the nonflammable, alcohol-free SAB hand sanitizer is the most favorable of the rise-free hand sanitizer formulas for normal hand washing.

Conspicuous vs customary location of hand hygiene agent dispensers on alcohol-based hand hygiene product usage in an intensive care unit.

PubMed

Thomas, Bruce W; Berg-Copas, Gina M; Vasquez, Donald G; Jackson, Brandy L; Wetta-Hall, Ruth

2009-05-01

Hand washing is considered the single most important nosocomial infection-control strategy, yet compliance rarely meets levels recommended by infection control authorities. To determine whether placement of hand hygiene foam dispensers in more conspicuous positions and closer proximity to patients would increase use of infection control agents as measured by volume of product used. Further, to ascertain the influence of dispenser placement vs the number of dispensers available on usage by volume. This prospective, observational study conducted in an intensive care unit was composed of three observation periods. A control period with standard agent dispenser location (8 dispensers) was followed by two experimental periods: (1) "conspicuous and immediate proximity to patient" placement (16 dispensers) and (2) standard locations with a dramatic increase in the number of dispensers (36 dispensers). Volume of use for alcohol-based hand hygiene agent during the three observation periods revealed a statistically significant increase in daily consumption after conspicuous and proximate positioning of dispensers (P<.001). However, increasing the number of dispensers did not increase agent use (P=.196). More conspicuous placement of dispensers containing alcohol-based hand hygiene agent (ie, immediate proximity to patients) resulted in statistically and clinically significant increases in product usage. An increase in the number of dispensers did not increase usage. The impact of dispenser positioning on usage by volume for these highly effective products should be considered when planning and implementing intensive care unit infection-control policies.

Surgical hand antisepsis in veterinary practice: evaluation of soap scrubs and alcohol based rub techniques.

PubMed

Verwilghen, Denis R; Mainil, Jacques; Mastrocicco, Emilie; Hamaide, Annick; Detilleux, Johann; van Galen, Gaby; Serteyn, Didier; Grulke, Sigrid

2011-12-01

Recent studies have shown that hydro-alcoholic solutions are more efficient than traditional medicated soaps in the pre-surgical hand antisepsis of human surgeons but there is little veterinary literature on the subject. The aim of this study was to compare the efficiency of medicated soaps and a hydro-alcoholic solution prior to surgery using an in-use testing method in a veterinary setting. A preliminary trial was performed that compared the mean log(10) number of bacterial colony forming units (CFU) and the reduction factors (RF) between two 5-min hand-scrubbing sessions using different soaps, namely, povidone iodine (PVP) and chlorhexidine gluconate (CHX), and the 1.5-min application of a hydro-alcoholic rub. A clinical in-use trial was then used to compare the hydro-alcoholic rub and CHX in a surgical setting. Sampling was performed using finger printing on agar plates. The hydro-alcoholic rub and CHX had a similar immediate effect, although the sustained effect was significantly better for the hydro-alcoholic rub, while PVP had a significantly lower immediate and sustained effect. The hydro-alcoholic rub showed good efficiency in the clinical trial and could be considered as a useful alternative method for veterinary surgical hand antisepsis. Copyright © 2010 Elsevier Ltd. All rights reserved.

Better compliance and better tolerance in relation to a well-conducted introduction to rub-in hand disinfection.

PubMed

Girard, R; Amazian, K; Fabry, J

2001-02-01

The aim of the study was to demonstrate that the introduction of rub-in hand disinfection (RHD) in hospital units, with the implementation of suitable equipment, drafting of specific protocols, and training users, improved compliance of hand disinfection and tolerance of user's hands. In four hospital units not previously using RHD an external investigator conducted two identical studies in order to measure the rate of compliance with, and the quality of, disinfection practices, [rate of adapted (i.e., appropriate) procedures, rate of correct (i.e., properly performed) procedures, rate of adapted and correct procedures carried out] and to assess the state of hands (clinical scores of dryness and irritation, measuring hydration with a corneometer). Between the two studies, the units were equipped with dispensers for RHD products and staff were trained. Compliance improved from 62.2 to 66.5%, quality was improved (rate of adapted procedures from 66.8% to 84.3%, P > or = 10(-6), rate of correct procedures from 11.1% to 28.9%, P > or = 10(-8), rate of adapted and correct procedures from 6.0 to 17.8%, P > or = 10(-8)). The tolerance was improved significantly (P > or = 10(-2)) for clinical dryness and irritation scores, although not significantly for measurements using a corneometer. This study shows the benefit of introducing RHD with a technical and educational accompaniment. Copyright 2001 The Hospital Infection Society.

[Disinfecting contact tonometers - a systematic review].

PubMed

Neubauer, A S; Heeg, P; Kampik, A; Hirneiss, C

2009-05-01

The aim of this study is to provide the best available evidence on how to disinfect contact Goldman tonometers. A systematic review of all articles on disinfection of contact tonometers was conducted. Articles published up to July 2008 were identified in Medline, Embase and references from included articles. Two observers participated in the data retrieval and assessment of the studies identified. A total of 89 articles was retrieved, of which 58 could be included. Of those, 18 were clinical studies, 17 experimental microbiological studies, 8 expert assessments or guidelines and 15 reviews, surveys, descriptions of new methods. The clinical studies illustrate the importance of the problem, possible side effects of some disinfection methods but yield inconclusive results regarding efficacy. Experimental studies investigated a variety of bacterial and virological questions as well as material damage by disinfection. Both chlorine-based and hydrogen peroxide-based liquid disinfection were shown to be effective if applied for 5 min. Inconsistent results exist for alcohol wipes and UV disinfection - material damage has been described for both. The US guidelines and most expert recommendations are supported by evidence of the existing data. Chlorine-based and hydrogen peroxide-based liquid disinfections for 5 minutes are effective and relatively safe for disinfecting contact tonometers.

A systematic review and cost-effectiveness analysis of tonometer disinfection methods.

PubMed

Omar Akhtar, Ahmad; Singh, Hargurinder; Si, Francie; Hodge, William G

2014-08-01

The Goldmann applanation tonometer presents the problem of being one of the most widely used pieces of equipment in the ophthalmic clinic and a known risk factor for the transmission of epidemic keratoconjunctivitis (EKC). The purpose of this review is to assess the effectiveness of 3 methods of disinfection: alcohol swabs, immersion in peroxide, and the use of disposable prisms. An economic evaluation is undertaken to assess the cost-effectiveness of the 3 alternatives. In doing so, we contribute an evidence-based overview of the issue at an opportune time, because several jurisdictions are developing protocols regarding tonometer tip disinfection. Systematic review and cost-effectiveness analysis. A comprehensive literature review was undertaken with a librarian, comprising searches of 6 electronic databases and hand searches of the grey literature. A 3-level screening process was undertaken by 2 reviewers according to prespecified inclusion and exclusion criteria. Values from included papers were used to inform a cost-effectiveness analysis undertaken using a decision tree model implemented in TreeAge. The analysis was undertaken from the hospital perspective and included all equipment and labour costs. Synthesis of in vitro data indicates that all 3 methods are plausible methods of disinfection with a 64% reduction in log growth of EKC when peroxide is used compared with alcohol swabs. The incremental cost-effective ratios from the cost-effectiveness analysis were $12,000/case averted using peroxide and $61,000/case averted with Tonosafe as compared with alcohol. Assuming clinical infection rates match in vitro disinfection data, the cost of bleach is high and the cost of Tonosafe is unacceptably high to reduce 1 potential case of adenoviral keratoconjunctivitis. Copyright © 2014. Published by Elsevier Inc.

Adherence to hand hygiene protocol by clinicians and medical students at Queen Elizabeth Central Hospital, Blantyre-Malawi.

PubMed

Kalata, N L; Kamange, L; Muula, A S

2013-06-01

While communicable diseases are the leading causes of morbidity and mortality in Malawi, the contribution of nosocomial or hospital-acquired infections (HAIs) is unknown but could be substantial. The single most important method of preventing nosocomial infections is hand hygiene. We report a study which was conducted in 2011 to investigate adherence to hand hygiene protocols by clinicians and medical students working at Queen Elizabeth Central Hospital in Blantyre, Malawi. There were two parts to the study: a single blinded arm in which participants were observed without their knowledge by trained nurses; and a second arm which included self-completion of questionnaire after participant consent was obtained. The 2009 World Health Organization hand hygiene technique and recommendations which were adopted by Queen Elizabeth Central Hospital were used to define an opportunity for hand washing and effectiveness of hand washing. Hand hygiene effectiveness was defined as adherence to at least 6 out of 7 steps (80%) of the hand hygiene technique when using alcohol-based formulation or at least 8 out of 10 steps (80%) of the hand hygiene technique when using water and soap formulation before and after having direct contact with patients or their immediate surroundings. Clinicians were found to have disinfected their hands more than medical students (p<0.05) but effectiveness was similar and very low between the two groups (p=0.2). No association was also found between having a personal hand sanitizer and hand hygiene practice (p=0.3). Adherence to hand hygiene was found to be 23%. Most of the participants mentioned infection transmission prevention as a reason for disinfecting their hands. Other reasons mentioned included: a routine personal hand hygiene behaviour and discomfort if not washing hands. The top three reasons why they did not disinfect hands were forgetfulness, unavailability of sanitizers and negligence. Adherence to hand hygiene practice was found to be low

Ethanol and ethyl glucuronide urine concentrations after ethanol-based hand antisepsis with and without permitted alcohol consumption.

PubMed

Gessner, Stephan; Below, Elke; Diedrich, Stephan; Wegner, Christian; Gessner, Wiebke; Kohlmann, Thomas; Heidecke, Claus-Dieter; Bockholdt, Britta; Kramer, Axel; Assadian, Ojan; Below, Harald

2016-09-01

During hand antisepsis, health care workers (HCWs) are exposed to alcohol by dermal contact and by inhalation. Concerns have been raised that high alcohol absorptions may adversely affect HCWs, particularly certain vulnerable individuals such as pregnant women or individuals with genetic deficiencies of aldehyde dehydrogenase. We investigated the kinetics of HCWs' urinary concentrations of ethanol and its metabolite ethyl glucuronide (EtG) during clinical work with and without previous consumption of alcoholic beverages by HCWs. The median ethanol concentration was 0.7 mg/L (interquartile range [IQR], 0.5-1.9 mg/L; maximum, 9.2 mg/L) during abstinence and 12.2 mg/L (IQR, 1.5-139.6 mg/L; maximum, 1,020.1 mg/L) during alcohol consumption. During abstinence, EtG reached concentrations of up to 958 ng/mL. When alcohol consumption was permitted, the median EtG concentration of all samples was 2,593 ng/mL (IQR, 890.8-3,576 ng/mL; maximum, 5,043 ng/mL). Although alcohol consumption was strongly correlated with both EtG and ethanol in urine, no significant correlation for the frequency of alcoholic hand antisepsis was observed in the linear mixed models. The use of ethanol-based handrub induces measurable ethanol and EtG concentrations in urine. Compared with consumption of alcoholic beverages or use of consumer products containing ethanol, the amount of ethanol absorption resulting from handrub applications is negligible. In practice, there is no evidence of any harmful effect of using ethanol-based handrubs as much as it is clinically necessary. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Does the clinical use of ethanol-based hand sanitizer elevate blood alcohol levels? A prospective study.

PubMed

Miller, Michael A; Rosin, Alex; Levsky, Marc E; Patel, Manish M; Gregory, Timothy J D; Crystal, Chad S

2006-11-01

Ethanol-based hand sanitizers (EBHSs) are used in most health care facilities in the United States. Infection control personnel advocate the use of generous quantities of EBHS before and after contact with patients. Although it is assumed that little systemic absorption of ethanol occurs during EBHS use, many alcohols are absorbed to varying degrees via the transdermal route. Ethanol intoxication by employees in the medical workplace is a potentially serious finding, and it is of forensic and medical-legal importance to elucidate the effects of frequent use of EBHS upon serum blood ethanol levels (BELs). To investigate the effect of frequent use of EBHS upon serum blood ethanol concentrations, we prospectively studied 5 volunteers undergoing frequent application of EBHS. Enrolled subjects applied 5 mL of the product (62% denatured ethyl alcohol manufactured by Kimberley-Clark, Roswell, GA) to both hands and rubbed until dry. This activity was repeated 50 times over 4 hours. Participants had their blood drawn before as well as after completing the study. Each participant was without alcohol exposure during the 12 hours preceding the study. Five volunteers were enrolled. All had an initial blood ethanol level of less than 5 mg/dL. All 5 participants completed the 4-hour study. There were no noted adverse reactions during the study. Blood ethanol level upon completion of the 50 applications of EBHS was less than 5 mg/dL in all 5 study participants. The results of this study demonstrate that use of ethanol-based hand sanitizers, when frequently used in accordance with labeling, do not raise serum blood ethanol levels.

[On the bactericidal action of dibromoisocyanuric acid; experiments concerning the disinfection of hands (author's transl)].

PubMed

Gottardi, W; Puritscher, M

1976-07-01

The action of dibromoisocyanuric acid (DBI), C12, Br2, trichloroisocyanuric acid (TCI) and chloramine T against Staph. aureus SG 511 was compared. Using the suspension test DBI and Br2 showed the strongest, chloramine T however, the weakest bactericidal power (Tab 2). Under the conditions of the "Hygienic disinfection of hands" a 0.005 M solution of DBI met the requirements specified in the "Richtlinien für die Prüfung chemischer Desinfektionsmittel" (3. Ed., Stuttgart: Gustav Fischer Verlag, 1972), and was comparable to a chloramine T solution containing the same amount of active halogen (Tab. 3). The decrease of disinfection power compared with the suspension test can be attributed to a great error induced by protein.

[Integrate the surgical hand disinfection as a quality indicator in an operating room of urology].

PubMed

Francois, M; Girard, R; Mauranne, C C; Ruffion, A; Terrier, J E

2017-12-01

The surgical hand disinfection by friction (SDF) helps to reduce the risk of surgical site infections. For this purpose and in order to promote good compliance to quality care, the urology service of Centre Hospitalier Lyon Sud achieved a continuous internal audit to improve the quality of the SDF. An internal audit executed by the medical students of urology was established in 2013. The study population was all operators, instrumentalists and operating aids of urology operating room (OR). Each student realized 5-10 random observations, of all types of professionals. The criteria measured by the audit were criteria for friction. The evolution of indicators was positive. Particularly, the increasing duration of the first and second friction was statistically significant during follow-up (P=0.001). The total duration of friction shows a similar trend for all professionals. The surgical hand disinfection by friction in the urology OR of the Centre Hospitalier Lyon Sud has gradually improved over the iterative audits. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Evaluation of an automated ultraviolet-C light disinfection device and patient hand hygiene for reduction of pathogen transfer from interactive touchscreen computer kiosks.

PubMed

Alhmidi, Heba; Cadnum, Jennifer L; Piedrahita, Christina T; John, Amrita R; Donskey, Curtis J

2018-04-01

Touchscreens are a potential source of pathogen transmission. In our facility, patients and visitors rarely perform hand hygiene after using interactive touchscreen computer kiosks. An automated ultraviolet-C touchscreen disinfection device was effective in reducing bacteriophage MS2, bacteriophage ϕX174, methicillin-resistant Staphylococcus aureus, and Clostridium difficile spores inoculated onto a touchscreen. In simulations, an automated ultraviolet-C touchscreen disinfection device alone or in combination with hand hygiene reduced transfer of the viruses from contaminated touchscreens to fingertips. Published by Elsevier Inc.

Comparative Virucidal Efficacy of Seven Disinfectants Against Murine Norovirus and Feline Calicivirus, Surrogates of Human Norovirus.

PubMed

Zonta, William; Mauroy, Axel; Farnir, Frederic; Thiry, Etienne

2016-03-01

Human noroviruses (HuNoV) are the leading cause of acute non-bacterial gastroenteritis in humans and can be transmitted either by person-to-person contact or by consumption of contaminated food. A knowledge of an efficient disinfection for both hands and food-contact surfaces is helpful for the food sector and provides precious information for public health. The aim of this study was to evaluate the effect of seven disinfectants belonging to different groups of biocides (alcohol, halogen, oxidizing agents, quaternary ammonium compounds, aldehyde and biguanide) on infectious viral titre and on genomic copy number. Due to the absence of a cell culture system for HuNoV, two HuNoV surrogates, such as murine norovirus and feline calicivirus, were used and the tests were performed in suspension, on gloves and on stainless steel discs. When, as criteria of efficacy, a log reduction >3 of the infectious viral titre on both surrogates and in the three tests is used, the most efficacious disinfectants in this study appear to be biocidal products B, C and D, representing the halogens, the oxidizing agents group and a mix of QAC, alcohol and aldehyde, respectively. In addition, these three disinfectants also elicited a significant effect on genomic copy number for both surrogate viruses and in all three tests. The results of this study demonstrate that a halogen compound, oxidizing agents and a mix of QAC, alcohol and aldehyde are advisable for HuNoV disinfection of either potentially contaminated surfaces or materials in contact with foodstuffs.

Hand hygiene with alcohol hand rub and gloves reduces the incidence of late onset sepsis in preterm neonates.

PubMed

Janota, Jan; Šebková, Sylva; Višňovská, Magda; Kudláčková, Jana; Hamplová, Drahomíra; Zach, Jiří

2014-10-01

To assess the impact of a hand hygiene protocol, using hand washing, alcohol hand rub and gloves when caring for preterm infants born after 31 weeks of gestation, on the incidence of neonatal late onset sepsis (LOS). All babies delivered between 32 + 0 and 36 + 6 weeks gestation and admitted to the neonatal intensive care unit during a 14-month period were included. We followed a hand hygiene protocol with hand washing and alcohol hand rub (hand rub period) for the first 7 months and a protocol of hand washing, alcohol hand rub and gloves (gloves period) for the second 7 months. The hand rub and gloves groups consisted of 111 and 89 patients, respectively. Five patients were diagnosed with a total of six episodes of LOS in the hand rub group, and the incidence of LOS during the hand rub period was 2.99/1000 hospital days and 54.1/1000 admissions. There were no patients diagnosed with LOS during the gloves period (significant decrease, p = 0.028). Using a hand hygiene protocol with hand washing, hand rub and gloves significantly reduced the incidence of LOS in preterm newborns, and the results suggest that it may produce a sustained improvement in the infection rate. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Effective reprocessing of reusable dispensers for surface disinfection tissues – the devil is in the details

PubMed Central

Kampf, Günter; Degenhardt, Stina; Lackner, Sibylle; Ostermeyer, Christiane

2014-01-01

Background: It has recently been reported that reusable dispensers for surface disinfection tissues may be contaminated, especially with adapted Achromobacter species 3, when products based on surface-active ingredients are used. Fresh solution may quickly become recontaminated if dispensers are not processed adequately. Methods: We evaluated the abilities of six manual and three automatic processes for processing contaminated dispensers to prevent recolonisation of a freshly-prepared disinfectant solution (Mikrobac forte 0.5%). Dispensers were left at room temperature for 28 days. Samples of the disinfectant solution were taken every 7 days and assessed quantitatively for bacterial contamination. Results: All automatic procedures prevented recolonisation of the disinfectant solution when a temperature of 60–70°C was ensured for at least 5 min, with or without the addition of chemical cleaning agents. Manual procedures prevented recontamination of the disinfectant solution when rinsing with hot water or a thorough cleaning step was performed before treating all surfaces with an alcohol-based disinfectant or an oxygen-releaser. Other cleaning and disinfection procedures, including the use of an alcohol-based disinfectant, did not prevent recolonisation. Conclusions: These results indicate that not all processes are effective for processing reusable dispensers for surface-disinfectant tissues, and that a high temperature during the cleaning step or use of a biofilm-active cleaning agent are essential. PMID:24653973

Comparison of 3 in vivo methods for assessment of alcohol-based hand rubs.

PubMed

Edmonds-Wilson, Sarah; Campbell, Esther; Fox, Kyle; Macinga, David

2015-05-01

Alcohol-based hand rubs (ABHRs) are the primary method of hand hygiene in health-care settings. ICPs increasingly are assessing ABHR product efficacy data as improved products and test methods are developed. As a result, ICPs need better tools and recommendations for how to assess and compare ABHRs. Two ABHRs (70% ethanol) were tested according to 3 in vivo methods approved by ASTM International: E1174, E2755, and E2784. Log10 reductions were measured after a single test product use and after 10 consecutive uses at an application volume of 2 mL. The test method used had a significant influence on ABHR efficacy; however, in this study the test product (gel or foam) did not significantly influence efficacy. In addition, for all test methods, log10 reductions obtained after a single application were not predictive of results after 10 applications. Choice of test method can significantly influence efficacy results. Therefore, when assessing antimicrobial efficacy data of hand hygiene products, ICPs should pay close attention to the test method used, and ensure that product comparisons are made head to head in the same study using the same test methodology. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Effect of Disinfectants on Glucose Monitors

PubMed Central

Mahoney, John J; Lim, Christine G

2012-01-01

Background Monitoring blood glucose levels is an integral part of routine diabetes management. To minimize the risk of transmission of bloodborne pathogens during monitoring, the Centers for Disease Control and Prevention (CDC) recommends that glucose meters be disinfected after each use whenever they are used to test multiple patients. The objective of this study is to assess the compatibility of some common disinfectants with certain blood glucose meter systems. Methods We tested six disinfectants for adverse impact on meter performance or the exterior meter surfaces. The disinfectants tested were 0.525% sodium hypochlorite, 20% 2-propanol and 10% ethanol, 17.2% isopropanol, 55% isopropanol, 70% isopropanol, and hydrogen peroxide. To assess meter performance, we tested OneTouch® Ultra® blood glucose monitoring systems with control solution before and after application of either water or disinfectant. To assess the effect on exterior meter surfaces, we performed a soaking test to simulate long-term exposure to disinfectant. Results Paired t-test results showed that the control solution data associated with disinfectant and with water application were not significantly different for each meter type. However, most of the meter types were adversely affected by hydrogen peroxide and/or by the higher concentrations of alcohol-based disinfectants. Conclusions Although none of the six disinfectants affected meter performance, hydrogen peroxide and isopropanol >20% adversely affected the exterior surfaces of the tested meters. When complying with CDC instructions for meter disinfection, users should use caution and choose disinfectants that have been validated by the meter manufacturer. PMID:22401326

Effect of disinfectants on glucose monitors.

PubMed

Mahoney, John J; Lim, Christine G

2012-01-01

Monitoring blood glucose levels is an integral part of routine diabetes management. To minimize the risk of transmission of bloodborne pathogens during monitoring, the Centers for Disease Control and Prevention (CDC) recommends that glucose meters be disinfected after each use whenever they are used to test multiple patients. The objective of this study is to assess the compatibility of some common disinfectants with certain blood glucose meter systems. We tested six disinfectants for adverse impact on meter performance or the exterior meter surfaces. The disinfectants tested were 0.525% sodium hypochlorite, 20% 2-propanol and 10% ethanol, 17.2% isopropanol, 55% isopropanol, 70% isopropanol, and hydrogen peroxide. To assess meter performance, we tested OneTouch® Ultra® blood glucose monitoring systems with control solution before and after application of either water or disinfectant. To assess the effect on exterior meter surfaces, we performed a soaking test to simulate long-term exposure to disinfectant. Paired t-test results showed that the control solution data associated with disinfectant and with water application were not significantly different for each meter type. However, most of the meter types were adversely affected by hydrogen peroxide and/or by the higher concentrations of alcohol-based disinfectants. Although none of the six disinfectants affected meter performance, hydrogen peroxide and isopropanol >20% adversely affected the exterior surfaces of the tested meters. When complying with CDC instructions for meter disinfection, users should use caution and choose disinfectants that have been validated by the meter manufacturer. © 2012 Diabetes Technology Society.

A method of assessing the efficacy of hand sanitizers: use of real soil encountered in the food service industry.

PubMed

Charbonneau, D L; Ponte, J M; Kochanowski, B A

2000-04-01

In many outbreaks of foodborne illness, the food worker has been implicated as the source of the infection. To decrease the likelihood of cross-contamination, food workers must clean and disinfect their hands frequently. To ensure their effectiveness, hand disinfectants should be tested using rigorous conditions that mimic normal use. Currently, several different methods are used to assess the efficacy of hand disinfectants. However, most of these methods were designed with the health care worker in mind and do not model the specific contamination situations encountered by the food worker. To fill this void, we developed a model that uses soil from fresh meat and a means of quantifying bacteria that is encountered and transferred during food preparation activities. Results of studies using various doses of para-chloro-meta-xylenol and triclosan confirm that the method is reproducible and predictable in measuring the efficacy of sanitizers. Consistent, dose-dependent results were obtained with relatively few subjects. Other studies showed that washing hands with a mild soap and water for 20 s was more effective than applying a 70% alcohol hand sanitizer.

Effectiveness of Liquid Soap and Hand Sanitizer against Norwalk Virus on Contaminated Hands▿

PubMed Central

Liu, Pengbo; Yuen, Yvonne; Hsiao, Hui-Mien; Jaykus, Lee-Ann; Moe, Christine

2010-01-01

Disinfection is an essential measure for interrupting human norovirus (HuNoV) transmission, but it is difficult to evaluate the efficacy of disinfectants due to the absence of a practicable cell culture system for these viruses. The purpose of this study was to screen sodium hypochlorite and ethanol for efficacy against Norwalk virus (NV) and expand the studies to evaluate the efficacy of antibacterial liquid soap and alcohol-based hand sanitizer for the inactivation of NV on human finger pads. Samples were tested by real-time reverse transcription-quantitative PCR (RT-qPCR) both with and without a prior RNase treatment. In suspension assay, sodium hypochlorite concentrations of ≥160 ppm effectively eliminated RT-qPCR detection signal, while ethanol, regardless of concentration, was relatively ineffective, giving at most a 0.5 log10 reduction in genomic copies of NV cDNA. Using the American Society for Testing and Materials (ASTM) standard finger pad method and a modification thereof (with rubbing), we observed the greatest reduction in genomic copies of NV cDNA with the antibacterial liquid soap treatment (0.67 to 1.20 log10 reduction) and water rinse only (0.58 to 1.58 log10 reduction). The alcohol-based hand sanitizer was relatively ineffective, reducing the genomic copies of NV cDNA by only 0.14 to 0.34 log10 compared to baseline. Although the concentrations of genomic copies of NV cDNA were consistently lower on finger pad eluates pretreated with RNase compared to those without prior RNase treatment, these differences were not statistically significant. Despite the promise of alcohol-based sanitizers for the control of pathogen transmission, they may be relatively ineffective against the HuNoV, reinforcing the need to develop and evaluate new products against this important group of viruses. PMID:19933337

Hand hygiene compliance in transplant and other special patient groups: an observational study.

PubMed

Graf, Karolin; Ott, Ella; Wolny, Michael; Tramp, Nadine; Vonberg, Ralf-Peter; Haverich, Axel; Chaberny, Iris Freya

2013-06-01

This study evaluates hand hygiene behavior of health care workers in a German university hospital stratified for treatment of special patient groups (eg, transplant patients). From 2008 to 2010, comprehensive education and training of all health care workers was implemented to improve hand hygiene compliance. Consumption rates of alcohol-based hand rub and gloves were collected and evaluated. Of the 5,647 opportunities of hand disinfection evaluated, 1,607 occurred during care for transplant patients. To our knowledge, this is the largest survey of hand hygiene compliance in special patient groups on intensive care units in a university hospital in Germany. Health care workers on surgical intensive care units showed lower hand hygiene compliance compared with health care workers on other types of intensive care units. Compliance toward hand hygiene was significantly higher on hemato-oncologic and pediatric wards. In general, hand disinfection was performed significantly more frequently after an intervention than before (P < .05, 95% confidence interval: 1.24-1.84). Overall, there was no significant difference in hand hygiene compliance when caring for transplant patients or other patients (odds ratio, 1.16; 95% confidence interval: 0.95-1.42). Nurse's and physician's hand hygiene compliance improved because of education. Hand hygiene compliance is not increased in the care for transplant patients (despite their predisposition for nosocomial infections) compared with other patients. Additional studies will be necessary to further investigate these findings. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Single treatment with ethanol hand rub is ineffective against human rhinovirus--hand washing with soap and water removes the virus efficiently.

PubMed

Savolainen-Kopra, Carita; Korpela, Terttu; Simonen-Tikka, Marja-Leena; Amiryousefi, Ali; Ziegler, Thedi; Roivainen, Merja; Hovi, Tapani

2012-03-01

Ethanol-containing hand rubs are used frequently as a substitute for hand washing with water and soap. However, not all viruses are inactivated by a short term rubbing with alcohol. The capacity of a single round of instructed and controlled hand cleaning with water and soap or ethanol-containing hand rub, respectively, was tested for removal of human rhinovirus administered onto the skin of healthy volunteers on the back of the hands. Hand washing with soap and water appeared to be much more efficient for removing rhinoviruses from skin than rubbing hands with an ethanol-containing disinfectant. After washing with soap and water the virus was detected in 3/9 (33.3%) test persons from the left hand and 1/9 (11.1%) cases from the right hand, whereas the virus was detected invariably by real-time RT-PCR from both hands after cleaning with alcohol hand rub (P-value <0.01). Both substances evaluated clinically were also tested in vitro for virucidal efficacy against Human rhinovirus2 (HRV2) using a standardized assay. Both tested substances were poor within the contact time used in the hand-cleaning test. In conclusion, thorough and conventional hand washing with water and soap can clean efficiently hands contaminated with the virus responsible for an extensive share of common cold episodes. Copyright © 2012 Wiley Periodicals, Inc.

Alcohol-based instant hand sanitizer use in military settings: a prospective cohort study of Army basic trainees.

PubMed

Mott, Peter J; Sisk, Brian W; Arbogast, James W; Ferrazzano-Yaussy, Cristina; Bondi, Cara A M; Sheehan, James J

2007-11-01

We investigated the impact of a customized alcohol-based instant hand sanitizer hand-hygiene regimen in an Army basic training setting. The entire population at the U.S. Army Field Artillery Training Center, Fort Sill, Oklahoma, participated in the 13-week prospective cohort study between January 18, 2005 and April 18, 2005. Two training battalions were randomly assigned to the control group, one to the primary intervention group (customized Purell Instant Hand Sanitizer regimen, education, reinforcement) and one to the secondary intervention group (customized Purell Instant Hand Sanitizer regimen). When compared to the control group, intervention groups experienced 40% less respiratory illness (p < 0.001), 48% less gastrointestinal illness (p < 0.02), 44% less lost training time (p < 0.001), and 31% fewer health care encounters (p < 0.001). These findings suggest that this intervention is capable of significantly reducing illness in this setting and has the potential to help reduce absenteeism in the military workforce as a whole.

Do hospital visitors wash their hands? Assessing the use of alcohol-based hand sanitizer in a hospital lobby.

PubMed

Birnbach, David J; Nevo, Igal; Barnes, Susan; Fitzpatrick, Maureen; Rosen, Lisa F; Everett-Thomas, Ruth; Sanko, Jill S; Arheart, Kristopher L

2012-05-01

Reports regarding hand hygiene compliance (HHC) among hospital visitors are limited. Although there is an implicit assumption that the availability of alcohol-based hand sanitizer (AHS) promotes visitor HHC, the degree of AHS use by visitors remains unclear. To assess AHS use, we observed visitor HHC and how it is affected by visual cues in a private university hospital. Using an observational controlled study, we tested 3 interventions: a desk sign mandating all visitors to use AHS, a free-standing AHS dispenser directly in front of a security desk, and a combination of a freestanding AHS dispenser and a sign. HHC was 0.52% at baseline and did not improve significantly when the desk sign was provided as a cue 0.67% (P = .753). However, HHC did improve significantly with use of the freestanding AHS dispenser (9.33%) and the sign and dispenser combination (11.67%) (P < .001 for all comparisons of dispenser alone and sign and dispenser with baseline and sign alone). The degree of improvement with the sign and dispenser combination over the dispenser was not statistically significant. Hospital visitors represent an important factor in infection prevention. A coordinated effort is needed to increase visitor HHC, including an evaluation of the AHS placement, education of visitors on the importance of HHC, and evaluation of corresponding changes in hand hygiene behavior. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Prospective, randomized in vivo comparison of a dual-active waterless antiseptic versus two alcohol-only waterless antiseptics for surgical hand antisepsis.

PubMed

Olson, Linda K M; Morse, Dan J; Duley, Collette; Savell, Brenon K

2012-03-01

This study aimed to demonstrate the value of adding an active level of a persistent antimicrobial agent, such as chlorhexidine gluconate (CHG), to an alcohol-based surgical hand antiseptic. The persistence of 3 waterless, brushless alcohol-based surgical hand antiseptics, including one product containing CHG, was compared. The test products were applied a total of 12 times over 5 days. Samples of aerobic bacteria were collected on days 1 and 5, on both days immediately after drying and 6 hours later, using the glove juice technique. Relative suppression of regrowth was compared using t tests. Using an equivalence margin of 20%, the alcohol plus CHG product showed noninferiority to the alcohol-only products at all sampling points and, based on significantly lower bacterial regrowth (P = .026), superior persistence to the alcohol-only products after 6 hours of glove wear. Given the primary objective of surgical hand antisepsis of reducing resident skin flora for the duration of the surgical procedure, using an alcohol-based hand antiseptic containing CHG appears to be the most appropriate choice for maintaining microbial levels as low as possible for as long as possible. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Practice of skin protection and skin care among German surgeons and influence on the efficacy of surgical hand disinfection and surgical glove perforation

PubMed Central

2014-01-01

SP/SC products and one alcohol-based hand rub formulation did not show a negative interaction with surgical hand rub or surgical glove perforation. However, it is advisable to ascertain the compatibility of SP/SC products with the used hand disinfectant prior to purchase. PMID:24912541

Use of alcohol hand sanitizer as an infection control strategy in an acute care facility.

PubMed

Hilburn, Jessica; Hammond, Brian S; Fendler, Eleanor J; Groziak, Patricia A

2003-04-01

Nosocomial infections are a major problem in health care facilities, resulting in extended durations of care, substantial morbidity and mortality, and excess costs. Since alcohol gel hand sanitizers combine high immediate antimicrobial efficacy with ease of use, this study was carried out to determine the effect of the use of an alcohol gel hand sanitizer by caregivers on infection types and rates in an acute care facility. Patients were educated about the study through a poster on the unit, and teachable patients were given portable bottles of the alcohol hand gel for bedside use, along with an educational brochure explaining how and why to practice good hand hygiene. Infection rate and type data were collected in 1 unit of a 498-bed acute care facility for 16 months (February 2000 to May 2001). An alcohol gel hand sanitizer was provided and used by caregivers in the orthopedic surgical unit of the facility during this period. The primary infection types (more than 80%) found were urinary tract (UTI) and surgical site (SSI) infections. Infection types and rates for the unit during the period the alcohol hand sanitizer (intervention) was used were compared with the infection types and rates for the same unit when the alcohol hand sanitizer was not used (baseline); the results demonstrated a 36.1% decrease in infection rates for the 10-month period that the hand sanitizer was used. This study indicates that use of an alcohol gel hand sanitizer can decrease infection rates and provide an additional tool for an effective infection control program in acute care facilities.

Susceptibility of Vaccinia Virus to Chemical Disinfectants

PubMed Central

de Oliveira, Tércia Moreira Ludolfo; Rehfeld, Izabelle Silva; Coelho Guedes, Maria Isabel Maldonado; Ferreira, Jaqueline Maria Siqueira; Kroon, Erna Geessien; Lobato, Zélia Inês Portela

2011-01-01

Vaccinia virus (VACV) is the cause of bovine vaccinia (BV), an emerging zoonotic disease that affects dairy cows and milkers. Some chemical disinfectants have been used on farms affected by BV to disinfect cow teats and milkers' hands. To date, there is no information about the efficacy of disinfectants against VACV. Therefore, this study aimed to assess the virucidal activity of some active disinfectants commonly used in the field. Sodium hypochlorite, quaternary ammonium combined with chlorhexidine, and quaternary ammonium combined with glutaraldehyde were effective in inactivating the virus at all concentrations tested. Iodine and quaternary ammonium as the only active component were partially effective. The presence of bovine feces as organic matter and light decreased the effectiveness of sodium hypochlorite. These results show that an appropriated disinfection and asepsis of teats and hands may be helpful in the control and prevention of BV and other infections with VACV. PMID:21734141

The mechanics of endoscope disinfection.

PubMed

Babb, J R; Bradley, C R

1991-06-01

The decontamination of flexible fibreoptic endoscopes has considerably improved in recent years. This is mainly due to the introduction of instruments with more accessible channels, the use of automated washer disinfectors and a greater awareness of the problems associated with disinfection. Unfortunately the most widely used and effective disinfectant is 2% glutaraldehyde and this is toxic, irritant and sensitizing. With the implementation of Control of Substances Hazardous to Health legislation, strict environmental controls are required to reduce skin contact and vapour inhalation. Alcohol is probably the most suitable alternative disinfectant at present but it is flammable and cannot be used in automated systems. Other agents are either insufficiently effective or corrosive. Autoclavable or heat tolerant rigid endoscopes are now available but flexible endoscopes will not tolerate heat disinfection temperatures.

Management of risk of microbial cross-contamination from uncooked frozen hamburgers by alcohol-based hand sanitizer.

PubMed

Schaffner, Donald W; Schaffner, Kristin M

2007-01-01

This research was undertaken to determine the effectiveness of an alcohol-based hand sanitizer on hands contaminated with a nonpathogen surrogate for Escherichia coli O157:H7, where the source of the contamination was frozen hamburger patties. A nonpathogenic nalidixic acid-resistant food-grade strain of Enterobacter aerogenes was used to inoculate frozen hamburger patties composed of 76% lean beef and 24% fat. Thirty-two individuals participated to produce the data used in this study. Each participant handled nine patties at least three times, a sample for microbiological analysis was collected from the surface of one hand, the participant sanitized both hands, and a sample was collected from the other hand. Burger handling created perceptible and visible food debris on the hands of most participants. Computer simulations also were used to perform a variety of risk calculations. The average reduction in bacteria from the use of sanitizer on hands contaminated by frozen burgers containing E. aerogenes was 2.6 +/- 0.7 log CFU per hand. An experiment designed to simultaneously test the effect of sanitizer on E. aerogenes and E. coli O157:H7 also revealed no significant difference in sanitizer effectiveness against the two organisms. The results of the real-world risk estimation calculations (using the actual prevalence and concentration of E. coli O157:H7 in ground beef) predict that once in 1 million trials, a single pathogen cell will be transferred to a single lettuce piece. The effectiveness of this sanitizer intervention was similar to that for hand washing and glove use previously reported. The person-to-person microbial reduction variability from sanitizer use is similar to published data for glove use and was less variable than published data on hand washing effectiveness.

Impact of an alcohol-based hand sanitizer intervention on the spread of viruses in homes.

PubMed

Tamimi, Akrum H; Carlino, Sheri; Edmonds, Sarah; Gerba, Charles P

2014-06-01

The objectives of this study were to determine the movement of a virus throughout a household and the impact of an alcohol-based hand sanitizer (ABHS) on reducing the movement and exposure of the virus to household members. Bacterial virus MS-2 was used as the surrogate for human enteric and respiratory viruses. Seven households with families having at least two children in the age range of 2-18 living in the home were used in this study. The hands of one adult family member were contaminated with 1 × 10(8). MS-2 bacteriophage in each home. After 8 h, the hands of each family member (10 fingers) and 20 frequently touched fomites were sampled to determine baseline contamination without intervention. Within 8 h, MS-2 was detected on all of the family member's hands and most of the fomites. The intervention consisted of providing the families in all selected homes with bottles of an ABHS, which were placed in the kitchen, bathrooms, and nurseries. Smaller individual bottles were provided for each family member greater than 12 years old to place in purses, pockets, backpacks, etc. The families were instructed to use the ABHS one time or three times during the day. For one and three uses, a statistically significant reduction of virus on un-inoculated and inoculated hands of ~99% occurred within 8 h. Similar reductions occurred on fomites throughout the households (97-99%). These results demonstrate that the use of an ABHS can significantly reduce transfer of a virus to the hands, and to the commonly touched surfaces within the household.

Disinfection of Tonometers: A Report by the American Academy of Ophthalmology.

PubMed

Junk, Anna K; Chen, Philip P; Lin, Shan C; Nouri-Mahdavi, Kouros; Radhakrishnan, Sunita; Singh, Kuldev; Chen, Teresa C

2017-12-01

To examine the efficacy of various disinfection methods for reusable tonometer prisms in eye care and to highlight how disinfectants can damage tonometer tips and cause subsequent patient harm. Literature searches were conducted last in October 2016 in the PubMed and the Cochrane Library databases for original research investigations. Reviews, non-English language articles, nonophthalmology articles, surveys, and case reports were excluded. The searches initially yielded 64 unique citations. After exclusion criteria were applied, 10 laboratory studies remained for this review. Nine of the 10 studies used tonometer prisms and 1 used steel discs. The infectious agents covered in this assessment include adenovirus 8 and 19, herpes simplex virus (HSV) 1 and 2, human immunodeficiency virus 1, hepatitis C virus, enterovirus 70, and variant Creutzfeldt-Jakob disease. All 4 studies of adenovirus 8 concluded that after sodium hypochlorite (dilute bleach) disinfection, the virus was undetectable, but only 2 of the 4 studies found that 70% isopropyl alcohol (e.g., alcohol wipes or soaks) eradicated all viable virus. All 3 HSV studies concluded that both sodium hypochlorite and 70% isopropyl alcohol eliminated HSV. Ethanol, 70% isopropyl alcohol, dilute bleach, and mechanical cleaning all lack the ability to remove cellular debris completely, which is necessary to prevent prion transmission. Therefore, single-use tonometer tips or disposable tonometer covers should be considered when treating patients with suspected prion disease. Damage to tonometer prisms can be caused by sodium hypochlorite, 70% isopropyl alcohol, 3% hydrogen peroxide, ethyl alcohol, water immersion, ultraviolet light, and heat exposure. Disinfectants can cause tonometer tips to swell and crack by dissolving the glue that holds the hollow tip together. The tonometer tip cracks can irritate the cornea, harbor microbes, or allow disinfectants to enter the interior of the tonometer tip. Sodium hypochlorite

Effectiveness of a hand hygiene promotion strategy using alcohol-based handrub in 6 intensive care units in Colombia.

PubMed

Barrera, Lena; Zingg, Walter; Mendez, Fabian; Pittet, Didier

2011-10-01

Hand hygiene is an effective strategy for the prevention of health care-associated infection (HAI). We investigated the effect of a hand hygiene promotion strategy introducing alcohol-based handrub (AHBR) on the incidence of HAI in a university hospital in Colombia. A Prospective cohort study was performed in 6 intensive care units from January 2001 to December 2005. HAI were identified using standard US Centers for Disease Control and Prevention definitions. Alcohol-based handrub dispensers were installed between February and June 2002. Total ABHR consumption was 5,794 L (mean, 28.9 L per 1,000 patient-days) and significantly increased over time (+9.2% per year; P < .001). Of 14,516 patients cumulating 166,498 patient-days, 2,398 (16.5%) acquired a total of 3,490 HAI episodes (20.9 per 1,000 patient-days). Incidence densities for central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia, and urinary tract infections were 7.7, 10.6, and 3.6 episodes per 1,000 device-days, respectively. A significant decrease was observed for CLABSI (-12.7% per year; P < .001) with low nurse-to-patient ratio independently associated with infection (odds ratio, 1.11; 95% confidence interval: 1.07-1.16; P < .001). Improved hand hygiene measured by increased ABHR consumption resulted in CLABSI reduction. Low nurse-to-patient ratio is independently associated with HAI in an upper-middle income country. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

The impact of alcohol hand sanitizer use on infection rates in an extended care facility.

PubMed

Fendler, E J; Ali, Y; Hammond, B S; Lyons, M K; Kelley, M B; Vowell, N A

2002-06-01

Nosocomial infections are a major problem in health care facilities, resulting in extended durations of care and substantial morbidity. Since alcohol gel hand sanitizers combine high immediate antimicrobial efficacy with ease of use, this study was carried out to determine the effect of the use of alcohol gel hand sanitizer by caregivers on infection types and rates in an extended care facility. Infection rate and type data were collected in a 275-bed extended care facility for 34 months (July 1997 to May 2000), during which an alcohol gel hand sanitizer was used by the caregivers in 2 units of the facility. The primary infection types found were urinary tract with Foley catheter, respiratory tract, and wound infections. Comparison of the infection types and rates for the units where hand sanitizer was used with those for the control units where the hand sanitizer was not used showed a 30.4% decrease in infection rates for the 34-month period in the units where hand sanitizer was used. This study indicates that use of an alcohol gel hand sanitizer can decrease infection rates and provide an additional tool for an effective infection control program.

Dental unit waterlines disinfection using hypochlorous acid-based disinfectant

PubMed Central

Shajahan, Irfana Fathima; Kandaswamy, D; Srikanth, Padma; Narayana, L Lakshmi; Selvarajan, R

2016-01-01

Objective: The purpose of the study was to investigate the efficacy of a new disinfectant to disinfect the dental unit waterlines. Materials and Methods: New dental unit waterlines were installed in 13 dental chairs, and biofilm was allowed to grow for 10 days. Disinfection treatment procedure was carried out in the 12 units, and one unit was left untreated. The dental unit waterlines were removed and analyzed using the scanning electron microscope (SEM) (TESCAN VEGA3 SBU). Result: On examination, SEM images showed that there was no slime layer or bacterial cells seen in any of the 12 cut sections obtained from the treated dental waterlines which mean that there was no evident of biofilm formation. Untreated dental unit waterlines showed a microbial colonization with continuous filamentous organic matrix. There was significant biofilm formation in the control tube relative to the samples. Conclusion: The tested disinfectant was found to be effective in the removal of biofilm from the dental unit waterlines. PMID:27563184

Effectiveness of an alcohol-based hand hygiene programme in reducing nosocomial infections in the Urology Ward of Binh Dan Hospital, Vietnam.

PubMed

Nguyen, Kim V; Nguyen, Phuong Tran My; Jones, Stephanie L

2008-10-01

To determine the effectiveness of hand hygiene in a developing healthcare setting in reducing nosocomial infections (NIs). Prospective study measuring NI rates in a urology ward in Ho Chi Minh City, Vietnam, before and after implementation of a hand hygiene programme with an alcohol-based decontaminant, and compliance rates of medical staff and carers with hand hygiene using standardised observation sheets. Incidence of NIs fell by 84%, from 13.1% to 2.1%, after implementation of the hand hygiene programme. Extended-spectrum beta-lactamase production was detected in 38.2%-50% of Enterobacteriaceae isolated from clinical samples. Length of patient stay and cost to the patient for antibiotics were reduced after implementation of the hand hygiene programme. The hand hygiene programme was effective in reducing incidence of NIs, leading to shorter inpatient stays and reduced treatment costs. Such programmes with measurable outcomes can be implemented at minimal cost in developing health contexts and should be promoted in all healthcare settings.

Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review

PubMed Central

Moureau, Nancy L.

2015-01-01

Background. Needleless connectors (NC) are used on virtually all intravascular devices, providing an easy access point for infusion connection. Colonization of NC is considered the cause of 50% of postinsertion catheter-related infections. Breaks in aseptic technique, from failure to disinfect, result in contamination and subsequent biofilm formation within NC and catheters increasing the potential for infection of central and peripheral catheters. Methods. This systematic review evaluated 140 studies and 34 abstracts on NC disinfection practices, the impact of hub contamination on infection, and measures of education and compliance. Results. The greatest risk for contamination of the catheter after insertion is the NC with 33–45% contaminated, and compliance with disinfection as low as 10%. The optimal technique or disinfection time has not been identified, although scrubbing with 70% alcohol for 5–60 seconds is recommended. Studies have reported statistically significant results in infection reduction when passive alcohol disinfection caps are used (48–86% reduction). Clinical Implications. It is critical for healthcare facilities and clinicians to take responsibility for compliance with basic principles of asepsis compliance, to involve frontline staff in strategies, to facilitate education that promotes understanding of the consequences of failure, and to comply with the standard of care for hub disinfection. PMID:26075093

Iodide Residues in Milk Vary between Iodine-Based Teat Disinfectants.

PubMed

French, Elizabeth A; Mukai, Motoko; Zurakowski, Michael; Rauch, Bradley; Gioia, Gloria; Hillebrandt, Joseph R; Henderson, Mark; Schukken, Ynte H; Hemling, Thomas C

2016-07-01

Majority of iodine found in dairy milk comes from the diet and teat disinfection products used during milking process. The objective of this study was to evaluate the effects of 4 iodine-based teat dips on milk iodide concentrations varying in iodine level (0.25% vs. 0.5%, w/w), normal low viscosity dip versus barrier dip, and application method (dip vs. spray) to ensure safe iodine levels in dairy milk when these products are used. The iodine exposure study was performed during a 2-wk period. The trial farm was purged of all iodine-based disinfection products for 21 d during a prestudy "washout period," which resulted in baseline milk iodide range of 145 to 182 ppb. During the experiment, iodine-based teat dips were used as post-milking teat disinfectants and compared to a non-iodine control disinfectant. Milk iodide residue levels for each treatment was evaluated from composited group samples. Introduction of different iodine-based teat disinfectants increased iodide residue content in milk relative to the control by between 8 and 29 μg/L when averaged across the full trial period. However, residues levels for any treatment remained well below the consumable limit of 500 μg/L. The 0.5% iodine disinfectant increased milk iodide levels by 20 μg/L more compared to the 0.25% iodine. Compared to dip-cup application, spray application significantly increased milk iodide residue by 21 μg/L and utilized approximately 23% more teat dip. This carefully controlled study demonstrated an increase in milk iodide concentrations from iodine disinfectants, but increases were small and within acceptable limits. © 2016 Institute of Food Technologists®

Improved inactivation of nonenveloped enteric viruses and their surrogates by a novel alcohol-based hand sanitizer.

PubMed

Macinga, David R; Sattar, Syed A; Jaykus, Lee-Ann; Arbogast, James W

2008-08-01

Norovirus is the leading cause of food-related illness in the United States, and contamination of ready-to-eat items by food handlers poses a high risk for disease. This study reports the in vitro (suspension test) and in vivo (fingerpad protocol) assessments of a new ethanol-based hand sanitizer containing a synergistic blend of polyquaternium polymer and organic acid, which is active against viruses of public health importance, including norovirus. When tested in suspension, the test product reduced the infectivity of the nonenveloped viruses human rotavirus (HRV), poliovirus type 1 (PV-1), and the human norovirus (HNV) surrogates feline calicivirus (FCV) F-9 and murine norovirus type 1 (MNV-1) by greater than 3 log(10) after a 30-s exposure. In contrast, a benchmark alcohol-based hand sanitizer reduced only HRV by greater than 3 log(10) and none of the additional viruses by greater than 1.2 log(10) after the same exposure. In fingerpad experiments, the test product produced a 2.48 log(10) reduction of MNV-1 after a 30-s exposure, whereas a 75% ethanol control produced a 0.91 log(10) reduction. Additionally, the test product reduced the infectivity titers of adenovirus type 5 (ADV-5) and HRV by > or =3.16 log(10) and > or =4.32 log(10), respectively, by the fingerpad assay within 15 s; and PV-1 was reduced by 2.98 log(10) in 30 s by the same method. Based on these results, we conclude that this new ethanol-based hand sanitizer is a promising option for reducing the transmission of enteric viruses, including norovirus, by food handlers and care providers.

Sepsis, parenteral vaccination and skin disinfection.

PubMed

Cook, Ian F

2016-10-02

ASBSTRACT Disinfection should be required for all skin penetrative procedures including parenteral administration of vaccines. This review analyses medically attended infectious events following parenteral vaccination in terms of their microbiological aetiology and pathogenesis. Like 'clean' surgical site infections, the major pathogens responsible for these events were Staphylococcal species, implicating endogenous con-tamination as a significant source of infection. As 70% isopropyl alcohol swabbing has been shown to effectively disinfect the skin, it would be medico-legally difficult to defend a case of sepsis with the omission of skin disinfection unless the very low risk of this event was adequately explained to the patient and documented prior to vaccination. There was a significant cost-benefit for skin disinfection and cellulitis. Skin disinfection in the context of parenteral vaccination represents a new paradigm of medical practice; the use of a low cost intervention to prevent an event of very low prevalence but of significant cost.

Sepsis, parenteral vaccination and skin disinfection

PubMed Central

Cook, Ian F.

2016-01-01

ASBSTRACT Disinfection should be required for all skin penetrative procedures including parenteral administration of vaccines. This review analyses medically attended infectious events following parenteral vaccination in terms of their microbiological aetiology and pathogenesis. Like ‘clean’ surgical site infections, the major pathogens responsible for these events were Staphylococcal species, implicating endogenous con-tamination as a significant source of infection. As 70% isopropyl alcohol swabbing has been shown to effectively disinfect the skin, it would be medico-legally difficult to defend a case of sepsis with the omission of skin disinfection unless the very low risk of this event was adequately explained to the patient and documented prior to vaccination. There was a significant cost-benefit for skin disinfection and cellulitis. Skin disinfection in the context of parenteral vaccination represents a new paradigm of medical practice; the use of a low cost intervention to prevent an event of very low prevalence but of significant cost. PMID:27295449

Microwave disinfection of maxillary and mandibular denture bases contaminated with Candida Albican.

PubMed

Bamigboye, S A; Dosumu, O O; Ajayi, D M

2015-09-01

Oral environment is not sterile, and dentures worn by the patients can be infected and therefore needs disinfection. Solution disinfectants such as sodium hypochlorite and glutaraldehyde can be used but they have side effects. Microwave disinfection method is more recent, however, there are conflicting reports at the moment on the appropriate power and time regimen for disinfection of denture. To determine the power and time regimen at which the disinfection of dentures can be achieved using microwave. Forty-five acrylic denture bases were fabricated for each of the jaws and infected with solution of a stock Candida albicans and 30 infected bases were employed as control. These were placed in normal saline and then subjected to different microwave power and time regimen. Aliquots from these post-microwave solution were titrated against sabauraud agar which was subsequently incubated at 37 degrees C for 48 hours. The agar were examined for candida growth. The denture bases subjected to microwave disinfection at 350W showed Candida growth after microwave treatment irrespective of the time employed. Conversely, those microwaved at 650W and 690W for four and six minutes showed no microbial growth. The microwave regimen of 650W at 4 and 6 minutes completely disinfected the denture bases. Disinfection at higher microwave energy should be done with caution as distortion of the denture may occur.

Back to basics: hand hygiene and surgical hand antisepsis.

PubMed

Spruce, Lisa

2013-11-01

Health care-associated infections (HAIs) are a significant issue in the United States and throughout the world, but following proper hand hygiene practices is the most effective and least expensive way to prevent HAIs. Hand hygiene is inexpensive and protects patients and health care personnel alike. The four general types of hand hygiene that should be performed in the perioperative environment are washing hands that are visibly soiled, hand hygiene using alcohol-based products, surgical hand scrubs, and surgical hand scrubs using an alcohol-based surgical hand rub product. Barriers to proper hand hygiene may include not thinking about it, forgetting, skin irritation, a lack of role models, or a lack of a safety culture. One strategy for improving hand hygiene practices is monitoring hand hygiene as part of a quality improvement project, but the most important aspect for perioperative team members is to set an example for other team members by following proper hand hygiene practices and reminding each other to perform hand hygiene. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Certified Athletic Trainers' Knowledge of Methicillin-Resistant Staphylococcus aureus and Common Disinfectants

PubMed Central

Kahanov, Leamor; Gilmore, Elizabeth J.; Eberman, Lindsey E.; Roberts, Jeffrey; Semerjian, Tamar; Baldwin, Linda

2011-01-01

Context: Methicillin-resistant Staphylococcus aureus (MRSA) infections are increasingly common in athletic settings. The MRSA knowledge and infection-control practices of certified athletic trainers (ATs) and the cleanliness of the athletic training room are important factors in preventing MRSA infections. Objective: To assess knowledge of MRSA and the use of common disinfectants among ATs and to explore their infection-control practices. Design: Cross-sectional study. Setting: High school and collegiate athletic training rooms. Patients or Other Participants: A total of 163 ATs from National Collegiate Athletic Association Divisions I, II, and III and high schools, representing all 10 National Athletic Trainers' Association districts. Main Outcome Measure(s): Frequencies, analyses of variance, and χ2 tests were used to assess current practices and opinions and relationships between factors. Results: Methicillin-resistant Staphylococcus aureus was perceived as a national problem by 92% of respondents; 57% perceived MRSA as a problem in their practice setting. Most respondents had treated general infections (88%), staphylococcal infections (75%), and MRSA infections (57%). Male sex was associated with treating all 3 types of infections (χ2 test, P < .05). Noncurriculum education was associated with a lack of recognition of environmental issues as risk factors and with the use of isopropyl alcohol for disinfection (χ2 test, P < .05). For example, 10% of respondents did not recognize that contaminated whirlpools can be a source of MRSA infection. Respondents also incorrectly identified effective cleaning solutions. Thirty percent of respondents cleaned their hands frequently or sometimes before treating each athlete and 35% cleaned their hands sometimes, occasionally, or never after seeing each athlete. Conclusions: The majority of ATs were informed about MRSA and made correct disinfection choices. However, improvements are still needed, and not all ATs were using

Analysis of alcohol-based hand sanitizer delivery systems: efficacy of foam, gel, and wipes against influenza A (H1N1) virus on hands.

PubMed

Larson, Elaine L; Cohen, Bevin; Baxter, Kathleen A

2012-11-01

Minimal research has been published evaluating the effectiveness of hand hygiene delivery systems (ie, rubs, foams, or wipes) at removing viruses from hands. The purposes of this study were to determine the effect of several alcohol-based hand sanitizers in removing influenza A (H1N1) virus, and to compare the effectiveness of foam, gel, and hand wipe products. Hands of 30 volunteers were inoculated with H1N1 and randomized to treatment with foam, gel, or hand wipe applied to half of each volunteer's finger pads. The log(10) count of each subject's treated and untreated finger pads were averaged. Log(10) reductions were calculated from these differences and averaged within treatment group. Between-treatment analysis compared changes from the untreated finger pads using analysis of covariance with treatment as a factor and the average log(10) untreated finger pads as the covariate. Log(10) counts on control finger pads were 2.7-5.3 log(10) of the 50% infectious dose for tissue culture (TCID(50)/0.1 mL) (mean, 3.8 ± 0.5 log(10) TCID(50)/0.1 mL), and treated finger pad counts for all test products were 0.5-1.9 log(10) TCID(50)/0.1 mL (mean, 0.53 ± 0.17 log(10) TCID(50)/0.1 mL). Treatments with all products resulted in a significant reduction in viral titers (>3 logs) at their respective exposure times that were statistically comparable. All 3 delivery systems (foam, gel, and wipe) produced significantly reduced viral counts on hands. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Effects of prolonged wakefulness combined with alcohol and hands-free cell phone divided attention tasks on simulated driving.

PubMed

Iudice, A; Bonanni, E; Gelli, A; Frittelli, C; Iudice, G; Cignoni, F; Ghicopulos, I; Murri, L

2005-03-01

Simulated driving ability was assessed following administration of alcohol, at an estimated blood level of 0.05%, and combined prolonged wakefulness, while participants were undertaking divided attention tasks over a hands-free mobile phone. Divided attention tasks were structured to provide a sustained cognitive workload to the subjects. Twenty three young healthy individuals drove 10 km simulated driving under four conditions in a counterbalanced, within-subject design: alcohol, alcohol and 19 h wakefulness, alcohol and 24 h wakefulness, and while sober. Study measures were: simulated driving, self-reported sleepiness, critical flicker fusion threshold (CFFT), Stroop word-colour interference test (Stroop) and simple visual reaction times (SVRT). As expected, subjective sleepiness was highly correlated with both sleep restriction and alcohol consumption. The combination of alcohol and 24 h sustained wakefulness produced the highest driving impairment, significantly beyond the alcohol effect itself. Concurrent alcohol and 19 h wakefulness significantly affected only driving time-to-collision. No significant changes of study measures occurred following alcohol intake in unrestricted sleep conditions. CFFT, SVRT and Stroop results showed a similar trend in the four study conditions. Thus apparently 'safe' blood alcohol levels in combination with prolonged wakefulness resulted in significant driving impairments. In normal sleep conditions alcohol effects on driving were partially counteracted by the concomitant hands-free phone based psychometric tasks. 2005 John Wiley & Sons, Ltd.

Hand hygiene with soap and water is superior to alcohol rub and antiseptic wipes for removal of Clostridium difficile.

PubMed

Oughton, Matthew T; Loo, Vivian G; Dendukuri, Nandini; Fenn, Susan; Libman, Michael D

2009-10-01

To evaluate common hand hygiene methods for efficacy in removing Clostridium difficile. Randomized crossover comparison among 10 volunteers with hands experimentally contaminated by nontoxigenic C. difficile. Interventions included warm water with plain soap, cold water with plain soap, warm water with antibacterial soap, antiseptic hand wipes, alcohol-based handrub, and a control involving no intervention. All interventions were evaluated for mean reduction in colony-forming units (CFUs) under 2 contamination protocols: "whole hand" and "palmar surface." Results were analyzed according to a Bayesian approach, by using hierarchical models adjusted for multiple observations. Under the whole-hand protocol, the greatest adjusted mean reductions were achieved by warm water with plain soap (2.14 log(10) CFU/mL [95% credible interval (CrI), 1.74-2.54 log(10) CFU/mL]), cold water with plain soap (1.88 log(10) CFU/mL [95% CrI, 1.48-2.28 log(10) CFU/mL), and warm water with antibacterial soap (1.51 log(10) CFU/mL [95% CrI, 1.12-1.91 log(10) CFU/mL]), followed by antiseptic hand wipes (0.57 log(10) CFU/mL [95% CrI, 0.17-0.96 log(10) CFU/mL]). Alcohol-based handrub (0.06 log(10) CFU/mL [95% CrI, -0.34 to 0.45 log(10) CFU/mL]) was equivalent to no intervention. Under the palmar surface protocol, warm water with plain soap, cold water with plain soap, and warm water with antibacterial soap again yielded the greatest mean reductions, followed by antiseptic hand wipes (26.6, 26.6, 26.6, and 21.9 CFUs per plate, respectively), when compared with alcohol-based handrub. Hypothenar (odds ratio, 10.98 [95% CrI, 1.96-37.65]) and thenar (odds ratio, 6.99 [95% CrI, 1.25-23.41]) surfaces were more likely than fingertips to remain heavily contaminated after handwashing. Handwashing with soap and water showed the greatest efficacy in removing C. difficile and should be performed preferentially over the use of alcohol-based handrubs when contact with C. difficile is suspected or likely.

Effectiveness of Disinfectants on Antimicrobial and Physical Properties of Dental Impression Materials.

PubMed

Demajo, Jean Karl; Cassar, Valter; Farrugia, Cher; Millan-Sango, David; Sammut, Charles; Valdramidis, Vasilis; Camilleri, Josette

2016-01-01

The aim of this study was to assess the antimicrobial activity of chemical disinfectants on alginate and silicone impression materials. The effect of chemical disinfectants on the dimensional stability of the impression materials was also assessed. For the microbiologic assessment, impressions of the maxillary arch were taken from 14 participants, 7 using alginate and 7 using an addition silicone. The impressions were divided into three sections. Each section was subjected to spraying with MD 520 or Minuten or no disinfection (control), respectively. Antimicrobial action of the chemical disinfectants was assessed by measuring microbial counts in trypticase soy agar (TSA) media and expressing the results in colony-forming units/cm2. The surface area of the dental impressions was calculated by scanning a stone cast using computer-aided design/computer-assisted manufacture and analyzing the data using a custom computer program. The dimensional stability of the impression materials after immersion in disinfectants was assessed by measuring the linear displacement of horizontally restrained materials using a traveling microscope. The percent change in length over 3 hours was thus determined. Alginate exhibited a higher microbial count than silicone. MD 520 eliminated all microbes as opposed to Minuten. The bacterial growth after Minuten disinfection was almost twice as much for alginate than for addition silicone impressions. The chemical disinfectants affected the alginate dimensional stability. Minuten reduced the shrinkage sustained by alginate during the first hour of storage. Alginate harbors three times more microorganisms than silicone impression material. Chemical disinfection by glutaraldehyde-based disinfectant was effective in eliminating all microbial forms for both alginate and silicone without modifying the dimensional stability. Alcohol-based disinfectants, however, reduced the alginate shrinkage during the first 90 minutes of setting. The current studies

Significant reduction in vancomycin-resistant enterococcus colonization and bacteraemia after introduction of a bleach-based cleaning-disinfection programme.

PubMed

Grabsch, E A; Mahony, A A; Cameron, D R M; Martin, R D; Heland, M; Davey, P; Petty, M; Xie, S; Grayson, M L

2012-12-01

Vancomycin-resistant enterococcus (VRE) colonization and infection have increased at our hospital, despite adherence to standard VRE control guidelines. We implemented a multi-modal, hospital-wide improvement programme including a bleach-based cleaning-disinfection programme ('Bleach-Clean'). VRE colonization, infection and environmental contamination were compared pre and post implementation. The programme included a new product (sodium hypochlorite 1000 ppm + detergent), standardized cleaning-disinfection practices, employment of cleaning supervisors, and modified protocols to rely on alcohol-based hand hygiene and sleeveless aprons instead of long-sleeved gowns and gloves. VRE was isolated using chromogenic agar and/or routine laboratory methods. Outcomes were assessed during the 6 months pre and 12 months post implementation, including proportions (per 100 patients screened) of VRE colonization in high-risk wards (HRWs: intensive care, liver transplant, renal, haematology/oncology); proportions of environmental contamination; and episodes of VRE bacteraemia throughout the entire hospital. Significant reductions in newly recognized VRE colonizations (208/1948 patients screened vs 324/4035, a 24.8% reduction, P = 0.001) and environmental contamination (66.4% reduction, P = 0.012) were observed, but the proportion of patients colonized on admission was stable. The total burden of inpatients with VRE in the HRWs also declined (median percentage of colonized inpatients per week, 19.4% vs 17.3%, P = 0.016). Hospital-wide VRE bacteraemia declined from 14/2935 patients investigated to 5/6194 (83.1% reduction; P < 0.001), but there was no change in vancomycin-susceptible enterococcal bacteraemia (P = 0.54). The Bleach-Clean programme was associated with marked reductions in new VRE colonizations in high-risk patients, and VRE bacteraemia across the entire hospital. These findings have important implications for VRE control in endemic healthcare settings. Copyright �

Impact of the use of an alcohol-based hand sanitizer in the home on reduction in probability of infection by respiratory and enteric viruses.

PubMed

Tamimi, A H; Maxwell, S; Edmonds, S L; Gerba, C P

2015-11-01

The goal of this study was to determine the reduction in risk of infection by viruses with the use of an alcohol-based hand sanitizer, used in addition to routine hand washing, in family members in households. A quantitative microbial risk model was used to determine the probability of infection from the concentration of virus on the hands. The model incorporated variation in hand size, frequency of touching orifices (nose, mouth, eyes), and percent transfer to the site of infection, as well as, dose-response for each virus. Data on the occurrence of virus on household members' hands from an intervention study using MS-2 coliphage was used to determine the reduction of viruses on the hands pre- and post-intervention. It was found that the risk of rhinovirus, rotavirus or norovirus infection after the intervention was reduced by 47-98% depending upon the initial concentration of virus on the hands.

Development of a Job-Task-Exposure Matrix to assess occupational exposure to disinfectants among U.S. nurses

PubMed Central

Quinot, C; Dumas, O; Henneberger, PK; Varraso, R; Wiley, AS; Speizer, FE; Goldberg, M; Zock, JP; Camargo, CA; Le Moual, N

2016-01-01

Objectives Occupational exposure to disinfectants is associated with work-related asthma, especially in healthcare workers. However, little is known about the specific products involved. To evaluate disinfectant exposures, we designed job-exposure (JEM) and job-task-exposure (JTEM) matrices, which are thought to be less prone to differential misclassification bias than self-reported exposure. We then compared the three assessment methods: self-reported exposure, JEM, and JTEM. Methods Disinfectant use was assessed by an occupational questionnaire in 9,073 U.S. female registered nurses without asthma, aged 49–68 years, drawn from the Nurses’ Health Study II. A JEM was created based on self-reported frequency of use (1–3, 4–7 days/week) of 7 disinfectants and sprays in 8 nursing jobs. We then created a JTEM combining jobs and disinfection tasks to further reduce misclassification. Exposure was evaluated in 3 classes (low, medium, high) using product-specific cut-offs (e.g., <30%, 30–49.9%, ≥50%, respectively, for alcohol); the cut-offs were defined from the distribution of self-reported exposure per job/task. Results The most frequently reported disinfectants were alcohol (weekly use: 39%), bleach (22%) and sprays (20%). More nurses were classified as highly exposed by JTEM (alcohol 41%, sprays 41%, bleach 34%) than by JEM (21%, 30%, 26%, respectively). Agreement between JEM and JTEM was fair-to-moderate (kappa: 0.3–0.5) for most disinfectants. JEM and JTEM exposure estimates were heterogeneous in most nursing jobs, except in emergency room and education/administration. Conclusion The JTEM may provide more accurate estimates than the JEM, especially for nursing jobs with heterogeneous tasks. Use of the JTEM is likely to reduce exposure misclassification. PMID:27566782

Improved Inactivation of Nonenveloped Enteric Viruses and Their Surrogates by a Novel Alcohol-Based Hand Sanitizer ▿

PubMed Central

Macinga, David R.; Sattar, Syed A.; Jaykus, Lee-Ann; Arbogast, James W.

2008-01-01

Norovirus is the leading cause of food-related illness in the United States, and contamination of ready-to-eat items by food handlers poses a high risk for disease. This study reports the in vitro (suspension test) and in vivo (fingerpad protocol) assessments of a new ethanol-based hand sanitizer containing a synergistic blend of polyquaternium polymer and organic acid, which is active against viruses of public health importance, including norovirus. When tested in suspension, the test product reduced the infectivity of the nonenveloped viruses human rotavirus (HRV), poliovirus type 1 (PV-1), and the human norovirus (HNV) surrogates feline calicivirus (FCV) F-9 and murine norovirus type 1 (MNV-1) by greater than 3 log10 after a 30-s exposure. In contrast, a benchmark alcohol-based hand sanitizer reduced only HRV by greater than 3 log10 and none of the additional viruses by greater than 1.2 log10 after the same exposure. In fingerpad experiments, the test product produced a 2.48 log10 reduction of MNV-1 after a 30-s exposure, whereas a 75% ethanol control produced a 0.91 log10 reduction. Additionally, the test product reduced the infectivity titers of adenovirus type 5 (ADV-5) and HRV by ≥3.16 log10 and ≥4.32 log10, respectively, by the fingerpad assay within 15 s; and PV-1 was reduced by 2.98 log10 in 30 s by the same method. Based on these results, we conclude that this new ethanol-based hand sanitizer is a promising option for reducing the transmission of enteric viruses, including norovirus, by food handlers and care providers. PMID:18586970

Ethanol-based cleanser versus isopropyl alcohol to decontaminate stethoscopes.

PubMed

Lecat, Paul; Cropp, Elliott; McCord, Gary; Haller, Nairmeen Awad

2009-04-01

Approximately 1 in 20 hospital admissions is complicated by a health care-associated infection. Stethoscopes may play a role in spreading nosocomial infections. The objective of this study was to determine the effectiveness of an ethanol-based cleanser (EBC) compared with isopropyl alcohol pads in reducing bacterial contamination of stethoscope diaphragms. Stethoscopes were cultured from medical professionals on 4 medical floors before and after cleaning with either EBC or isopropyl alcohol pads. The numbers of colony-forming units (cfu) grown were compared between the 2 cleaners and to baseline values. A total of 99 stethoscopes were cultured (49 EBC; 50 isopropyl alcohol), and all were positive for growth. After cleaning, 28.28% of the stethoscopes were growth-free (12 EBC; 16 isopropyl alcohol). Cleaning with EBC and isopropyl alcohol pads significantly reduced the cfu counts (by 92.8% and 92.5%, respectively), but neither was found to be statistically superior (F = 1.22; P = .2721). Cleaning a stethoscope diaphragm using either EBC or isopropyl alcohol led to a significant reduction in bacterial growth in culture. As an extension of the hand, a stethoscope should be cleaned with the same frequency as the hands. The simultaneous cleaning of hands and stethoscope may further increase compliance with current standards.

Comparative evaluation of sodium hypochlorite and microwave disinfection on dimensional stability of denture bases.

PubMed

Nirale, Rutuja Madhukarrao; Thombre, Ram; Kubasad, Girish

2012-02-01

To compare the effect of sodium hypochlorite and microwave disinfection on the dimensional stability of denture bases without and with relining. A brass die was prepared by simulating an edentulous maxillary arch. It was used to fabricate 1.5 mm and 3 mm of thickness denture bases (n = 40). The 1.5 mm of thickness-specimens (n = 20) were relined with 1.5 mm of autopolymerizing relining resin. Five holes were prepared over crest of ridge of brass die with intimately fitting stainless steel pins which were transferred to the intaglio surface of specimens during fabrication of denture bases. For calculation of dimensional changes in denture bases, differences between the baseline area before and after disinfection of the specimens were used. The denture bases without and with relining were divided into 2 groups (each n = 20). Data were analyzed using student paired 't' and unpaired 't' test. Microwave disinfection produces significant shrinkage in both denture bases without relining (t = 17.16; P<.001) and with relining (t = 14.9; P<.001). Denture bases without relining showed more shrinkage when compared with relined denture bases after microwave disinfection (t = 6.09; P<.001). The changes in dimensional stability after sodium hypochlorite disinfection were not significant for both denture bases without relining (t = 2.19; P=.056) and denture bases with relining (t = 2.17; P=.058). Microwave disinfection leads to increased shrinkage of denture bases without and with relining. Chemical disinfection with sodium hypochlorite seems to be a safer method of disinfection with regards to physical properties such as changes in dimensional stability.

Stethoscope disinfection campaign in a Nigerian teaching hospital:results of a before-and-after study.

PubMed

Uneke, Chigozie J; Ndukwe, Chinwendu D; Nwakpu, Kingsley O; Nnabu, Richard C; Ugwuoru, Cletus D; Prasopa-Plaizier, Nittita

2014-01-15

This study aimed to assess the impact of a stethoscope disinfection sensitization campaign among doctors and nurses in a Nigerian teaching hospital. The design was a before-and-after study. Pre-program measurements were used to provide a baseline against which the post-program results were compared. Interventions that promoted compliance with stethoscope disinfection practice that were implemented included training and education on stethoscope disinfection and introduction of 70% isopropyl alcohol disinfectant at points-of-care places. Microbiological assessment of stethoscopes used by health workers was conducted after the intervention and the outcome was compared with the pilot study results. After the intervention, of the 89 stethoscopes screened, 18 (20.2%) were contaminated with bacterial agents. A higher prevalence of stethoscope contamination was observed among stethoscopes from the intensive care unit (66.7%), the VIP unit (50%), and the antenatal unit (37.5%). The main isolates were Staphylococcus aureus (44.4%) and Escherichia coli (50%). The antibiotic sensitivity assessment indicated that the bacterial isolates were resistant to nearly all the antibiotics tested. All the 89 health workers whose stethoscopes were screened after the intervention admitted to cleaning their stethoscopes after seeing each patient, representing a compliance rate of 100%, unlike the 15% compliance at the pilot phase. The baseline stethoscope contamination rate was 78.5% versus 20.2% post-intervention. Training and education and introduction of alcohol-based disinfectants inexpensive but very effective methods to improve stethoscope disinfection compliance among health workers in low-income settings.

Effect of mixing techniques on bacterial attachment and disinfection time of polyether impression material

PubMed Central

Guler, Umut; Budak, Yasemin; Ruh, Emrah; Ocal, Yesim; Canay, Senay; Akyon, Yakut

2013-01-01

Objective: The aim of this study was 2-fold. The first aim was to evaluate the effects of mixing technique (hand-mixing or auto-mixing) on bacterial attachment to polyether impression materials. The second aim was to determine whether bacterial attachment to these materials was affected by length of exposure to disinfection solutions. Materials and Methods: Polyether impression material samples (n = 144) were prepared by hand-mixing or auto-mixing. Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa were used in testing. After incubation, the bacterial colonies were counted and then disinfectant solution was applied. The effect of disinfection solution was evaluated just after the polymerization of impression material and 30 min after polymerization. Differences in adherence of bacteria to the samples prepared by hand-mixing and to those prepared by auto-mixing were assessed by Kruskal-Wallis and Mann-Whitney U-tests. For evaluating the efficiency of the disinfectant, Kruskal-Wallis multiple comparisons test was used. Results: E. coli counts were higher in hand-mixed materials (P < 0.05); no other statistically significant differences were found between hand- and auto-mixed materials. According to the Kruskal-Wallis test, significant differences were found between the disinfection procedures (Z > 2.394). Conclusion: The methods used for mixing polyether impression material did not affect bacterial attachment to impression surfaces. In contrast, the disinfection procedure greatly affects decontamination of the impression surface. PMID:24966729

Effect of mixing techniques on bacterial attachment and disinfection time of polyether impression material.

PubMed

Guler, Umut; Budak, Yasemin; Ruh, Emrah; Ocal, Yesim; Canay, Senay; Akyon, Yakut

2013-09-01

The aim of this study was 2-fold. The first aim was to evaluate the effects of mixing technique (hand-mixing or auto-mixing) on bacterial attachment to polyether impression materials. The second aim was to determine whether bacterial attachment to these materials was affected by length of exposure to disinfection solutions. Polyether impression material samples (n = 144) were prepared by hand-mixing or auto-mixing. Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa were used in testing. After incubation, the bacterial colonies were counted and then disinfectant solution was applied. The effect of disinfection solution was evaluated just after the polymerization of impression material and 30 min after polymerization. Differences in adherence of bacteria to the samples prepared by hand-mixing and to those prepared by auto-mixing were assessed by Kruskal-Wallis and Mann-Whitney U-tests. For evaluating the efficiency of the disinfectant, Kruskal-Wallis multiple comparisons test was used. E. coli counts were higher in hand-mixed materials (P < 0.05); no other statistically significant differences were found between hand- and auto-mixed materials. According to the Kruskal-Wallis test, significant differences were found between the disinfection procedures (Z > 2.394). The methods used for mixing polyether impression material did not affect bacterial attachment to impression surfaces. In contrast, the disinfection procedure greatly affects decontamination of the impression surface.

Enhancing blood donor skin disinfection using natural oils.

PubMed

Alabdullatif, Meshari; Boujezza, Imen; Mekni, Mohamed; Taha, Mariam; Kumaran, Dilini; Yi, Qi-Long; Landoulsi, Ahmed; Ramirez-Arcos, Sandra

2017-12-01

Effective donor skin disinfection is essential in preventing bacterial contamination of blood components with skin flora bacteria like Staphylococcus epidermidis. Cell aggregates of S. epidermidis (biofilms) are found on the skin and are resistant to the commonly used donor skin disinfectants chlorhexidine-gluconate and isopropyl alcohol. It has been demonstrated that essential oils synergistically enhance the antibacterial activity of chlorhexidine-gluconate. The objective of this study was to test plant-extracted essential oils in combination with chlorhexidine-gluconate or chlorhexidine-gluconate plus isopropyl alcohol for their ability to eliminate S. epidermidis biofilms. The composition of oils extracted from Artemisia herba-alba, Lavandula multifida, Origanum marjoram, Rosmarinus officinalis, and Thymus capitatus was analyzed using gas chromatography-mass spectrometry. A rabbit model was used to assess skin irritation caused by the oils. In addition, the anti-biofilm activity of the oils used alone or in combination with chlorhexidine-gluconate or chlorhexidine-gluconate plus isopropyl alcohol was tested against S. epidermidis biofilms. Essential oil concentrations 10%, 20%, and 30% were chosen for anti-biofilm assays, because skin irritation was observed at concentrations greater than 30%. All oils except for O. marjoram had anti-biofilm activity at these three concentrations. L. multifida synergistically enhanced the anti-biofilm activity of chlorhexidine-gluconate and resulted in the highest anti-biofilm activity observed when combined with chlorhexidine-gluconate plus isopropyl alcohol. Gas chromatography-mass spectrometry revealed that the main component contributing to the activity of L. multifida oil was a natural terpene alcohol called linalool. The anti-biofilm activity of chlorhexidine-gluconate plus isopropyl alcohol can be greatly enhanced by L. multifida oil or linalool. Therefore, these components could potentially be used to improve blood

Virucidal efficacy of disinfectant actives against feline calicivirus, a surrogate for norovirus, in a short contact time.

PubMed

Whitehead, Kelly; McCue, Karen A

2010-02-01

Among other measures, handwashing and targeted disinfection are important in preventing and controlling norovirus outbreaks. Presently, there are a limited number of disinfectants effective against norovirus. There is a need to develop alternatives to bleach that are effective against norovirus, and, in particular, fast-acting disinfectants are desired. The aim of this study was to determine the disinfectant actives and formulation factors necessary to achieve efficacy against norovirus in a short contact time. Feline calicivirus (FCV) was used as a surrogate for norovirus. In a carrier test method, common disinfectant actives including alcohol, acid, quaternary compound, and phenol both alone and as formulated disinfectants were contacted with dried FCV virus for 1 minute. The virus treatment was neutralized and assayed in Crandell-Reese kidney cells for cytopathic effect. Log(10) virus inactivation was calculated comparing treatment results to virus control titer. Bleach and acid-based disinfectants inactivate FCV in 1 minute. Inactivation of FCV by alcohol and quaternary actives depends on how these actives are formulated as disinfectants. Actives and extreme pH are determined predictive of efficacy. Ethanol and quaternary compounds formulated at appropriate concentration and alkaline pH inactivates FCV in 1-minute contact. Acid cleaners, ethanol, and quaternary compounds formulated at appropriate concentration and pH can be fast-acting antimicrobial choices and alternatives to bleach for the consumer and health care providers to use to inactivate FCV, a surrogate for norovirus, and protect against this important pathogen. Copyright 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Comparative evaluation of sodium hypochlorite and microwave disinfection on dimensional stability of denture bases

PubMed Central

Thombre, Ram; Kubasad, Girish

2012-01-01

PURPOSE To compare the effect of sodium hypochlorite and microwave disinfection on the dimensional stability of denture bases without and with relining. MATERIALS AND METHODS A brass die was prepared by simulating an edentulous maxillary arch. It was used to fabricate 1.5 mm and 3 mm of thickness denture bases (n = 40). The 1.5 mm of thickness-specimens (n = 20) were relined with 1.5 mm of autopolymerizing relining resin. Five holes were prepared over crest of ridge of brass die with intimately fitting stainless steel pins which were transferred to the intaglio surface of specimens during fabrication of denture bases. For calculation of dimensional changes in denture bases, differences between the baseline area before and after disinfection of the specimens were used. The denture bases without and with relining were divided into 2 groups (each n = 20). Data were analyzed using student paired 't' and unpaired 't' test. RESULTS Microwave disinfection produces significant shrinkage in both denture bases without relining (t = 17.16; P<.001) and with relining (t = 14.9; P<.001). Denture bases without relining showed more shrinkage when compared with relined denture bases after microwave disinfection (t = 6.09; P<.001). The changes in dimensional stability after sodium hypochlorite disinfection were not significant for both denture bases without relining (t = 2.19; P=.056) and denture bases with relining (t = 2.17; P=.058). CONCLUSION Microwave disinfection leads to increased shrinkage of denture bases without and with relining. Chemical disinfection with sodium hypochlorite seems to be a safer method of disinfection with regards to physical properties such as changes in dimensional stability. PMID:22439097

Improving stethoscope disinfection at a children's hospital.

PubMed

Zaghi, Justin; Zhou, Jing; Graham, Dionne A; Potter-Bynoe, Gail; Sandora, Thomas J

2013-11-01

Stethoscopes are contaminated with pathogenic bacteria and pose a risk for transmission of infections, but few clinicians disinfect their stethoscope after every use. We sought to improve stethoscope disinfection rates among pediatric healthcare providers by providing access to disinfection materials and visual reminders to disinfect stethoscopes. Prospective intervention study. Inpatient units and emergency department of a major pediatric hospital. Physicians and nurses with high anticipated stethoscope use. Baskets filled with alcohol prep pads and a sticker reminding providers to regularly disinfect stethoscopes were installed outside of patient rooms. Healthcare providers' stethoscope disinfection behaviors were directly observed before and after the intervention. Multivariable logistic regression models were created to identify independent predictors of stethoscope disinfection. Two hundred twenty-six observations were made in the preintervention period and 261 in the postintervention period (83% were of physicians). Stethoscope disinfection compliance increased significantly from a baseline of 34% to 59% postintervention (P < .001). In adjusted analyses, the postintervention period was associated with improved disinfection among both physicians (odds ratio [OR], 2.3 [95% confidence interval (CI), 1.4-3.5]) and nurses (OR, 14.3 [95% CI, 4.6-44.6]). Additional factors independently associated with disinfection included subspecialty unit (vs general pediatrics; OR, 0.5 [95% CI, 0.3-0.8]) and contact precautions (OR, 2.3 [95% CI, 1.2-4.1]). Providing stethoscope disinfection supplies and visible reminders outside of patient rooms significantly increased stethoscope disinfection rates among physicians and nurses at a children's hospital. This simple intervention could be replicated at other healthcare facilities. Future research should assess the impact on patient infections.

Tonometer disinfection practice in the United Kingdom: a national survey.

PubMed

Hillier, R J; Kumar, N

2008-08-01

To assess current tonometer disinfection practice in the UK, and compare with published recommendations. Every ophthalmology unit with training recognition in the UK was contacted (n=155). A senior nurse at each institution completed a telephone questionnaire regarding local tonometer disinfection practice. The response rate was 100%. Thirty-five units (23%) reported exclusive use of disposable tonometer heads and were excluded from further analysis. One hundred and twenty units (77%) used either reusable or a combination of reusable and disposable tonometer heads. Where reusable heads were used, 80 units (67%) immersed them in a chlorine-based solution such as sodium hypochlorite or sodium dichloroisocyanurate. Others used isopropyl alcohol (18 units), hydrogen peroxide (12 units), chloramine (5 units), chlorhexidine (4 units) and peracetic acid (1 unit). Where a chlorine-based agent was used, the concentration of available chlorine ranged from 125 to 30 000 p.p.m., with 50 units (63%) using a concentration of less than 5 000 p.p.m. (i.e., inadequate based on published recommendations). Where the tonometer head was immersed in disinfectant between patients (n=101), 29 units (29%) provided just one tonometer head per practitioner, making adequate soak time between patients unlikely. Every unit replenished the disinfectant at least daily, deemed sufficient for most agents. However, hydrogen peroxide solutions should be replenished twice daily, which did not take place in nine units. This survey reveals disparity between current tonometer disinfection practice and published international recommendations, with some institutions using practices that may render patients susceptible to transmissible infection.

Surface Dielectric Barrier Discharge Jet for Skin Disinfection

NASA Astrophysics Data System (ADS)

Creyghton, Yves; Meijer, Rogier; Verweij, Paul; van der Zanden, Frank; Leenders, Paul

A consortium consisting of the research institute TNO, the medical ­university and hospital St Radboud and two industrial enterprises is working on a non-thermal plasma treatment method for hand disinfection. The group is seeking for cooperation, in particular in the field of validation methods and potential ­standardization for plasma based disinfection procedures. The present paper describes technical progress in plasma source development together with initial microbiological data. Particular properties of the sheet shaped plasma volume are the possibility of treating large irregular surfaces in a short period of time, effective plasma produced species transfer to the surface together with high controllability of the nature of plasma species by means of temperature conditioning.

An evaluation of hand hygiene in an intensive care unit: Are visitors a potential vector for pathogens?

PubMed

Birnbach, David J; Rosen, Lisa F; Fitzpatrick, Maureen; Arheart, Kristopher L; Munoz-Price, L Silvia

2015-01-01

Patients in an intensive care unit (ICU) are frequently immunocompromised and might be highly susceptible to infection. Visitors to an ICU who do not adequately clean their hands could carry pathogenic organisms, resulting in risk to a vulnerable patient population. This observational study identifies pathogens carried on the hands of visitors into an ICU and investigates the effect of hand hygiene. Two observers, one stationed outside and one inside the ICU, evaluated whether visitors performed hand hygiene at any of the wall-mounted alcohol-based hand sanitizer dispensers prior to reaching a patient's room. Upon reaching a patient's room, the dominant hand of all of the participants was cultured. Of the 55 participating visitors, 35 did not disinfect their hands. Among the cultures of those who failed to perform hand hygiene, eight cultures grew Gram-negative rods and one grew methicillin-resistant Staphylococcus aureus. Of the cultures of the 20 individuals who performed hand hygiene, 14 (70%) had no growth on the cultures, and the remaining six (30%) showed only the usual skin flora. The visitors who do not perform hand hygiene might carry pathogens that pose a risk to ICU patients. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

TiO{sub 2}-based photocatalytic disinfection of microbes in aqueous media: A review

DOE Office of Scientific and Technical Information (OSTI.GOV)

Laxma Reddy, P.Venkata

The TiO{sub 2} based photocatalyst has great potential for the disinfection/inactivation of harmful pathogens (such as E.coli in aqueous media) along with its well-known usefulness on various chemical pollutants. The disinfection property of TiO{sub 2} is primarily attributed to surface generation of reactive oxygen species (ROS) as well as free metal ions formation. Furthermore, its disinfection capacity and overall performance can be significantly improved through modifications of the TiO{sub 2} material. In this review, we provide a brief survey on the effect of various TiO{sub 2} materials in the disinfection of a wide range of environmentally harmful microbial pathogens (e.g.,more » bacteria, fungi, algae, and viruses) in aqueous media. The influencing factors (such as reactor design, water chemistry, and TiO{sub 2} modifications) of such processes are discussed along with the mechanisms of such disinfection. It is believed that the combined application of disinfection and decontamination will greatly enhance the utilization of TiO{sub 2} photocatalyst as a potential alternative to conventional methods of water purification. - Highlights: • The advent of industrialization jeopardized the quality of drinking water. • TiO{sub 2} photocatalysis holds promise both in the degradation of pollutants and for disinfection. • The applicability of TiO{sub 2}-based decontamination is explored for microbial disinfection. • Here we provide a comprehensive review on titania-based photocatalysts for disinfection.« less

Outcomes of an infection prevention project focusing on hand hygiene and isolation practices.

PubMed

Aragon, Daleen; Sole, Mary Lou; Brown, Scott

2005-01-01

Nosocomial infections are a major health problem for hospitalized patients and their families. Since the 1800s, hand hygiene has been recognized as the single best method to prevent the spread of pathogens and nosocomial infections. Despite this fact, many healthcare workers do not adhere to hand hygiene policies. The Centers for Disease Control and Prevention issued a guideline for hand hygiene practices in 2002. Multifaceted approaches to improve hand hygiene have been shown to increase compliance among healthcare workers and subsequently reduce infections. A performance improvement project was initiated to implement this guideline and other strategies to prevent nosocomial infection. This article summarizes the performance improvement processes and the preliminary outcomes on adherence to infection prevention policies related to hand hygiene and isolation practices. Clinically and statistically significant increases were noted for hand hygiene prior to patient care and in wearing masks when indicated. Nurses and patient care technicians had the greatest increases in compliance. Increases in hand hygiene after patient contact and wearing of gown and gloves were also noted, but results were not statistically significant. Nosocomial infection rates from antibiotic-resistant organisms decreased in the first surveillance, but rates increased during the 1-year surveillance. Consumption of alcohol-based foam disinfectant doubled from baseline. Findings are consistent with other published studies. The project will continue with further reinforcement and education over the second year.

Assessment of transpulmonary absorption of ethanol from alcohol-based hand rub.

PubMed

Hautemanière, Alexis; Ahmed-Lecheheb, Djihane; Cunat, Lisiane; Hartemann, Philippe

2013-03-01

Alcohol-based hand rubs (ABHRs) have been associated with a reduction of nosocomial infections. Despite the worldwide introduction of these products in health care settings, the aim of this study was to assess the transpulmonary absorption of ethanol contains in ABHRs used by health care workers (HCWs) in real conditions of work shift. Twenty-six HCWs of Nancy University Hospital were included. Research consisted in monitoring participants during 4 hours of work shift to assess their exposure to ethanol. The measurement of ethanol vapors in exhaled breath was performed using a class B ethylometer (Alco-Sensor FST). Ethanol concentration in inhaled breath was measured using Gilian pump LFS-113. Concentration of ethanol, acetaldehyde, and acetate in blood and urine samples were determined using gas chromatography with flame ionization detector. Participants were 12% male and 88% female. The mean age was 40 ± 8 years. None of the employees included in the study presented any traces of ethanol or its metabolites in the blood or urine. Ethanol (0.08 ± 0.07 mg/L) was detected in the breath of 10 HCWs at 1 to 2 minutes postexposure. The mean concentration of ethanol in the inhaled air was 46.2 mg/m. Absorption of ethanol vapor from ABHRs among HCWs during their care activities was not detected. Quantification of ethanol fumes inhaled during 4 hours of work shift was below the regulatory limitations of exposure to ethanol. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Can pulsed xenon ultraviolet light systems disinfect aerobic bacteria in the absence of manual disinfection?

PubMed

Jinadatha, Chetan; Villamaria, Frank C; Ganachari-Mallappa, Nagaraja; Brown, Donna S; Liao, I-Chia; Stock, Eileen M; Copeland, Laurel A; Zeber, John E

2015-04-01

Whereas pulsed xenon-based ultraviolet light no-touch disinfection systems are being increasingly used for room disinfection after patient discharge with manual cleaning, their effectiveness in the absence of manual disinfection has not been previously evaluated. Our study indicates that pulsed xenon-based ultraviolet light systems effectively reduce aerobic bacteria in the absence of manual disinfection. These data are important for hospitals planning to adopt this technology as adjunct to routine manual disinfection. Published by Elsevier Inc.

Efficacy of computer-based endoscope cleaning and disinfection using a hospital management information system.

PubMed

Wang, Caixia; Chen, Yuanyuan; Yang, Feng; Ren, Jie; Yu, Xin; Wang, Jiani; Sun, Siyu

2016-08-01

The present study aimed to assess the efficacy of computer-based endoscope cleaning and disinfection using a hospital management information system (HMIS). A total of 2,674 gastroscopes were eligible for inclusion in this study. For the processes of disinfection management, the gastroscopes were randomly divided into 2 groups: gastroscope disinfection HMIS (GD-HMIS) group and manual group. In the GD-HMIS group, an integrated circuit card (IC card) chip was installed to monitor and record endoscope cleaning and disinfection automatically and in real time, whereas the endoscope cleaning and disinfection in the manual group was recorded manually. The overall disinfection progresses for both groups were recorded, and the total operational time was calculated. For the GD-HMIS group, endoscope disinfection HMIS software was successfully developed. The time to complete a single session of cleaning and disinfecting on a gastroscope was 15.6 minutes (range, 14.3-17.2 minutes) for the GD-HMIS group and 21.3 minutes (range, 20.2-23.9 minutes) for the manual group. Failure to record information, such as the identification number of the endoscope, occasionally occurred in the manual group, which affected the accuracy and reliability of manual recording. Computer-based gastroscope cleaning and disinfection using a hospital management information system could monitor the process of gastroscope cleaning and disinfection in real time and improve the accuracy and reliability, thereby ensuring the quality of gastroscope cleaning and disinfection. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Commercial Disinfectants During Disinfection Process Validation: More Failures than Success.

PubMed

Chatterjee, Shiv Sekhar; Chumber, Sushil Kumar; Khanduri, Uma

2016-08-01

Disinfection process validation is mandatory before introduction of a new disinfectant in hospital services. Commercial disinfection brands often question existing hospital policy claiming greater efficacy and lack of toxicity of their products. Inadvertent inadequate disinfection leads to morbidity, patient's economic burden, and the risk of mortality. To evaluate commercial disinfectants for high, intermediate and low-level disinfection so as to identify utility for our routine situations. This laboratory based experiment was conducted at St Stephen Hospital, Delhi during July-September 2013. Twelve commercial disinfectants: Sanidex®, Sanocid®, Cidex®, SekuSept Aktiv®, BIB Forte®, Alprojet W®, Desnet®, Sanihygiene®, Incidin®, D125®, Lonzagard®, and Glutishield® were tested. Time-kill assay (suspension test) was performed against six indicator bacteria (Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella Typhi, Bacillus cereus, and Mycobacterium fortuitum). Low and high inoculum (final concentrations 1.5X10(6) and 9X10(6) cfu/ml) of the first five bacteria while only low level of M. fortuitum was tested. Cidex® (2.4% Glutaraldehyde) performed best as high level disinfectant while newer quarternary ammonium compounds (QACs) (Incidin®, D125®, and Lonzagard®) were good at low level disinfection. Sanidex® (0.55% Ortho-pthalaldehyde) though mycobactericidal took 10 minutes for sporicidal activity. Older QAC containing BIB Forte® and Desnet® took 20 minutes to fully inhibit P. aeruginosa. All disinfectants effectively reduced S. Typhi to zero counts within 5 minutes. Cidex® is a good high-level disinfectant while newer QACs (Incidin®, D125®, and Lonzagard®) were capable low-level disinfectants.

Death caused by ingestion of an ethanol-based hand sanitizer.

PubMed

Schneir, Aaron B; Clark, Richard F

2013-09-01

The use of hand sanitizer is effective in preventing the transmission of disease. Many hand sanitizers are alcohol-based, and significant intoxications have occurred, often in health care facilities, including the emergency department (ED). We present this case to highlight potential toxicity after the ingestion of an ethanol-based hand sanitizer. A 36-year-old man presented to the ED with ethanol intoxication. Ethanol breath analysis was measured at 278 mg/dL. After 4 h, the patient was less intoxicated and left the ED. Thirty minutes later, he was found apneic and pulseless in the ED waiting room bathroom after having ingested an ethanol-based hand sanitizer. Soon after a brief resuscitation, his serum ethanol was 526 mg/dL. He never regained consciousness and died 7 days later. No other cause of death was found. The case highlights the potential for significant toxicity after the ingestion of a product found throughout health care facilities. Balancing the benefit of hand sanitizers for preventing disease transmission and their potential misuse remains a challenge. Copyright © 2013 Elsevier Inc. All rights reserved.

Neonatal ethanol exposure from ethanol-based hand sanitisers in isolettes.

PubMed

Hsieh, Shizuka; Sapkota, Amir; Wood, Rebecca; Bearer, Cynthia; Kapoor, Shiv

2018-01-01

The aims of this study is to measure the ethanol vapours in the isolette after use of hands cleaned with ethanol-based hand sanitiser (EBHS). Two squirts (1.5 mL) of hand sanitiser were rubbed on hands for 10 or 20 s before inserting the hands in the isolette for 5 min. Ethanol vapours were measured in the isolette with photoionisation detector and alcohol breathalyser for 30 min. Peak ethanol concentration in the isolette was considerably higher with a 10 s hand rub (381±192 ppm) compared with a 20 s hand rub (99±50 ppm), and dissipated to ≤5 ppm within 30 min. Under routine care, EBHS use by care providers exposes neonates in isolettes to 3.7-7.3 or 1.4-2.8 mg/kg ethanol per day with 10 or 20 s hand rubs, respectively. The expected blood level from average single exposure is 0.036 mg/dL with 10 s hand rub and may increase further with multiple exposures in a short period. Preterm neonates in the isolette are at risk of inadvertent exposure to ethanol. The expected blood alcohol level from this exposure is small and below 1 mg/dL level recommended by European Medicines Agency to limit the ethanol exposure in children. The unintended ethanol exposure can be avoided by rubbing hands for at least 20 s after applying EBHS. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Adoption of Alcohol-Based Handrub by United States Hospitals: A National Survey

PubMed Central

Mody, Lona; Saint, Sanjay; Kaufman, Samuel R.; Kowalski, Christine; Krein, Sarah L.

2009-01-01

The extent to which the use of alcohol-based handrub for hand hygiene has been adopted by US hospitals is unknown. A survey of infection control coordinators (response rate, 516 [72%] of 719) revealed that most hospitals (436 [84%] of 516) have adopted alcohol-based handrub. Leadership support and staff receptivity play a significant role in its adoption. PMID:18986300

False-positive ethyl glucuronide immunoassay screening caused by a propyl alcohol-based hand sanitizer.

PubMed

Arndt, Torsten; Grüner, Joachim; Schröfel, Stefanie; Stemmerich, Karsten

2012-11-30

Urine ethyl glucuronide (EtG) is considered as a specific marker of recent ethanol consumption. We describe false-positive DRI(®) EIA EtG enzyme immunoassay results caused by propyl glucuronides in urine after using a propanol-based hand sanitizer. EtG screening was done with the DRI(®) EIA EtG assay (Microgenics), using a cut-off of 0.5 mg/L as recommended by the manufacturer and of 0.1 mg/L as demanded by the German Regulations for Reissuing Drivers Licenses. Confirmatory EtG analysis was done with the ClinMass(®) EtG LC-MS/MS testkit (Recipe), extended by the mass transitions 235.1→75.1, 235.1→85.1, and 235.1→113.1 for the detection of the 1- and 2-propyl glucuronides. Self-experiments were done by staff members of our lab (n=7), using 3 mL Sterillium(®) Classic Pure (30 g/100 g 1-propanol and 45 g/100 g 2-propanol) for hand sanitation every quarter of an hour for 8 h according to DIN EN 1500:2011-05 with and without an exhauster and by passive inhalation of the sanitizer vapor. Spot urine samples were taken immediately before and up to 24 h after the first sanitizer use. False-positive immunoassay results of up to 4 mg/L or 2.3 mg/g creatinine were obtained after normal use of the sanitizer and also after passive inhalation of the sanitizer vapor (up to 0.89 mg/L or 0.61 mg/g). Immunoassay results were positive even after 4-fold use of the sanitizer (up to 0.14 mg/L or 0.38 mg/g) and up to 6 h after the last sanitizer contact (maximum 0.63 mg/L and 0.33 mg/g for sanitizer users and 0.25 mg/g after passive inhalation). Spiking of EtG-free urine with 1-propyl glucuronide (Athena Environmental Sciences) between 0.05 and 10 mg/L clearly demonstrated a cross reaction of the immunoassay of approx. 10% as compared to EtG. LC-MS/MS of urines with a positive immunoassay EtG result did not show EtG signals, but distinct signals of 1-propyl glucuronide (n-propyl glucuronide) and 2-propyl glucuronide (iso-propyl glucuronide). An exhauster effectively prevented

DEVELOPMENT OF A RATIONALLY BASED DESIGN PROTOCOL FOR THE ULTRAVIOLET LIGHT DISINFECTION PROCESS

EPA Science Inventory

A protocol is demonstrated for the design and evaluation of ultraviolet (UV) disinfection systems based on a mathematical model. The disinfection model incorporates the system's physical dimensions, the residence time distribution of the reactor and dispersion characteristics, th...

Acute ethanol poisoning in a 6-year-old girl following ingestion of alcohol-based hand sanitizer at school.

PubMed

Joseph, Madeline Matar; Zeretzke, Cristina; Reader, Sara; Sollee, Dawn R

2011-01-01

Alcohol-based hand sanitizers (ABHSs) have been widely used in homes, workplaces and schools to prevent the spread of infectious diseases. We report a young child unintentionally ingested ABHS at a school, resulting in intoxication. The child was a 6-year-old girl who had been brought to the emergency department (ED) for hypothermia, altered mental status (AMS), periods of hypoventilation, hypothermia and vomiting. Computed tomography of her head revealed nothing abnormal in intracranial pathology. Urine drug screening was negative. Alcohol level was 205 mg/dL on admission. Other abnormal values included potassium of 2.8 mEq/L, osmolality of 340 mOsm/kg and no hypoglycemia. Further investigation revealed that the patient had gone frequently to the class restroom for ingestion of unknown quantities of ABHSs during the day. The patient was admitted for one day for intravenous fluid hydration and close observation of her mental status. The patient was discharged from the hospital the next day without any complications. Despite the large safety margin of ABHSs, emergency physicians need to be aware of the potential risk of ingestion of a large amount of such products in children and consider it in the assessment and management of school-age children with acute AMS.

Can a school-based hand hygiene program reduce asthma exacerbations among elementary school children?

PubMed Central

Gerald, Joe K.; Zhang, Bin; McClure, Leslie A.; Bailey, William C.; Harrington, Kathy F.

2012-01-01

Background Viral upper respiratory infections have been implicated as a major cause of asthma exacerbations among school age children. Regular hand washing is the most effective method to prevent the spread of viral respiratory infections but, effective hand washing practices are difficult to establish in schools. Objectives This randomized controlled trial evaluated whether a standardized regimen of hand washing plus alcohol-based hand sanitizer could reduce asthma exacerbations more than schools’ usual hand hygiene practices. Methods This was a two year, community-based, randomized controlled crossover trial. Schools were randomized to usual care then intervention (Sequence 1) or intervention then usual care (Sequence 2). Intervention schools were provided with alcohol-based hand sanitizer, hand soap, and hand hygiene education. The primary outcome was the proportion of students experiencing an asthma exacerbation each month. Generalized estimating equations were used to model the difference in the marginal rate of exacerbations between sequences while controlling for individual demographic factors and the correlation within each student and between students within each school. Results 527 students with asthma were enrolled among 31 schools. The hand hygiene intervention did not reduce the number of asthma exacerbations as compared to the schools’ usual hand hygiene practices (p=0.132). There was a strong temporal trend as both sequences experienced fewer exacerbations during Year 2 as compared to Year 1 (p<0.001). Conclusions While the intervention was not found to be effective, the results were confounded by the H1N1 influenza pandemic that resulted in substantially increased hand hygiene behaviors and resources in usual care schools. Therefore, these results should be viewed cautiously. PMID:23069487

Antiseptics and Disinfectants: Activity, Action, and Resistance

PubMed Central

McDonnell, Gerald; Russell, A. Denver

1999-01-01

Antiseptics and disinfectants are extensively used in hospitals and other health care settings for a variety of topical and hard-surface applications. A wide variety of active chemical agents (biocides) are found in these products, many of which have been used for hundreds of years, including alcohols, phenols, iodine, and chlorine. Most of these active agents demonstrate broad-spectrum antimicrobial activity; however, little is known about the mode of action of these agents in comparison to antibiotics. This review considers what is known about the mode of action and spectrum of activity of antiseptics and disinfectants. The widespread use of these products has prompted some speculation on the development of microbial resistance, in particular whether antibiotic resistance is induced by antiseptics or disinfectants. Known mechanisms of microbial resistance (both intrinsic and acquired) to biocides are reviewed, with emphasis on the clinical implications of these reports. PMID:9880479

Evaluation of skin surface hydration state and barrier function of stratum corneum of dorsa of hands and heels treated with PROTECT X2 skin protective cream.

PubMed

Kubota, Takahiro

2012-06-01

Skin roughness is a term commonly used in Japan to describe a poor skin condition related to a rough and dry skin surface that develops as a result of various damaging effects from the environment or skin inflammation. Recovery from skin roughness requires skin care for a long period, thus it is important to prevent development of such skin changes. PROTECT X2 contains agents used for a protective covering of the skin from frequent hand washing or use of alcohol-based disinfectants. These unique components are also thought to be effective to treat skin roughness of the dorsa of the hands and heels. In the present study, we evaluated the effectiveness of PROTECT X2 to increase skin surface hydration state, as well as enhance the barrier function of the stratum corneum of the dorsa of the hands and heels in elderly individuals. A total of 8 elderly subjects and their caretakers without any skin diseases participated in the study. They applied PROTECT X2 by themselves to the dorsum area of 1 hand and heel 3 to 5 times daily for 1 month, while the opposite sides were left untreated. We measured stratum corneum (SC) hydration and transepidermal water loss (TEWL) before beginning treatment, then 1 week and 1 month after the start of treatment to compare between the treated and untreated skin. SC hydration state after applications of PROTECT X2 was 1.5- to 3.0-fold higher than that of the untreated skin in the dorsa of both hands and heels, indicating that the moisturizing ingredients accompanied by water were replenished in those areas where the cream was applied. Also, TEWL in the dorsum of the hands was 17.0-27.9% lower on the treated side, indicating improvement in SC barrier function. On the basis of these findings, we concluded that PROTECT X2 enhances water-holding in the SC and aids the barrier function of the skin in the dorsum of the hands. In addition, we consider that this formulation is useful for not only protecting the hands from the effects of such agents

Revisiting the hand wipe versus gel rub debate: is a higher-ethanol content hand wipe more effective than an ethanol gel rub?

PubMed

D'Antonio, Natalie N; Rihs, John D; Stout, Janet E; Yu, Victor L

2010-11-01

The Centers for Disease Control and Prevention's guidelines for hand hygiene state that the use of alcohol-based hand wipes is not an effective substitute for the use of an alcohol-based hand rub or handwashing with an antimicrobial soap and water. The objective of this study was to determine whether a hand wipe with higher ethanol content (65.9%) is as effective as an ethanol hand rub or antimicrobial soap in removing bacteria and spores from hands. In two separate experiments, the hands of 7 subjects were inoculated with a suspension of Serratia marcescens or Geobacillus stearothermophilus. Subjects washed with each of 3 different products: 65.9% ethanol hand wipes (Sani-Hands ALC), 62% ethanol gel rub (Purell), and antimicrobial soap containing 0.75% triclosan (Kindest Kare). A total of 56 observations were analyzed for S marcescens removal and 70 observations were analyzed for G stearothermophilus removal. The rank order of product efficacy for both bacteria and spore removal was antibacterial soap > 65.9% ethanol hand wipes >62% ethanol hand rub. Mean S marcescens log reductions (±SD) for the 65.9% ethanol alcohol wipe, 62% ethanol alcohol rub, and antimicrobial foam soap were 3.44 ± 0.847, 2.32 ± 1.065, and 4.44 ± 1.018, respectively (P < .001). Mean G stearothermophilus log reductions for the 65.9% ethanol wipe, 62% ethanol rub, and antimicrobial foam soap were 0.51 ± 0.26, -0.8 ± 0.32 increase over baseline, and 1.72 ± 0.62, respectively (P < .001). The alcohol-based hand wipe containing 65.9% ethanol was significantly more effective than the 62% ethanol rub in reducing the number of viable bacteria and spores on the hands. Copyright © 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Validated measurements of microbial loads on environmental surfaces in intensive care units before and after disinfecting cleaning.

PubMed

Frickmann, H; Bachert, S; Warnke, P; Podbielski, A

2018-03-01

Preanalytic aspects can make results of hygiene studies difficult to compare. Efficacy of surface disinfection was assessed with an evaluated swabbing procedure. A validated microbial screening of surfaces was performed in the patients' environment and from hands of healthcare workers on two intensive care units (ICUs) prior to and after a standardized disinfection procedure. From a pure culture, the recovery rate of the swabs for Staphylococcus aureus was 35%-64% and dropped to 0%-22% from a mixed culture with 10-times more Staphylococcus epidermidis than S. aureus. Microbial surface loads 30 min before and after the cleaning procedures were indistinguishable. The quality-ensured screening procedure proved that adequate hygiene procedures are associated with a low overall colonization of surfaces and skin of healthcare workers. Unchanged microbial loads before and after surface disinfection demonstrated the low additional impact of this procedure in the endemic situation when the pathogen load prior to surface disinfection is already low. Based on a validated screening system ensuring the interpretability and reliability of the results, the study confirms the efficiency of combined hand and surface hygiene procedures to guarantee low rates of bacterial colonization. © 2017 The Society for Applied Microbiology.

Evaluation of hand hygiene compliance and associated factors with a radio-frequency-identification-based real-time continuous automated monitoring system.

PubMed

Dufour, J-C; Reynier, P; Boudjema, S; Soto Aladro, A; Giorgi, R; Brouqui, P

2017-04-01

Hand hygiene is a major means for preventing healthcare-associated infections. One critical point in understanding poor compliance is the lack of relevant markers used to monitor practices systematically. This study analysed hand hygiene compliance and associated factors with a radio-frequency-identification-based real-time continuous automated monitoring system in an infectious disease ward with 17 single bedrooms. Healthcare workers (HCWs) were tracked while performing routine care over 171 days. A multi-level multi-variate logistics model was used for data analysis. The main outcome measures were hand disinfection before entering the bedroom (outside use) and before entering the patient care zone, defined as the zone surrounding the patient's bed (inside/bedside use). Variables analysed included HCWs' characteristics and behaviour, patients, room layouts, path chains and duration of HCWs' paths. In total, 4629 paths with initial hand hygiene opportunities when entering the patient care zone were selected, of which 763 (16.5%), 285 (6.1%) and 3581 (77.4%) were associated with outside use, inside/bedside use and no use, respectively. Hand hygiene is caregiver-dependent. The shorter the duration of the HCW's path, the worse the bedside hand hygiene. Bedside hand hygiene is improved when one or two extra HCWs are present in the room. Hand hygiene compliance at the bedside, as analysed using the continuous monitoring system, depended upon the HCW's occupation and personal behaviour, number of HCWs, time spent in the room and (potentially) dispenser location. Meal tray distribution was a possible factor in the case of failure to disinfect hands. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Nudging to improve hand hygiene.

PubMed

Caris, M G; Labuschagne, H A; Dekker, M; Kramer, M H H; van Agtmael, M A; Vandenbroucke-Grauls, C M J E

2018-04-01

Hand hygiene is paramount to prevent healthcare-associated infections, but improving compliance is challenging. When healthcare workers seldom encounter healthcare-associated infections, they will consider the odds of causing infections through poor hand hygiene negligible. Cognitive biases such as these may induce non-compliance. Nudging, 'a friendly push to encourage desired behaviour', could provide an easily implemented, inexpensive measure to address cognitive biases and thus support hand hygiene interventions. To investigate whether behavioural nudges, displayed as posters, can increase the use of alcohol-based hand rub. We developed nudges based on a systematic review of previously described cognitive biases, and tested these through a cross-sectional survey among the target audience. We then conducted a controlled before-after trial on two hospital wards, to assess the effect of these nudges on the use of alcohol-based hand rub, measured with electronic dispensers. Poisson regression analyses adjusted for workload showed that nudges displayed next to dispensers increased their overall use on one ward [poster 1: relative risk: 1.6 (95% confidence interval: 1.2-2.2); poster 2: 1.7 (1.2-2.5)] and during doctor's rounds on both wards [poster 1: ward A: 1.7 (1.1-2.6); ward B: 2.2 (1.3-3.8)]. Use of dispensers without adjacent nudges did not increase. Nudges based on cognitive biases that play a role in hand hygiene, and displayed as posters, could provide an easy, inexpensive measure to increase use of alcohol-based hand rub. When applying nudges to change behaviour, it is important to identify the right nudge for the right audience. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

TiO2-based photocatalytic disinfection of microbes in aqueous media: A review.

PubMed

Laxma Reddy, P Venkata; Kavitha, Beluri; Kumar Reddy, Police Anil; Kim, Ki-Hyun

2017-04-01

The TiO 2 based photocatalyst has great potential for the disinfection/inactivation of harmful pathogens (such as E.coli in aqueous media) along with its well-known usefulness on various chemical pollutants. The disinfection property of TiO 2 is primarily attributed to surface generation of reactive oxygen species (ROS) as well as free metal ions formation. Furthermore, its disinfection capacity and overall performance can be significantly improved through modifications of the TiO 2 material. In this review, we provide a brief survey on the effect of various TiO 2 materials in the disinfection of a wide range of environmentally harmful microbial pathogens (e.g., bacteria, fungi, algae, and viruses) in aqueous media. The influencing factors (such as reactor design, water chemistry, and TiO 2 modifications) of such processes are discussed along with the mechanisms of such disinfection. It is believed that the combined application of disinfection and decontamination will greatly enhance the utilization of TiO 2 photocatalyst as a potential alternative to conventional methods of water purification. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluation of a hydrogen peroxide-based system for high-level disinfection of vaginal ultrasound probes.

PubMed

Johnson, Stephen; Proctor, Matthew; Bluth, Edward; Smetherman, Dana; Baumgarten, Katherine; Troxclair, Laurie; Bienvenu, Michele

2013-10-01

Because of the complex process and the risk of errors associated with the glutaraldehyde-based solutions previously used at our institution for disinfection, our department has implemented a new method for high-level disinfection of vaginal ultrasound probes: the hydrogen peroxide-based Trophon system (Nanosonics, Alexandria, New South Wales, Australia). The aim of this study was to compare the time difference, safety, and sonographers' satisfaction between the glutaraldehyde-based Cidex (CIVCO Medical Solutions, Kalona, IA) and the hydrogen peroxide-based Trophon disinfection systems. The Institutional Review Board approved a 14-question survey administered to the 13 sonographers in our department. Survey questions addressed a variety of aspects of the disinfection processes with graded responses over a standardized 5-point scale. A process diagram was developed for each disinfection method with segmental timing analysis, and a cost analysis was performed. Nonvariegated analysis of the survey data with the Wilcoxon signed rank test showed a statistical difference in survey responses in favor of the hydrogen peroxide-based system over the glutaraldehyde-based system regarding efficiency (P = .0013), ease of use (P = .0013), ability to maintain work flow (P = .026), safety (P = .0026), fixing problems (P = .0158), time (P = .0011), and overall satisfaction (P = .0018). The glutaraldehyde-based system took 32 minutes versus 14 minutes for the hydrogen peroxide-based system; the hydrogen peroxide-based system saved on average 7.5 hours per week. The cost of the hydrogen peroxide-based system and weekly maintenance pays for itself if 1.5 more ultrasound examinations are performed each week. The hydrogen peroxide-based disinfection system was proven to be more efficient and viewed to be easier and safer to use than the glutaraldehyde-based system. The adoption of the hydrogen peroxide-based system led to higher satisfaction among sonographers.

Poorly processed reusable surface disinfection tissue dispensers may be a source of infection.

PubMed

Kampf, Günter; Degenhardt, Stina; Lackner, Sibylle; Jesse, Katrin; von Baum, Heike; Ostermeyer, Christiane

2014-01-21

Reusable surface disinfectant tissue dispensers are used in hospitals in many countries because they allow immediate access to pre-soaked tissues for targeted surface decontamination. On the other hand disinfectant solutions with some active ingredients may get contaminated and cause outbreaks. We determined the frequency of contaminated surface disinfectant solutions in reusable dispensers and the ability of isolates to multiply in different formulations. Reusable tissue dispensers with different surface disinfectants were randomly collected from healthcare facilities. Solutions were investigated for bacterial contamination. The efficacy of two surface disinfectants was determined in suspension tests against two isolated species directly from a contaminated solution or after 5 passages without selection pressure in triplicate. Freshly prepared use solutions were contaminated to determine survival of isolates. 66 dispensers containing disinfectant solutions with surface-active ingredients were collected in 15 healthcare facilities. 28 dispensers from nine healthcare facilities were contaminated with approximately 107 cells per mL of Achromobacter species 3 (9 hospitals), Achromobacter xylosoxidans or Serratia marcescens (1 hospital each). In none of the hospitals dispenser processing had been adequately performed. Isolates regained susceptibility to the disinfectants after five passages without selection pressure but were still able to multiply in different formulations from different manufacturers at room temperature within 7 days. Neglecting adequate processing of surface disinfectant dispensers has contributed to frequent and heavy contamination of use-solutions based on surface active ingredients. Tissue dispenser processing should be taken seriously in clinical practice.

Poorly processed reusable surface disinfection tissue dispensers may be a source of infection

PubMed Central

2014-01-01

Background Reusable surface disinfectant tissue dispensers are used in hospitals in many countries because they allow immediate access to pre-soaked tissues for targeted surface decontamination. On the other hand disinfectant solutions with some active ingredients may get contaminated and cause outbreaks. We determined the frequency of contaminated surface disinfectant solutions in reusable dispensers and the ability of isolates to multiply in different formulations. Methods Reusable tissue dispensers with different surface disinfectants were randomly collected from healthcare facilities. Solutions were investigated for bacterial contamination. The efficacy of two surface disinfectants was determined in suspension tests against two isolated species directly from a contaminated solution or after 5 passages without selection pressure in triplicate. Freshly prepared use solutions were contaminated to determine survival of isolates. Results 66 dispensers containing disinfectant solutions with surface-active ingredients were collected in 15 healthcare facilities. 28 dispensers from nine healthcare facilities were contaminated with approximately 107 cells per mL of Achromobacter species 3 (9 hospitals), Achromobacter xylosoxidans or Serratia marcescens (1 hospital each). In none of the hospitals dispenser processing had been adequately performed. Isolates regained susceptibility to the disinfectants after five passages without selection pressure but were still able to multiply in different formulations from different manufacturers at room temperature within 7 days. Conclusions Neglecting adequate processing of surface disinfectant dispensers has contributed to frequent and heavy contamination of use-solutions based on surface active ingredients. Tissue dispenser processing should be taken seriously in clinical practice. PMID:24447780

Evaluation of Disinfection Techniques for, and Their Effects on, Rectal Thermocouple Catheters1

PubMed Central

Maher, J. T.; Rogers, M. R.; Peterson, D. W.

1961-01-01

The antibacterial activities of an iodophor (Wescodyne G), a quaternary ammonium compound (Roccal), and an iodine tincture as agents for the cold disinfection of rectal catheters contaminated in vitro were determined. Following thorough cleaning with an alcoholic solution of soft soap, each of the three disinfectants tested showed satisfactory results (100% kill) in 5 min against the enteric test bacteria (Escherichia coli and Salmonella typhosa) as well as a test species of the genus Pseudomonas, among the bacteria most resistant to surface-active agents. An aqueous solution of Wescodyne G containing 75 ppm available iodine was used both as a wiping solution and for subsequent disinfection of rectal catheters contaminated in vivo. Total bacterial destruction was found to follow a 60-min soak preceded by the wiping procedure. Rectal catheters subjected to prolonged immersion in each of the test disinfectants were found to be essentially unaffected, retaining their initial calibrations within a permissible tolerance. Neither Roccal nor Wescodyne G solutions were found to measurably attack bare thermocouples. Alcoholic iodine 0.5% did, however, exert a deteriorating effect on bare thermocouples in a short time, as measured by change in resistance characteristics. The results of this study have led to the recommendation that Wescodyne G containing 75 ppm available iodine be used in standing operating procedures for the initial cleaning and subsequent disinfection of rectal thermocouple catheters. Images Fig. 1 PMID:13765378

Effect of hand sanitizer on the performance of fingermark detection techniques.

PubMed

Chadwick, Scott; Neskoski, Melissa; Spindler, Xanthe; Lennard, Chris; Roux, Claude

2017-04-01

Hand sanitizers have seen a rapid increase in popularity amongst the general population and this increased use has led to the belief that hand sanitizers may have an effect on subsequent fingermark detection. Based on this hypothesis, three alcoholic and two non-alcoholic hand sanitizers were evaluated to determine the effect they had on the detection of fingermarks deposited after their use. The following fingermark detection methods were applied: 1,2-indanedione-zinc, ninhydrin, physical developer (porous substrate); and cyanoacrylate, rhodamine 6G, magnetic powder (non-porous substrate). Comparison between hand sanitized fingermarks and non-hand sanitized fingermarks showed that the alcohol-based hand sanitizers did not result in any visible differences in fingermark quality. The non-alcoholic hand sanitizers, however, improved the quality of fingermarks developed with 1,2-indanedione-zinc and ninhydrin, and marginally improved those developed with magnetic powder. Different parameters, including time since hand sanitizer application prior to fingermark deposition and age of deposited mark, were tested to determine the longevity of increased development quality. The non-alcoholic hand sanitized marks showed no decrease in quality when aged for up to two weeks. The time since sanitizer application was determined to be an important factor that affected the quality of non-alcoholic hand sanitized fingermarks. It was hypothesized that the active ingredient in non-alcoholic hand sanitizers, benzalkonium chloride, is responsible for the increase in fingermark development quality observed with amino acid reagents, while the increased moisture content present on the ridges resulted in better powdered fingermarks. Copyright © 2017 Elsevier B.V. All rights reserved.

Sequential UV- and chlorine-based disinfection to mitigate Escherichia coli in drinking water biofilms.

PubMed

Murphy, H M; Payne, S J; Gagnon, G A

2008-04-01

This study was designed to examine the potential downstream benefits of sequential disinfection to control the persistence of Escherichia coli under conditions relevant to drinking water distribution systems. Eight annular reactors (four polycarbonate and four cast iron) were setup in parallel to address various factors that could influence biofilm growth in distribution systems. Eight reactors were treated with chlorine, chlorine dioxide and monochloramine alone or in combination with UV to examine the effects on Escherichia coli growth and persistence in both the effluent and biofilm. In general, UV-treated systems in combination with chlorine or chlorine dioxide and monochloramine achieved greater log reductions in both effluent and biofilm than systems treated with chlorine-based disinfectants alone. However, during UV-low chlorine disinfection, E. coli was found to persist at low levels, suggesting that the UV treatment had instigated an adaptive mutation. During UV-chlorine-dioxide treatment, the E. coli that was initially below the detection limit reappeared during a low level of disinfection (0.2 mg/L) in the cast iron systems. Chloramine was shown to be effective in disinfecting suspended E. coli in the effluent but was unable to reduce biofilm counts to below the detection limit. Issues such as repair mechanism of E. coli and nitrification could help explain some of these aberrations. Improved understanding of the ability of chlorine-based disinfectant in combination with UV to provide sufficient disinfection will ultimately effect in improved management and safety of drinking water.

Alcohol-free instant hand sanitizer reduces elementary school illness absenteeism.

PubMed

Dyer, D L; Shinder, A; Shinder, F

2000-10-01

BACKGROUND AND HYPOTHESES: A substantial percentage of school absenteeism among children is related to transmissible infection. Rates of transmission can be reduced by hand washing with soap and water, but such washing occurs infrequently. This study tested whether an alcohol-free instant hand sanitizer (CleanHands) could reduce illness absenteeism in school-age children. A 10-week, open-label, crossover study was performed on 420 elementary school-age children (ages 5-12). Students were given a brief orientation immediately prior to the start of the study on the relationship of germs, illness, and hand washing. Each student in the treatment group then received the test product in individual bottles, with instructions to apply one to two sprays to the hands after coming into the classroom, before eating, and after using the restroom, in addition to their normal hand washing with soap and water. The control group was instructed to continue hand washing as normal with non-medicated soap. After 4 weeks of treatment and a 2-week wash-out period, the control and experimental groups were reversed. Data gathered on absenteeism were classified as gastrointestinal or respiratory related and normalized for nonillness-related absenteeism and school holidays. Compared to the hand washing-only control group, students using CleanHands were found to have 41.9% fewer illness-related absence days, representing a 28.9% and a 49.7% drop in gastrointestinal- and respiratory-related illnesses, respectively. Likewise, absence incidence decreased by 31.7%, consisting of a 44.2% and 50.2% decrease in incidence of gastrointestinal- and respiratory-related illnesses, respectively. No adverse events were reported during the study. Daily use of the instant hand sanitizer was associated with significantly lower rates of illness-related absenteeism.

Generation of ozone foam and its application for disinfection

NASA Astrophysics Data System (ADS)

Hiragaki, Keisuke; Ishimaru, Tomiya; Nakanishi, Masaru; Muraki, Ryouji; Nieda, Masanori; Yamabe, Chobei

2015-07-01

Generated ozone foam was applied to the disinfection of Pseudomonas fluorescens. The effect of disinfection has been confirmed experimentally and new equipment for the disinfection of hands using this ozone foam has been put on the market for the practical use. The ozone foam was produced in the foam generator after mixing the water including surfactant (30 mL/min) and air including ozone (1000 ppm = 2.14 g/m3 ~ 1600 ppm = 3.4 g/m3, 300 mL/min). The liquid-to-gas ratio is 100 L/m3. The concentration of dissolved ozone in the thin liquid films of the bubbles was about 3 mg/L which was measured by the chemical method of the KI absorption and titration of sodium thiosulfate solution. The disinfection test samples were prepared using the PET disk on which Pseudomonas fluorescens of its number of more than 108 were attached. Test sample was inserted into ozone foam set on the glass plate for one to 6 min. The survival rate log (N/N0 decreased with time and its value of about-2.6 (i.e., ~1/400) was obtained at 6 min (2 min × 3 times repeated). It was also confirmed that the ozone foam was useful for the disinfection of hands. For more effective disinfection (in case of taking a long time for foam melting), the ozone foam was broken by force and changed into ozone water by which the survival rate decreased ×4 (i.e., N/N0 = 1/10 000) at 4 ~ 6 min. Contribution to the topical issue "The 14th International Symposium on High Pressure Low Temperature Plasma Chemistry (HAKONE XIV)", edited by Nicolas Gherardi, Ronny Brandenburg and Lars Stollenwark

Silver-based Antibacterial Surfaces for Drinking Water Disinfection - An overview

EPA Science Inventory

Risks associated with current disinfection techniques, including the formation of disinfection by-products and multi-drug resistant bacterial species, have prompted the exploration of advanced disinfection methods. One such technique employs silver nanoparticles incorporation on ...

Development of a bar code-based exposure assessment method to evaluate occupational exposure to disinfectants and cleaning products: a pilot study.

PubMed

Quinot, Catherine; Amsellem-Dubourget, Sylvie; Temam, Sofia; Sevin, Etienne; Barreto, Christine; Tackin, Arzu; Félicité, Jérémy; Lyon-Caen, Sarah; Siroux, Valérie; Girard, Raphaële; Descatha, Alexis; Le Moual, Nicole; Dumas, Orianne

2018-05-14

Healthcare workers are highly exposed to various types of disinfectants and cleaning products. Assessment of exposure to these products remains a challenge. We aimed to investigate the feasibility of a method, based on a smartphone application and bar codes, to improve occupational exposure assessment among hospital/cleaning workers in epidemiological studies. A database of disinfectants and cleaning products used in French hospitals, including their names, bar codes and composition, was developed using several sources: ProdHyBase (a database of disinfectants managed by hospital hygiene experts), and specific regulatory agencies and industrial websites. A smartphone application has been created to scan bar codes of products and fill a short questionnaire. The application was tested in a French hospital. The ease of use and the ability to record information through this new approach were estimated. The method was tested in a French hospital (7 units, 14 participants). Through the application, 126 records (one record referred to one product entered by one participant/unit) were registered, majority of which were liquids (55.5%) or sprays (23.8%); 20.6% were used to clean surfaces and 15.9% to clean toilets. Workers used mostly products with alcohol and quaternary ammonium compounds (>90% with weekly use), followed by hypochlorite bleach and hydrogen peroxide (28.6%). For most records, information was available on the name (93.7%) and bar code (77.0%). Information on product compounds was available for all products and recorded in the database. This innovative and easy-to-use method could help to improve the assessment of occupational exposure to disinfectants/cleaning products in epidemiological studies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effectiveness of Halogen-Based Disinfectants Against Acinetobacter Baumannii: Wound Care and Environmental Decontamination

DTIC Science & Technology

2006-11-01

EFFECTIVENESS OF HALOGEN-BASED DISINFECTANTS AGAINST Acinetobacter baumannii: WOUND CARE AND ENVIROMENTAL DECONTAMINATION James...a standard E. coli comparator, in a novel bacterial culture system that incorporated a three log range of organic growth media concentrations. We...report the highest dilutions of stock disinfectant able to inhibit replication or kill the bacteria , denoted as the maximum inhibitory dilution

Evaluating the tolerability and acceptability of an alcohol-based hand rub - real-life experience with the WHO protocol.

PubMed

Wolfensberger, Aline; Durisch, Nina; Mertin, Juliane; Ajdler-Schaeffler, Evelyne; Sax, Hugo

2015-01-01

Optimizing user satisfaction with alcohol-based hand rubs (ABHR) may be vital to enhance hand hygiene performance. This study tested the tolerability and acceptability of a new ABHR (EVO9; Ecolab) in healthcare workers under daily working conditions and evaluated the practicability of the corresponding WHO protocol. We strictly applied the WHO single product ABHR evaluation protocol. A trained observer assessed hand skin conditions of healthy volunteers using at least 30 ml ABHR per day during their clinical work at baseline, day 3-5 and one month (visit 1-3). Participants rated ABHR tolerability and acceptability at visit 2 and 3. Additionally, we registered study time for participants and study team. Among 46 volunteers, 76% were female; 37% nurses, 28% physicians. Skin was observer-rated "not" or "incidentally" dry in 64.4%, 77.8%, and 90.9% participants at visit 1, 2, and 3, respectively. EVO9 was scored ≥5 (progressive scale, 1-7) for appearance, intactness, moisture content, and sensation by 95.7%, 97.7%, 88.9%, and 97.8% participants at visit 3, respectively. All WHO benchmarks were exceeded except for "speed of drying" at visit 2, and "texture" at visit 2 and 3. Cumulative study time expenditure was 14 days for the observer and four days for participants. EVO9 was well tolerated and accepted according to the WHO single ABHR evaluation protocol with the potential for improvement for stickiness. The WHO protocol is feasible but requires considerable time and logistics. It does not preclude bias, in this case especially due to the necessary switch to personal dispensers.

Is free halogen necessary for disinfection?

PubMed Central

Williams, D E; Elder, E D; Worley, S D

1988-01-01

The principle of Le Chatelier was used in demonstrating that 3-chloro-4,4-dimethyl-2-oxazolidinone (compound 1) itself kills Staphylococcus aureus rather than the very small amount of free chlorine in hydrolysis equilibrium with compound 1. On the other hand, when the N-bromo analog of compound 1 (compound 1B) was used as the disinfectant, the mixture of combined compound 1B and free bromine formed in the hydrolysis equilibrium provided disinfection. When the hydrolysis equilibrium for 1B was suppressed to the level at which a negligible amount of free bromine remained in solution, combined compound 1B was much more efficacious than combined compound 1 at killing S. aureus. PMID:3202636

Is free halogen necessary for disinfection?

PubMed

Williams, D E; Elder, E D; Worley, S D

1988-10-01

The principle of Le Chatelier was used in demonstrating that 3-chloro-4,4-dimethyl-2-oxazolidinone (compound 1) itself kills Staphylococcus aureus rather than the very small amount of free chlorine in hydrolysis equilibrium with compound 1. On the other hand, when the N-bromo analog of compound 1 (compound 1B) was used as the disinfectant, the mixture of combined compound 1B and free bromine formed in the hydrolysis equilibrium provided disinfection. When the hydrolysis equilibrium for 1B was suppressed to the level at which a negligible amount of free bromine remained in solution, combined compound 1B was much more efficacious than combined compound 1 at killing S. aureus.

Assessment of disinfection of hospital surfaces using different monitoring methods.

PubMed

Ferreira, Adriano Menis; de Andrade, Denise; Rigotti, Marcelo Alessandro; de Almeida, Margarete Teresa Gottardo; Guerra, Odanir Garcia; dos Santos Junior, Aires Garcia

2015-01-01

to assess the efficiency of cleaning/disinfection of surfaces of an Intensive Care Unit. descriptive-exploratory study with quantitative approach conducted over the course of four weeks. Visual inspection, bioluminescence adenosine triphosphate and microbiological indicators were used to indicate cleanliness/disinfection. Five surfaces (bed rails, bedside tables, infusion pumps, nurses' counter, and medical prescription table) were assessed before and after the use of rubbing alcohol at 70% (w/v), totaling 160 samples for each method. Non-parametric tests were used considering statistically significant differences at p<0.05. after the cleaning/disinfection process, 87.5, 79.4 and 87.5% of the surfaces were considered clean using the visual inspection, bioluminescence adenosine triphosphate and microbiological analyses, respectively. A statistically significant decrease was observed in the disapproval rates after the cleaning process considering the three assessment methods; the visual inspection was the least reliable. the cleaning/disinfection method was efficient in reducing microbial load and organic matter of surfaces, however, these findings require further study to clarify aspects related to the efficiency of friction, its frequency, and whether or not there is association with other inputs to achieve improved results of the cleaning/disinfection process.

Investigation of Acrylic Resin Disinfection Using Chemicals and Ultrasound.

PubMed

Muscat, Ylainia; Farrugia, Cher; Camilleri, Liberato; Arias-Moliz, Maria Teresa; Valdramidis, Vasilis; Camilleri, Josette

2018-06-01

Dental prosthetic and orthodontic appliances are transported from the clinic to the laboratory for additions and repairs. These appliances, containing microbes from the oral flora, are a high risk for cross-contamination. The aim of this study was to evaluate the effect of chemical and ultrasound disinfection against two in vitro biofilms and an in vivo formed biofilm grown on unprepared and polished polymethyl methacrylate (PMMA) surfaces. Rough and polished self-curing PMMA surfaces were infected with strains of both Candida albicans and Streptococcus oralis. After incubation, the samples were treated with different disinfection methods, including ultrasound treatment for both 15 and 30 seconds, and immersion in glutaraldehyde and alcohol-based chemical disinfectants (MD520 and Minuten, respectively). The disinfecting efficacy was assessed by colony forming units (CFU) analysis and by scanning electron microscopy (SEM). Furthermore the adequacy of bacterial elimination of application of 30-second ultrasound and MD520 was assessed on PMMA retrieved from ten volunteers by CFU analyses. ANOVA with p = 0.05 followed by the Tukey post hoc test and the Student t-test was used to analyze the data. The ultrasound treatment for 30 seconds, MD520, and Minuten were the most effective disinfectant methods as they reduced the microbial counts compared to the control (p < 0.05) as shown in the in vitro analyses. S. oralis adhered more to rough acrylic resin surfaces (p < 0.05). Ultrasound treatment was the most effective way to reduce microbial counts on PMMA exposed to oral flora (p = 0.043). Ultrasound treatment for 30 seconds was effective against C. albicans, S. oralis, and the oral flora as shown by testing microbial growth on agar plates and SEM. © 2016 by the American College of Prosthodontists.

Evaluation of Different Disinfectants on the Performance of an On-Meter Dosed Amperometric Glucose-Oxidase-Based Glucose Meter

PubMed Central

Sarmaga, Don; DuBois, Jeffrey A; Lyon, Martha E

2011-01-01

Background Off-meter dosed photometric glucose-oxidase-based glucose meters have been reported to be susceptible to interference by hydrogen-peroxide-based disinfecting agents. The objective of this study was to determine if a single application of hydrogen-peroxide-containing Accel® wipe to disinfect an on-meter dosed amperometric glucose-oxidase-based glucose meter will influence its performance. Method The performance of five on-meter dosed amperometric glucose-oxidase-based glucose meters was determined before and after disinfecting the devices with a single application of either CaviWipes® (14.3% isopropanol and 0.23% diisobutyl-phenoxy-ethoxyethyl dimethyl benzyl ammonium chloride) or Accel (0.5% hydrogen peroxide) wipes. Replicate glucose measurements were conducted before disinfecting the devices, immediately after disinfecting, and then 1 and 2 min postdisinfecting, with measurements in triplicate. Analysis was sequentially completed for five different meters. Results were analyzed by a two-way analysis of variance (Analyze-it software). Results No clinical (<0.3 mmol/liter) or statistical differences (p > .05) in glucose concentration were detected when the on-meter dosed amperometric glucose-oxidase-based glucose meters were disinfected with either CaviWipes or Accel wipes and measured immediately or 1 or 2 min postdisinfecting. No clinically significant difference in glucose concentration was detected between meters (<0.3 mmol/liter). Conclusion The on-meter dosed glucose oxidase amperometric-based glucose meters are not analytically susceptible to interference by a single application of hydrogen-peroxide-containing Accel disinfectant wipes. PMID:22226263

Evaluation of different disinfectants on the performance of an on-meter dosed amperometric glucose-oxidase-based glucose meter.

PubMed

Sarmaga, Don; Dubois, Jeffrey A; Lyon, Martha E

2011-11-01

Off-meter dosed photometric glucose-oxidase-based glucose meters have been reported to be susceptible to interference by hydrogen-peroxide-based disinfecting agents. The objective of this study was to determine if a single application of hydrogen-peroxide-containing Accel® wipe to disinfect an on-meter dosed amperometric glucose-oxidase-based glucose meter will influence its performance. The performance of five on-meter dosed amperometric glucose-oxidase-based glucose meters was determined before and after disinfecting the devices with a single application of either CaviWipes® (14.3% isopropanol and 0.23% diisobutyl-phenoxy-ethoxyethyl dimethyl benzyl ammonium chloride) or Accel (0.5% hydrogen peroxide) wipes. Replicate glucose measurements were conducted before disinfecting the devices, immediately after disinfecting, and then 1 and 2 min postdisinfecting, with measurements in triplicate. Analysis was sequentially completed for five different meters. Results were analyzed by a two-way analysis of variance (Analyze-it software). No clinical (<0.3 mmol/liter) or statistical differences (p > .05) in glucose concentration were detected when the on-meter dosed amperometric glucose-oxidase-based glucose meters were disinfected with either CaviWipes or Accel wipes and measured immediately or 1 or 2 min postdisinfecting. No clinically significant difference in glucose concentration was detected between meters (<0.3 mmol/liter). The on-meter dosed glucose oxidase amperometric-based glucose meters are not analytically susceptible to interference by a single application of hydrogen-peroxide-containing Accel disinfectant wipes. © 2011 Diabetes Technology Society.

Antimicrobial Activity of Chlorhexidine, Peracetic acid/ Peroxide hydrogen and Alcohol based compound on Isolated Bacteria in Madani Heart Hospital, Tabriz, Azerbaijan, Iran

PubMed Central

Ghotaslou, Reza; Bahrami, Nashmil

2012-01-01

Purpose: The aim of present study was to investigate the effect of chemical agents on the clinical isolates in Madani Heart Hospital, Tabriz, Iran. Methods: The minimum bactericide concentration (MBC) of disinfectants including chlorhexidine (Fort), peracetic acid (Micro) and an alcohol based compound (Deconex) on selected bacteria at various dilutions were determined by the standard suspension technique. Results: MBC of Micro, Fort and Deconex were 2-128 mg/L, 2-64 mg/L and 4 - 32 mg/L, respectively. The Gram negative bacteria were more resistance to disinfectant relation to Gram positive bacteria. Conclusion: The results showed that these agents are able to eradicate the bacteria and they can be used lonely. PMID:24312771

Strain-Specific Virolysis Patterns of Human Noroviruses in Response to Alcohols

PubMed Central

Park, Geun Woo; Collins, Nikail; Barclay, Leslie; Hu, Liya; Prasad, B. V. Venkataram; Lopman, Benjamin A.; Vinjé, Jan

2016-01-01

Alcohol-based hand sanitizers are widely used to disinfect hands to prevent the spread of pathogens including noroviruses. Alcohols inactivate norovirus by destruction of the viral capsid, resulting in the leakage of viral RNA (virolysis). Since conflicting results have been reported on the susceptibility of human noroviruses against alcohols, we exposed a panel of 30 human norovirus strains (14 GI and 16 GII strains) to different concentrations (50%, 70%, 90%) of ethanol and isopropanol and tested the viral RNA titer by RT-qPCR. Viral RNA titers of 10 (71.4%), 14 (100%), 3 (21.4%) and 7 (50%) of the 14 GI strains were reduced by > 1 log10 RNA copies/ml after exposure to 70% and 90% ethanol, and 70% and 90% isopropanol, respectively. RNA titers of 6 of the 7 non-GII 4 strains remained unaffected after alcohol exposure. Compared to GII strains, GI strains were more susceptible to ethanol than to isopropanol. At 90%, both alcohols reduced RNA titers of 8 of the 9 GII.4 strains by ≥ 1 log10 RNA copies/ml. After exposure to 70% ethanol, RNA titers of GII.4 Den Haag and Sydney strains decreased by ≥ 1.9 log10, whereas RNA reductions for GII.4 New Orleans strains were < 0.5 log10. To explain these differences, we sequenced the complete capsid gene of the 9 GII.4 strains and identified 17 amino acid substitutions in the P2 region among the 3 GII.4 variant viruses. When comparing with an additional set of 200 GII.4 VP1 sequences, only S310 and P396 were present in all GII.4 New Orleans viruses but not in the ethanol-sensitive GII.4 Sydney and GII.4 Den Haag viruses Our data demonstrate that alcohol susceptibility patterns between different norovirus genotypes vary widely and that virolysis data for a single strain or genotype are not representative for all noroviruses. PMID:27337036

Strain-Specific Virolysis Patterns of Human Noroviruses in Response to Alcohols.

PubMed

Park, Geun Woo; Collins, Nikail; Barclay, Leslie; Hu, Liya; Prasad, B V Venkataram; Lopman, Benjamin A; Vinjé, Jan

2016-01-01

Alcohol-based hand sanitizers are widely used to disinfect hands to prevent the spread of pathogens including noroviruses. Alcohols inactivate norovirus by destruction of the viral capsid, resulting in the leakage of viral RNA (virolysis). Since conflicting results have been reported on the susceptibility of human noroviruses against alcohols, we exposed a panel of 30 human norovirus strains (14 GI and 16 GII strains) to different concentrations (50%, 70%, 90%) of ethanol and isopropanol and tested the viral RNA titer by RT-qPCR. Viral RNA titers of 10 (71.4%), 14 (100%), 3 (21.4%) and 7 (50%) of the 14 GI strains were reduced by > 1 log10 RNA copies/ml after exposure to 70% and 90% ethanol, and 70% and 90% isopropanol, respectively. RNA titers of 6 of the 7 non-GII 4 strains remained unaffected after alcohol exposure. Compared to GII strains, GI strains were more susceptible to ethanol than to isopropanol. At 90%, both alcohols reduced RNA titers of 8 of the 9 GII.4 strains by ≥ 1 log10 RNA copies/ml. After exposure to 70% ethanol, RNA titers of GII.4 Den Haag and Sydney strains decreased by ≥ 1.9 log10, whereas RNA reductions for GII.4 New Orleans strains were < 0.5 log10. To explain these differences, we sequenced the complete capsid gene of the 9 GII.4 strains and identified 17 amino acid substitutions in the P2 region among the 3 GII.4 variant viruses. When comparing with an additional set of 200 GII.4 VP1 sequences, only S310 and P396 were present in all GII.4 New Orleans viruses but not in the ethanol-sensitive GII.4 Sydney and GII.4 Den Haag viruses Our data demonstrate that alcohol susceptibility patterns between different norovirus genotypes vary widely and that virolysis data for a single strain or genotype are not representative for all noroviruses.

Disinfecting the iPad: evaluating effective methods.

PubMed

Howell, V; Thoppil, A; Mariyaselvam, M; Jones, R; Young, H; Sharma, S; Blunt, M; Young, P

2014-06-01

Tablet computers are increasingly used in healthcare, but they may carry nosocomial pathogens. There are few data available on how to clean an iPad effectively for use in the clinical setting. We aimed to identify the most effective method of decontaminating the Apple iPad, without causing damage, and establish the duration of any residual effect. Following contamination with a microbial broth (meticillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE) and Clostridium difficile), we examined efficacy of iPad disinfection in the laboratory using six different disinfectant wipes: Sani-Cloth CHG 2% (chlorhexidine 2%/alcohol 70%), Clorox, Tristel, Trigene, soap and water, and plain cloth. Following cleaning, iPads were recontaminated to examine residual activity. After 480 Sani-Cloth CHG 2% disinfecting episodes, functional and visual analysis of iPads was performed by blinded subjects. With the exception of Clostridium difficile, Sani-Cloth CHG 2% and Clorox wipes were most effective against MRSA and VRE, and they were significantly better than the Apple-recommended plain cloth (P ≤ 0.001). A substantial residual antimicrobial effect was seen for >6h after wiping the iPad with Sani-Cloth CHG 2% despite repeated recontamination and without further disinfection. The functionality or visual appearance of the iPad was not damaged by repeated use of Sani-Cloth CHG 2% wipes. Sani-Cloth CHG 2% wipes effectively disinfect the iPad against MRSA and VRE, with a residual antibacterial effect and without causing damage. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Estimating Retrospective Exposure of Household Humidifier Disinfectants

PubMed Central

Park, Dong-Uk; Friesen, Melissa C; Roh, Hyun-Suk; Choi, Ye-Yong; Ahn, Jong-Ju; Lim, Heung-Kyu; Kim, Sun-Kyung; Koh, Dong-Hee; Jung, Hye-Jung; Lee, Jong-Hyeon; Cheong, Hae-Kwan; Lim, Sin-Ye; Leem, Jong-Han; Kim, Yong-Hwa; Paek, Do-Myung

2014-01-01

We conducted a comprehensive humidifier disinfectant exposure characterization for 374 subjects with lung disease who presumed their disease was related to humidifier disinfectant use (patient group) and for 303 of their family members (family group) for an ongoing epidemiological study. We visited the homes of the registered patients to investigate disinfectant use characteristics. Probability of exposure to disinfectants was determined from the questionnaire and supporting evidence from photographs demonstrating the use of humidifier disinfectant, disinfectant purchase receipts, any residual disinfectant and the consistency of their statements. Exposure duration was estimated as cumulative disinfectant use hours from the questionnaire. Airborne disinfectant exposure intensity (μg/m3) was estimated based on the disinfectant volume (mL) and frequency added to the humidifier per day, disinfectant bulk level (μg/mL), the volume of the room (m3) with humidifier disinfectant, and the degree of ventilation. Overall, the distribution patterns of the intensity, duration and cumulative exposure to humidifier disinfectants for the patient group were higher than those of the family group, especially for pregnant women and patients ≤ 6 years old. Further study is underway to evaluate the association between the disinfectant exposure estimated here with clinically diagnosed lung disease. PMID:25557769

Decontamination formulations for disinfection and sterilization

DOEpatents

Tucker, Mark D.; Engler, Daniel E.

2007-09-18

Aqueous decontamination formulations that neutralize biological pathogens for disinfection and sterilization applications. Examples of suitable applications include disinfection of food processing equipment, disinfection of areas containing livestock, mold remediation, sterilization of medical instruments and direct disinfection of food surfaces, such as beef carcasses. The formulations include at least one reactive compound, bleaching activator, inorganic base, and water. The formulations can be packaged as a two-part kit system, and can have a pH value in the range of 7-8.

Efficacy of Two Peroxygen-Based Disinfectants for Inactivation of Cryptosporidium parvum Oocysts

PubMed Central

Quilez, Joaquin; Sanchez-Acedo, Caridad; Avendaño, Catalina; del Cacho, Emilio; Lopez-Bernad, Fernando

2005-01-01

Two commercial peroxygen-based disinfectants containing hydrogen peroxide plus either peracetic acid (Ox-Virin) or silver nitrate (Ox-Agua) were tested for their ability to inactivate Cryptosporidium parvum oocysts. Oocysts were obtained from naturally infected goat kids and exposed to concentrations of 2, 5, and 10% Ox-Virin or 1, 3, and 5% Ox-Agua for 30, 60, and 120 min. In vitro excystation, vital dyes (4′,6′-diamidino-2-phenylindole and propidium iodide), and infectivity in neonatal BALB/c mice were used to assess the viability and infectivity of control and disinfectant-treated oocysts. Both disinfectants had a deleterious effect on the survival of C. parvum oocysts, since disinfection significantly reduced and in some cases eliminated their viability and infectivity. When in vitro assays were compared with an infectivity assay as indicators of oocyst inactivation, the excystation assay showed 98.6% inactivation after treatment with 10% Ox-Virin for 60 min, while the vital-dye assay showed 95.2% inactivation and the infectivity assay revealed 100% inactivation. Treatment with 3% Ox-Agua for 30 min completely eliminated oocyst infectivity for mice, although we were able to observe only 74.7% inactivation as measured by excystation assays and 24.3% with vital dyes (which proved to be the least reliable method for predicting C. parvum oocyst viability). These findings indicate the potential efficacy of both disinfectants for C. parvum oocysts in agricultural settings where soil, housing, or tools might be contaminated and support the argument that in comparison to the animal infectivity assay, vital-dye and excystation methods overestimate the viability of oocysts following chemical disinfection. PMID:15870337

Monitoring and improving the effectiveness of surface cleaning and disinfection.

PubMed

Rutala, William A; Weber, David J

2016-05-02

Disinfection of noncritical environmental surfaces and equipment is an essential component of an infection prevention program. Noncritical environmental surfaces and noncritical medical equipment surfaces may become contaminated with infectious agents and may contribute to cross-transmission by acquisition of transient hand carriage by health care personnel. Disinfection should render surfaces and equipment free of pathogens in sufficient numbers to prevent human disease (ie, hygienically clean). Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

40 CFR 141.54 - Maximum residual disinfectant level goals for disinfectants.

Code of Federal Regulations, 2014 CFR

2014-07-01

... for disinfectants. MRDLGs for disinfectants are as follows: Disinfectant residual MRDLG(mg/L) Chlorine... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Maximum residual disinfectant level goals for disinfectants. 141.54 Section 141.54 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY...

40 CFR 141.54 - Maximum residual disinfectant level goals for disinfectants.

Code of Federal Regulations, 2012 CFR

2012-07-01

... for disinfectants. MRDLGs for disinfectants are as follows: Disinfectant residual MRDLG(mg/L) Chlorine... 40 Protection of Environment 24 2012-07-01 2012-07-01 false Maximum residual disinfectant level goals for disinfectants. 141.54 Section 141.54 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY...

40 CFR 141.54 - Maximum residual disinfectant level goals for disinfectants.

Code of Federal Regulations, 2013 CFR

2013-07-01

... for disinfectants. MRDLGs for disinfectants are as follows: Disinfectant residual MRDLG(mg/L) Chlorine... 40 Protection of Environment 24 2013-07-01 2013-07-01 false Maximum residual disinfectant level goals for disinfectants. 141.54 Section 141.54 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY...

[Surface disinfection in the context of infection prevention in intensive care units].

PubMed

Kossow, A; Schaber, S; Kipp, F

2013-03-01

The highest proportion of nosocomial infections occurs on intensive care units (ICU) and infections with multiresistant pathogens are an ever increasing problem. Preventative measures should consist of a bundle of different measures including measures that address a specific problem and standard hygiene measures that are relevant in all areas. Specific measures in ICUs primarily aim at the prevention of ventilator associated pneumonia, blood vessel catheter associated infections and nosocomial urinary tract infections. Surface disinfection belongs to the standard hygiene measures and plays an inferior role compared to hand hygiene; however, surfaces come into focus in outbreak situations. The Commission on Hospital Hygiene (KRINKO) at the Robert Koch Institute (the German health protection agency) published recommendations regarding the cleaning and disinfection of surfaces. The frequency with which cleaning and/or disinfection is required varies according to defined areas of risk. The frequency and the disinfection agents used are documented in the disinfection plan.

Estimating retrospective exposure of household humidifier disinfectants.

PubMed

Park, D U; Friesen, M C; Roh, H S; Choi, Y Y; Ahn, J J; Lim, H K; Kim, S K; Koh, D H; Jung, H J; Lee, J H; Cheong, H K; Lim, S Y; Leem, J H; Kim, Y H; Paek, D M

2015-12-01

We conducted a comprehensive humidifier disinfectant exposure characterization for 374 subjects with lung disease who presumed their disease was related to humidifier disinfectant use (patient group) and for 303 of their family members (family group) for an ongoing epidemiological study. We visited the homes of the registered patients to investigate disinfectant use characteristics. Probability of exposure to disinfectants was determined from the questionnaire and supporting evidence from photographs demonstrating the use of humidifier disinfectant, disinfectant purchase receipts, any residual disinfectant, and the consistency of their statements. Exposure duration was estimated as cumulative disinfectant use hours from the questionnaire. Airborne disinfectant exposure intensity (μg/m(3)) was estimated based on the disinfectant volume (ml) and frequency added to the humidifier per day, disinfectant bulk level (μg/ml), the volume of the room (m(3)) with humidifier disinfectant, and the degree of ventilation. Overall, the distribution patterns of the intensity, duration, and cumulative exposure to humidifier disinfectants for the patient group were higher than those of the family group, especially for pregnant women and patients ≤6 years old. Further study is underway to evaluate the association between the disinfectant exposures estimated here with clinically diagnosed lung disease. Retrospective exposure to household humidifier disinfectant as estimated here can be used to evaluate associations with clinically diagnosed lung disease due to the use of humidifier disinfectant in Korea. The framework, with modifications to account for dispersion and use patterns, can also be potentially adapted to assessment of other household chemical exposures. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Proteomic Adaptations to Starvation Prepare Escherichia coli for Disinfection Tolerance

PubMed Central

Du, Zhe; Nandakumar, Renu; Nickerson, Kenneth; Li, Xu

2015-01-01

Despite the low nutrient level and constant presence of secondary disinfectants, bacterial re-growth still occurs in drinking water distribution systems. The molecular mechanisms that starved bacteria use to survive low-level chlorine-based disinfectants are not well understood. The objective of this study is to investigate these molecular mechanisms at the protein level that prepare starved cells for disinfection tolerance. Two commonly used secondary disinfectants chlorine and monochloramine, both at 1 mg/L, were used in this study. The proteomes of normal and starved Escherichia coli (K12 MG1655) cells were studied using quantitative proteomics. Over 60-min disinfection, starved cells showed significantly higher disinfection tolerance than normal cells based on the inactivation curves for both chlorine and monochloramine. Proteomic analyses suggest that starvation may prepare cells for the oxidative stress that chlorine-based disinfection will cause by affecting glutathione metabolism. In addition, proteins involved in stress regulation and stress responses were among the ones up-regulated under both starvation and chlorine/monochloramine disinfection. By comparing the fold changes under different conditions, it is suggested that starvation prepares E. coli for disinfection tolerance by increasing the expression of enzymes that can help cells survive chlorine/monochloramine disinfection. Protein co-expression analyses show that proteins in glycolysis and pentose phosphate pathway that were up-regulated under starvation are also involved in disinfection tolerance. Finally, the production and detoxification of methylglyoxal may be involved in the chlorine-based disinfection and cell defense mechanisms. PMID:25463932

Reduction of illness absenteeism in elementary schools using an alcohol-free instant hand sanitizer.

PubMed

White, C G; Shinder, F S; Shinder, A L; Dyer, D L

2001-10-01

Hand washing is the most effective way to prevent the spread of communicable disease. The purpose of this double-blind, placebo-controlled study was to assess whether an alcohol-free, instant hand sanitizer containing surfactants, allantoin, and benzalkonium chloride could reduce illness absenteeism in a population of 769 elementary school children and serve as an effective alternative when regular soap and water hand washing was not readily available. Prior to the study, students were educated about proper hand washing technique, the importance of hand washing to prevent transmission of germs, and the relationship between germs and illnesses. Children in kindergarten through the 6th grade (ages 5-12) were assigned to the active or placebo hand-sanitizer product and instructed to use the product at scheduled times during the day and as needed after coughing or sneezing. Data on illness absenteeism were tracked. After 5 weeks, students using the active product were 33% less likely to have been absent because of illness when compared with the placebo group.

Visitor characteristics and alcohol-based hand sanitizer dispenser locations at the hospital entrance: Effect on visitor use rates.

PubMed

Hobbs, Mary A; Robinson, Susan; Neyens, David M; Steed, Connie

2016-03-01

Hospital visitors' hand hygiene (HH) is an important aspect of preventing health care-associated infections, but little is known about visitors' use of alcohol-based hand sanitizers (AHS). The study aim was to examine if use of AHS is influenced by visitor characteristics and the location of AHS within the lobby of a large hospital. An observational study was conducted with AHS placed in 3 different locations. The data included visitor characteristics and if AHS were used. The results suggest that visitors are 5.28 times (95% confidence interval [CI], 3.68-7.82) more likely to use AHS when dispensers are located in the middle of the lobby with limited landmarks or barriers, 1.35 times more likely to use the AHS in the afternoon compared with the morning, or when they are younger visitors (adjusted odds ratio, 1.47; 95% CI, 1.09-1.97). Individuals in a group are more likely (adjusted odds ratio, 1.39; 95% CI, 1.06-1.84) to use AHS. In addition to location, time of day, and age, there is a group effect that results in visitors being more likely to use AHS when in a group. The increased use related to groups may serve as a mechanism to encourage visitor HH. The results suggest future research opportunities to investigate the effect of group dynamics and social pressure on visitor AHS use and to identify strategies for improving visitor HH. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

A step-wise approach towards introduction of an alcohol based hand rub, and implementation of front line ownership- using a, rural, tertiary care hospital in central India as a model.

PubMed

Sharma, Megha; Joshi, Rita; Shah, Harshada; Macaden, Ragini; Lundborg, Cecilia Stålsby

2015-04-29

Appropriate hand hygiene is a gold standard to combat healthcare associated infections (HAIs). The World Health Organization (WHO) has recommended alcohol based hand rub (ABHR) as the most effective tool to maintain hand hygiene. In resource poor settings commercially available ABHR is not "economically accessible". The objectives of this study were to assess the acceptability of, and to build confidence for an in-house prepared (based on WHO guidelines) alcohol based hand rub among healthcare workers (HCWs) using a rural, tertiary care hospital in central India as an example. A series of activities were developed and conducted based on the Precede-Proceed model, the Trans Theoretical model of behaviour change, Front line ownership and Social marketing. A modified WHO-ABHR formulation, the 'test product' and 'WHO product evaluation form' were used for self assessment of acceptability of the 'test product'. Confidence building activities, as finger tip culture, visual portrayal method and handmade posters, were used in high-risk wards for HAIs, to build confidence for the 'test product' in removing transient flora from the hands. A locally developed feedback from was used to evaluate the impact of the activities conducted. Overall 183 HCWs were enrolled for the assessment of the 'test product' (130- doctors and 53 nurses). Out of these 83% (108/130) doctors and 94% (50/53) nurses were satisfied with the 'test product'. The confidence building activity was conducted with 116 participants (49 doctors). After single use of the 'test product', overall a significant reduction was observed for the CFUs on the blood agar plates (0.77 Log(10), p < 0.001). A complete reduction (100%) in colony forming units on incubated blood agar plates was seen for 13% (15/116) participants. Eighty two percent (95/116) participants expressed their confidence in the 'test product'. The self reported acceptance level for the 'test product' was high. The use of finger tip culture coupled

Rapid water disinfection over a Ag/AgBr/covalent triazine-based framework composite under visible light.

PubMed

Li, Liuyi; Li, Xiaofen; Cheng, Zhi; Bi, Jinhong; Liang, Shijing; Zhang, Zizhong; Yu, Yan; Wu, Ling

2018-05-22

Development of visible-light-induced and rapid water disinfection is of significant importance. Covalent triazine-based frameworks (CTFs) with pre-designable structures and favorable semiconductive behaviors hold great promise for photocatalytic water disinfection. Here, we report an Ag/AgBr/CTF composite with a layered structure, which serves as an efficient photocatalyst for rapid water disinfection. Water disinfection with >99.99% inactivation of Escherichia coli within 12 min was achieved by using a small amount of Ag/AgBr/CTF under visible light irradiation. The inactivation efficiency of Ag/AgBr/CTF was ∼10 times better than that of bare Ag/AgBr. Rapid water disinfection by the Ag/AgBr/CTF composite mainly results from the greatly improved generation of reactive oxygen species through the synergistic effects among the three components and the affinity of CTF to the cell wall of bacteria.

Assessment of disinfection of hospital surfaces using different monitoring methods1

PubMed Central

Ferreira, Adriano Menis; de Andrade, Denise; Rigotti, Marcelo Alessandro; de Almeida, Margarete Teresa Gottardo; Guerra, Odanir Garcia; dos Santos, Aires Garcia

2015-01-01

OBJECTIVE: to assess the efficiency of cleaning/disinfection of surfaces of an Intensive Care Unit. METHOD: descriptive-exploratory study with quantitative approach conducted over the course of four weeks. Visual inspection, bioluminescence adenosine triphosphate and microbiological indicators were used to indicate cleanliness/disinfection. Five surfaces (bed rails, bedside tables, infusion pumps, nurses' counter, and medical prescription table) were assessed before and after the use of rubbing alcohol at 70% (w/v), totaling 160 samples for each method. Non-parametric tests were used considering statistically significant differences at p<0.05. RESULTS: after the cleaning/disinfection process, 87.5, 79.4 and 87.5% of the surfaces were considered clean using the visual inspection, bioluminescence adenosine triphosphate and microbiological analyses, respectively. A statistically significant decrease was observed in the disapproval rates after the cleaning process considering the three assessment methods; the visual inspection was the least reliable. CONCLUSION: the cleaning/disinfection method was efficient in reducing microbial load and organic matter of surfaces, however, these findings require further study to clarify aspects related to the efficiency of friction, its frequency, and whether or not there is association with other inputs to achieve improved results of the cleaning/disinfection process. PMID:26312634

Environmental cleaning and disinfection.

PubMed

Traverse, Michelle; Aceto, Helen

2015-03-01

The guidelines in this article provide veterinarians, veterinary technicians, and veterinary health care workers with an overview of evidence-based recommendations for the best practices associated with environmental cleaning and disinfection of a veterinary clinic that deals with small animals. Hospital-associated infections and the control and prevention programs necessary to alleviate them are addressed from an environmental perspective. Measures of hospital cleaning and disinfection include understanding mechanisms and types of contamination in veterinary settings, recognizing areas of potential concern, addressing appropriate decontamination techniques and selection of disinfectants, the management of potentially contaminated equipment, laundry, and waste management, and environmental surveillance strategies. Copyright © 2015 Elsevier Inc. All rights reserved.

Humidifier disinfectants, unfinished stories

PubMed Central

Choi, Yeyong

2016-01-01

Once released into the air, humidifier disinfectants became tiny nano-size particles, and resulted in chemical bronchoalveolitis. Families had lost their most beloved members, and even some of them became broken. Based on an estimate of two million potential victims who had experienced adverse effects from the use of humidifier disinfectants, we can say that what we have observed was only the tip of the iceberg. Problems of entire airways, as well as other systemic effects, should be examined, as we know these nano-size particles can irritate cell membranes and migrate into systemic circulation. The story of humidifier disinfectant is not finished yet. PMID:26987713

Proteomic adaptations to starvation prepare Escherichia coli for disinfection tolerance.

PubMed

Du, Zhe; Nandakumar, Renu; Nickerson, Kenneth W; Li, Xu

2015-02-01

Despite the low nutrient level and constant presence of secondary disinfectants, bacterial re-growth still occurs in drinking water distribution systems. The molecular mechanisms that starved bacteria use to survive low-level chlorine-based disinfectants are not well understood. The objective of this study is to investigate these molecular mechanisms at the protein level that prepare starved cells for disinfection tolerance. Two commonly used secondary disinfectants chlorine and monochloramine, both at 1 mg/L, were used in this study. The proteomes of normal and starved Escherichia coli (K12 MG1655) cells were studied using quantitative proteomics. Over 60-min disinfection, starved cells showed significantly higher disinfection tolerance than normal cells based on the inactivation curves for both chlorine and monochloramine. Proteomic analyses suggest that starvation may prepare cells for the oxidative stress that chlorine-based disinfection will cause by affecting glutathione metabolism. In addition, proteins involved in stress regulation and stress responses were among the ones up-regulated under both starvation and chlorine/monochloramine disinfection. By comparing the fold changes under different conditions, it is suggested that starvation prepares E. coli for disinfection tolerance by increasing the expression of enzymes that can help cells survive chlorine/monochloramine disinfection. Protein co-expression analyses show that proteins in glycolysis and pentose phosphate pathway that were up-regulated under starvation are also involved in disinfection tolerance. Finally, the production and detoxification of methylglyoxal may be involved in the chlorine-based disinfection and cell defense mechanisms. Copyright © 2014 Elsevier Ltd. All rights reserved.

Occurrence and exposures to disinfectants and disinfection by-products

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cumming, R.B.; Jolley, R.L.

1992-12-31

Disinfection by-products are associated with all chemical disinfectants. The concentration and toxic nature of the disinfection byproducts (DBPs) is a direct function of the chemical nature of the disinfectant itself and/or of the chemical reactions of the disinfectant with reaction substrates in the water, especially organic constituents. A principal advantage of biological and physical water treatment processes, such as filtration, is the lack of chemical reactions producing disinfectant-related DBPs. The use of the highest quality source water available is important for minimization of DBP formation. In lieu of such high quality water, improvement of water quality by removal of DBPmore » precursors through filtration or other means before application of chemical disinfectants is important. Most, if not all, water treatment experts are aware of these simplistic axioms. In view of the increasing knowledge being developed concerning DBPs including the identification of ``new`` DBPs, prudence dictates minimization of DBP formation. Wholesome drinking water is perhaps the biggest economic bargain available to consumers. The cost-effectiveness of water quality improvement should be evaluated with that in mind.« less

Occurrence and exposures to disinfectants and disinfection by-products

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cumming, R.B.; Jolley, R.L.

1992-01-01

Disinfection by-products are associated with all chemical disinfectants. The concentration and toxic nature of the disinfection byproducts (DBPs) is a direct function of the chemical nature of the disinfectant itself and/or of the chemical reactions of the disinfectant with reaction substrates in the water, especially organic constituents. A principal advantage of biological and physical water treatment processes, such as filtration, is the lack of chemical reactions producing disinfectant-related DBPs. The use of the highest quality source water available is important for minimization of DBP formation. In lieu of such high quality water, improvement of water quality by removal of DBPmore » precursors through filtration or other means before application of chemical disinfectants is important. Most, if not all, water treatment experts are aware of these simplistic axioms. In view of the increasing knowledge being developed concerning DBPs including the identification of new'' DBPs, prudence dictates minimization of DBP formation. Wholesome drinking water is perhaps the biggest economic bargain available to consumers. The cost-effectiveness of water quality improvement should be evaluated with that in mind.« less

Comparison of hand hygiene procedures for removing Bacillus cereus spores.

PubMed

Sasahara, Teppei; Hayashi, Shunji; Hosoda, Kouichi; Morisawa, Yuji; Hirai, Yoshikazu

2014-01-01

Bacillus cereus is a spore-forming bacterium. B. cereus occasionally causes nosocomial infections, in which hand contamination with the spores plays an important role. Therefore, hand hygiene is the most important practice for controlling nosocomial B. cereus infections. This study aimed to determine the appropriate hand hygiene procedure for removing B. cereus spores. Thirty volunteers' hands were experimentally contaminated with B. cereus spores, after which they performed 6 different hand hygiene procedures. We compared the efficacy of the procedures in removing the spores from hands. The alcohol-based hand-rubbing procedures scarcely removed them. The soap washing procedures reduced the number of spores by more than 2 log10. Extending the washing time increased the spore-removing efficacy of the washing procedures. There was no significant difference in efficacy between the use of plain soap and antiseptic soap. Handwashing with soap is appropriate for removing B. cereus spores from hands. Alcohol-based hand-rubbing is not effective.

Hand eczema and occupational contact allergies in healthcare workers with a focus on rubber additives.

PubMed

Hamnerius, Nils; Svedman, Cecilia; Bergendorff, Ola; Björk, Jonas; Bruze, Magnus; Engfeldt, Malin; Pontén, Ann

2018-06-20

Hand eczema (HE) in healthcare workers (HCWs) is common. Besides wet work, healthcare work also implies exposure to contact allergens. To assess HE and contact allergy related to occupational exposures in HCWs. In a cross-sectional study, 311 HCWs with HE within the preceding 12 months and a control group of 114 HCWs without HE were investigated with the baseline series and a special patch test series based on substances found in the gloves, soaps, alcoholic hand disinfectants and hand creams provided at the hospitals. Contact allergy to rubber additives was significantly more common in HCWs with HE (6%) than in HCWs without HE (1%, P = .02). The corresponding percentages for fragrances were 11% and 3%, respectively (P = .004). Occupational HE was found in 193 of 311 (62%) HCWs. Of these, 22 of 193 (11%) had occupational allergic contact dermatitis, including 17 with glove-related rubber contact allergy. Contact allergy to diphenylguanidine was as common as contact allergy to thiurams. Occupational contact allergy to rubber additives was significantly associated with sick-leave related to HE. Contact allergy to rubber additives in medical gloves is the most common cause of occupational allergic contact dermatitis in HCWs. Aimed patch testing with relevant rubber additives is mandatory when HE in HCWs is investigated. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of disinfective potential of reactivated free chlorine in pooled tap water by electrolysis.

PubMed

Nakajima, Norihito; Nakano, Takashi; Harada, Fumiue; Taniguchi, Hiromasa; Yokoyama, Isao; Hirose, Jun; Daikoku, Eriko; Sano, Kouichi

2004-05-01

Tap water is one of the causative factors of hospital infections. We examined the disinfective potential of electrolysis and mechanism of disinfection, and clarified the disinfective effect of electrolysis on tap water contaminated with bacteria, and discussed its clinical applications. Tap waters artificially contaminated with Pseudomonas aeruginosa, Escherichia coli, Legionella pneumophila, and Staphylococcus aureus could be sterilized by electrolysis at 20-30 mA for 5 min. A high-density suspension (10(6) CFU/ml) of a spore forming bacterium, Bacillus subtilis was not completely sterilized by electrolysis at 50 mA up to 30 min, but a low-density suspension (10(5) CFU/ml) was totally sterilized by electrolysis at 50 mA for 5 min. Electrolyzed P. aeruginosa changed morphologically, that is, there was bleb formation on the cell wall and irregular aggregation of cytoplasmic small granules. Moreover, cytoplasmic enzyme, nitrate reductase, was inactivated by the electrolysis. On the other hand, genomic DNA of the electrolyzed bacteria was not degenerated, therefore, their DNA polymerase activity was not completely inactivated. Consequently, the major agent in electrolysis for bactericidal action was considered to be free chlorine, and the possible bactericidal mechanism was by destruction of bacterial membranes, followed by the aggregation of peripheral cytoplasmic proteins. Electrolysis of tap water for both disinfecting contaminating bacteria and increasing the disinfectant capacity was considered effective with some limitations, particularly against high-density contamination by spore-forming bacteria. In clinical settings, electrolysis of tap water is considered effective to disinfect water for hand washing in operation theatres, and bathing water for immunocompromised hosts.

Water disinfection agents and disinfection by-products

NASA Astrophysics Data System (ADS)

Ilavský, J.; Barloková, D.; Kapusta, O.; Kunštek, M.

2017-10-01

The aim of this work is to describe factors of water quality change in the distribution network and legislative requirements in Slovakia for disinfectants and disinfection byproducts (DBPs). In the experimental part, the time dependence of the application of the chlorine dioxide and sodium hypochlorite on the formation of some by-products of disinfection for drinking water from WTP Hriňová is studied. We monitored trihalomethanes, free chlorine, chlorine dioxide and chlorites.

[Control of disinfection in buildings used for poultry raising].

PubMed

Maris, P

1989-01-01

During a 2-year survey in turkey breeding farms, it was possible to compare six disinfection procedures by monitoring 14 first disinfections following the breeding house cleaning and 14 second disinfections prior to animal return. By swabbing all the germs from asbestos concrete surfaces, we noted that in the case of first disinfection the chloramine T-based product was more effective than phenol or quaternary ammonium-aldehyde-based products. For the second disinfection, it was demonstrated that a minimal dose of 15 kg of formaldehyde was necessary for disinfection to be satisfactory; 12 to 15 kg paraformaldehyde was as effective as 40 to 60 liters of 30-35% formol for buildings, the ground surface of which covered between 1,000 and 1,300 m2.

Inspections of hand washing supplies and hand sanitizer in public schools.

PubMed

Ramos, Mary M; Blea, Mary; Trujillo, Rebecca; Greenberg, Cynthia

2010-10-01

Hand washing and hand antisepsis are proven infection control measures in the school setting, yet barriers such as lack of soap, paper towels, and hand sanitizer can hinder compliance. This pilot study measured the prevalence of hand cleaning supplies in public schools. Ten school districts (93 schools) participated in school nurse inspections. In November 2008, 90 schools (97%) reported their inspection results. Among 697 total bathrooms, 88.8% had soap and 91.7% had paper towels or hand dryers. Hand sanitizer was reported in 1.2% of bathrooms and 15.2% of cafeterias. No difference was observed between boys' and girls' bathrooms, or primary and secondary schools, in the prevalence of soap or paper towels/hand dryers. Hand washing supplies were generally available in public school bathrooms. Alcohol-based hand sanitizer in school bathrooms was reported occasionally and should be discouraged. Hand sanitizer in a supervised setting, the school cafeteria, was not often reported and should be promoted.

Health effects of drinking water disinfectants and disinfection by-products

DOE Office of Scientific and Technical Information (OSTI.GOV)

Condie, L.W.; Bercz, J.P.

This paper summarizes toxicological studies conducted with drinking water disinfectants. Toxicological effects, which are associated with the disinfectants themselves as well as with the by-products formed when disinfectants react with organic material present in water, are considered. The health impact of chemical reactions occurring between residual disinfectants and nutrients in the gastrointestinal tract is also discussed. 40 references, 5 tables.

Disinfection of wastewater by hydrogen peroxide or peracetic acid: development of procedures for measurement of residual disinfectant and application to a physicochemically treated municipal effluent.

PubMed

Wagner, Monika; Brumelis, Daina; Gehr, Ronald

2002-01-01

The Montreal Urban Community Wastewater Treatment Plant (MUCWTP) located in Montreal. Quebec, Canada, uses physicochemical treatment processes prior to discharging wastewater into the St. Lawrence River via an outfall tunnel of 2 hours retention time. Although chlorination facilities exist, they are not being used, and the MUCWTP is seeking alternative methods for disinfection to achieve a 2- to 3-log fecal coliform reduction. Liquid chemical disinfectants were attractive options because of their low capital costs. This led to an investigation of the feasibility of using hydrogen peroxide or peracetic acid. A method for measuring peroxycompounds (hydrogen peroxide or peracetic acid plus hydrogen peroxide) was developed using the peroxidase-based oxidation of 2,2'-azino-bis(3-ethylbenz-thiazoline-6-sulfuric acid) diammonium salt (ABTS) with hydrogen peroxide. The validity of the method was confirmed using effluent from the MUCWTP. Recovery was higher than 90% for peracetic acid levels as low as 1.0 mg/L. Quenching of hydrogen peroxide was achieved with 50-mg/L catalase; quenching of peracetic acid was achieved with 100 mg/L of sodium thiosulfate, followed by 50 mg/L of catalase. Batch disinfection tests were conducted on MUCWTP effluent. Hydrogen peroxide and peracetic acid in wastewater over time could be modeled as a second-order decay, with the decay "constant" being a function of the initial concentration of peroxycompounds. This function was the same for both hydrogen peroxide and peracetic acid, possibly indicating similar decomposition pathways in wastewater matrices. Disinfection was modeled using a modified Hom equation. Required doses of hydrogen peroxide to reach the target fecal coliform levels ranged from 106 to 285 mg/L, with the higher doses occurring when ferric chloride instead of alum was used as the coagulant. Hence, hydrogen peroxide was infeasible as a disinfectant for this application. On the other hand, the peracetic acid dose needed to

Randomized Controlled Trial of Antiseptic Hand Hygiene Methods in an Outpatient Surgery Clinic.

PubMed

Therattil, Paul J; Yueh, Janet H; Kordahi, Anthony M; Cherla, Deepa V; Lee, Edward S; Granick, Mark S

2015-12-01

Outpatient wound care plays an integral part in any plastic surgery practice. However, compliance with hand hygiene measures has shown to be low, due to skin irritation and lack of time. The objective of this trial was to determine whether single-use, long-acting antiseptics can be as effective as standard multiple-use hand hygiene methods in an outpatient surgical setting. A prospective, randomized controlled trial was performed in the authors' outpatient plastic surgery clinic at Rutgers New Jersey Medical School, Newark, NJ to compare the efficacy of an ethyl alcohol-based sanitizer (Avagard D Instant Hand Aniseptic, 3M Health Care, St. Paul, MN), a benzalkonium chloride-based sanitizer (Soft & Shield, Bioderm Technologies, Inc, Trenton, NJ, distributed by NAPP Technologies, Hackensack, NJ ), and soap and- water handwashing. Subjects included clinic personnel, who were followed throughout the course of a 3-hour clinic session with hourly hand bacterial counts taken. During the course of the trial, 95 subjects completed the clinic session utilizing 1 of the hand hygiene methods (36 ethyl alcohol-based sanitizer, 38 benzalkonium chloride-based sanitizer, and 21 soap-and-water handwashing). There was no difference between hand bacterial counts using the different methods at 4 hourly time points (P greater than 0.05). Hand bacterial counts increased significantly over the 3-hour clinic session with the ethyl alcohol-based sanitizer (9.24 to 21.90 CFU, P less than 0.05), benzalkonium chloride-based sanitizer (6.69 to 21.59 CFU, P less than 0.05), and soap-and-water handwashing (8.43 to 22.75 CFU, P less than 0.05). There does not appear to be any difference in efficacy between single-use, long-acting sanitizer, and standard multiple-use hand hygiene methods. Hand bacterial counts increased significantly over the course of the 3-hour clinic session regardless of the hand hygiene measure used. Hand condition of subjects was improved with the ethyl alcohol-based

How clean is your scope? A completed audit cycle of the disinfection of nasendoscopes

PubMed Central

Lakhani, Raj; Smithard, Abigail; Bleach, Nigel

2010-01-01

INTRODUCTION Correct disinfection of nasendoscopes is essential to address both the potential iatrogenic transmission of infection and to avoid injury from the chemicals used. MATERIALS AND METHODS Standards-based audit of the disinfection of nasendoscopes against the ENT UK guidelines, ervention: instructional poster and staff training session. The disinfection process was re-audited one month later. RESULTS A total of 10 sessions and 31 cleaning episodes were audited in the first cycle (C1). A total of 12 sessions and 36 cleaning episodes were re-audited in the second cycle (C2). Clinic set-up results: there was a marked improvement in the checking of the expiry date (C1 = 5/10; C2 = 10/12; P ≤ 0.001) and recording the date for the solution to be discarded (C1 = 0/10; C2 = 10/12; P ≤ 0.048). Each cleaning episode results: an improvement in transportation in a ‘dirty bag’ (C1 = 0/31; C2 = 19/36; P ≤ 0.001), washing of the scope (C1 = 0/31; C2 = 36/36; P ≤ 0.001), adequate disinfection time (C1 = 16/31; C2 = 33/36; P≤ 0.001), rinsing and drying with alcohol swab (C1 = 0/31; C2 = 35/36; P ≤ 0.001) and placing of the scope in a ‘clean bag’ for storage (C1 = 0/31; C2 = 35/36; P ≤ 0.001) was seen after the intervention. CONCLUSIONS The introduction of a poster and training in the disinfection of nasendoscopes proved successful in improving compliance with the published guidelines. These simple measures were simple, cheap and effective to institute. The benefit of improving the disinfection of nasendoscopes to patients, doctors and the organisations that they work in is clear. PMID:20883605

Relationship between Exposure to Household Humidifier Disinfectants and Risk of Lung Injury: A Family-Based Study

PubMed Central

Park, Dong-Uk; Choi, Ye-Yong; Ahn, Jong-Ju; Lim, Heung-Kyu; Kim, Sun-Kyung; Roh, Hyun-Suk; Cheong, Hae-Kwan; Leem, Jong-Han; Koh, Dong-Hee; Jung, Hye-Jung; Lee, Kyoung-Mu; Lee, Jong-Hyeon; Kim, Yong-Hwa; Lim, Sin-Ye; Paek, Do-Myung; Lim, Chae-Man; Hong, Soo-Jong

2015-01-01

Background In South Korea, a cluster of acute lung disease patients included lung injury disease suspected of being caused by the use of humidifier disinfectants. We examined the relationship between humidifier disinfectant exposure and clinically diagnosed humidifier disinfectant-associated lung injury (HDLI) in a family-based study. Methods This case-control study included 169 clinically confirmed HDLI cases and 303 family controls who lived with the HDLI patients. A range of information on exposure to humidifier disinfectants was obtained using a structured questionnaire and field investigations. Odds ratios (ORs) and confidence intervals (CIs) were estimated using unconditional logistic regression models that were adjusted for age, sex, presence of a factory within 1 km of residence, and the number of household chemical products used. Results HDLI risk increased approximately two-fold or more among the highest quartile compared with the lowest quartile in terms of the hours sleeping in a room with an operating humidifier treated with disinfectant (adjusted OR = 2.0, 95 % CI = 1.1-3.7), average hours of disinfectant-treated humidifier use per day (adjusted OR = 2.1, 95 % CI = 1.0-4.5), airborne disinfectant intensity (adjusted OR = 2.6, 95% CI = 1.2-5.3), and cumulative disinfectant inhalation level (adjusted OR = 2.0, 95% CI = 1.0-4.1). HDLI risk increased as the distance of the bed from humidifier gets shorter; compared with longer distance (> 1 m), the odds ratio was 2.7 for 0.5 to 1 m (95 % CI = 1.5-5.1) and 13.2 for <0.5 m (95 % CI = 2.4-73.0). Conclusions The use of household humidifier disinfectants was associated with HDLI risk in a dose-response manner. PMID:25978522

[Survey of synthetic disinfectants in grapefruit seed extract and its compounded products].

PubMed

Sugimoto, Naoki; Tada, Atsuko; Kuroyanagi, Masanori; Yoneda, Yuko; Yun, Young Sook; Kunugi, Akira; Sato, Kyoko; Yamazaki, Takeshi; Tanamoto, Ken-Ichi

2008-02-01

Grapefruit seed extract (GSE), derived from the seeds of grapefruit (Citrus paradisi MCAF.), is listed as a natural food additive in Japan. Products containing GSE are used as disinfectants made from only natural sources, especially after Japanese researchers found that GSE prevents the growth of norovirus. On the other hand, recent overseas studies indicated that synthetic disinfectants, such as benzalkonium and benzethonium chlorides, were present in some commercial GSE products. To confirm the quality of commercial GSE products available in Japanese markets, we carried out comprehensive research to identify the major constituents of commercial GSE products which are used as food additives (13 products from 6 manufacturers), dietary supplements (5 products from 4 manufacturers), cosmetic materials (16 products from 10 manufacturers) and disinfectant or deodorant sprays (7 products from 7 manufacturers). By means of NMR and LC/MS analysis, synthetic disinfectants such as benzethonium or benzalkonium salts were detected in most of the commercial GSE products.

Efficacy of a Hand Regimen in Skin Barrier Protection in Individuals With Occupational Irritant Contact Dermatitis.

PubMed

Jordan, Laura

2016-11-01

Occupational irritant contact dermatitis (OICD) is a dif cult and hard to manage condition. It occurs more frequently in certain occupations where contact with harsh chemicals, use of alcohol-based disinfectants, and frequent hand washing heightens the risk. Treatment for OICD includes patient education in addition to physical, topical, and systemic therapies. To review the pathogenesis and treatment options for OICD and evaluate the ef cacy of a selective skin-care regimen involv- ing a hand protectant cream alone as well as combined with a repair cream and speci c cleanser. A single-center open study was performed comprising 42 healthy male and female adult volunteers prone to occupational irritant contact dermatitis due to frequent wet work or contact with detergents. Between day 0 and day 7, subjects applied a hand protectant cream as needed on both hands (at least twice daily). On days 7 to 14, subjects applied a hand protectant cream and cleanser as needed on both hands (at least twice daily) as well as a repair cream each evening. A diary log was given to each volunteer for application control and for a subjective evaluation of daily tolerability. In these subjects prone to occupational irritant contact dermatitis, the hand protectant cream applied during the initial 7-day period was effective in restoring the damaged skin barrier and improving the stratum corneum hydration. A regimen that combined the hand protectant and repair creams with a speci c cleanser during a further 7-day period allowed contin- ued improvement of skin hydration and additional clinical bene ts while respecting the skin barrier function. The results of this study support the use of a 3-step approach for patients who are at risk of repeated exposure to external irritants. J Drugs Dermatol. 2016;15(suppl 11):s81-85..

Solar optics-based active panel for solar energy storage and disinfection of greywater.

PubMed

Lee, W; Song, J; Son, J H; Gutierrez, M P; Kang, T; Kim, D; Lee, L P

2016-09-01

Smart city and innovative building strategies are becoming increasingly more necessary because advancing a sustainable building system is regarded as a promising solution to overcome the depleting water and energy. However, current sustainable building systems mainly focus on energy saving and miss a holistic integration of water regeneration and energy generation. Here, we present a theoretical study of a solar optics-based active panel (SOAP) that enables both solar energy storage and photothermal disinfection of greywater simultaneously. Solar collector efficiency of energy storage and disinfection rate of greywater have been investigated. Due to the light focusing by microlens, the solar collector efficiency is enhanced from 25% to 65%, compared to that without the microlens. The simulation of greywater sterilization shows that 100% disinfection can be accomplished by our SOAP for different types of bacteria including Escherichia coli . Numerical simulation reveals that our SOAP as a lab-on-a-wall system can resolve the water and energy problem in future sustainable building systems.

Solar optics-based active panel for solar energy storage and disinfection of greywater

PubMed Central

Lee, W.; Song, J.; Son, J. H.; Gutierrez, M. P.; Kang, T.; Kim, D.; Lee, L. P.

2016-01-01

Smart city and innovative building strategies are becoming increasingly more necessary because advancing a sustainable building system is regarded as a promising solution to overcome the depleting water and energy. However, current sustainable building systems mainly focus on energy saving and miss a holistic integration of water regeneration and energy generation. Here, we present a theoretical study of a solar optics-based active panel (SOAP) that enables both solar energy storage and photothermal disinfection of greywater simultaneously. Solar collector efficiency of energy storage and disinfection rate of greywater have been investigated. Due to the light focusing by microlens, the solar collector efficiency is enhanced from 25% to 65%, compared to that without the microlens. The simulation of greywater sterilization shows that 100% disinfection can be accomplished by our SOAP for different types of bacteria including Escherichia coli. Numerical simulation reveals that our SOAP as a lab-on-a-wall system can resolve the water and energy problem in future sustainable building systems. PMID:27822328

An Increase in Healthcare-Associated Clostridium difficile Infection Associated with Use of a Defective Peracetic Acid-Based Surface Disinfectant.

PubMed

Cadnum, Jennifer L; Jencson, Annette L; O'Donnell, Marguerite C; Flannery, Elizabeth R; Nerandzic, Michelle M; Donskey, Curtis J

2017-03-01

BACKGROUND We investigated an increase in the incidence of healthcare-associated Clostridium difficile infection (CDI) that occurred following a change from a bleach disinfectant to a peracetic acid-based disinfectant. OBJECTIVE To evaluate the efficacy of the peracetic acid-based disinfectant. DESIGN Laboratory-based product evaluation. METHODS The commercial peracetic acid-based product is activated on site by mixing a small volume of concentrated hydrogen peroxide and peracetic acid present in a "SmartCap" reservoir with the remaining contents of the container. We measured concentrations of peracetic acid in newly activated and in-use product and determined the stability of nonactivated and activated product. We tested the efficacy of the product against C. difficile spores using the American Society for Testing and Materials standard quantitative carrier disk test method. RESULTS Measured concentrations of peracetic acid (50-800 parts per million [ppm]) were significantly lower than the level stated on the product label (1,500 ppm), and similar results were obtained for containers from multiple lot numbers and from another hospital. Product with peracetic acid levels below 600 ppm had significantly reduced activity against C. difficile spores. Peracetic acid concentrations were reduced markedly after storage of either activated or nonactivated product for several weeks. The Environmental Protection Agency confirmed the finding of low disinfectant levels and ordered discontinuation of sale of the product. CONCLUSION Use of a defective peracetic acid-based surface disinfectant may have contributed to an increase in healthcare-associated CDI. Our findings highlight the importance of evaluating the efficacy of liquid disinfectants in healthcare settings. Infect Control Hosp Epidemiol 2017;38:300-305.

9 CFR 96.9 - Casings admitted on disinfection; sealing; transfer and disinfection.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Casings admitted on disinfection; sealing; transfer and disinfection. 96.9 Section 96.9 Animals and Animal Products ANIMAL AND PLANT HEALTH... STATES § 96.9 Casings admitted on disinfection; sealing; transfer and disinfection. Foreign animal...

9 CFR 96.9 - Casings admitted on disinfection; sealing; transfer and disinfection.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Casings admitted on disinfection; sealing; transfer and disinfection. 96.9 Section 96.9 Animals and Animal Products ANIMAL AND PLANT HEALTH... STATES § 96.9 Casings admitted on disinfection; sealing; transfer and disinfection. Foreign animal...

9 CFR 96.9 - Casings admitted on disinfection; sealing; transfer and disinfection.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Casings admitted on disinfection; sealing; transfer and disinfection. 96.9 Section 96.9 Animals and Animal Products ANIMAL AND PLANT HEALTH... STATES § 96.9 Casings admitted on disinfection; sealing; transfer and disinfection. Foreign animal...

Hand hygiene: product preference and compliance.

PubMed

Tanner, Judith; Mistry, Neetesh

Hospitals are trying to improve patient hand hygiene by providing handwashing products at the bedside. Patients' compliance with handwashing depends on their satisfaction with hygiene products but no one has looked at which products patients prefer. Research on this will help hospitals target hand hygiene more appropriately and effectively. To explore patient satisfaction with hand hygiene products and identify those that are most popular. Two hundred patients were given five hand hygiene products to evaluate. These represent the interventions most widely used by patients in hospitals: alcohol foams, alcohol wipes, wet cloths with antiseptic solutions, bowls of soapy water and mobile sinks. Alcohol foam achieved the highest mean satisfaction score and was significantly more popular than the other products. Alcohol foam was the most popular choice regardless of age, sex, dexterity, mobility and religion.

40 CFR 141.54 - Maximum residual disinfectant level goals for disinfectants.

Code of Federal Regulations, 2011 CFR

2011-07-01

... for disinfectants. MRDLGs for disinfectants are as follows: Disinfectant residual MRDLG(mg/L) Chlorine 4 (as Cl 2). Chloramines 4 (as Cl 2). Chlorine dioxide 0.8 (as ClO2) [63 FR 69465, Dec. 16, 1998] ...

40 CFR 141.54 - Maximum residual disinfectant level goals for disinfectants.

Code of Federal Regulations, 2010 CFR

2010-07-01

... for disinfectants. MRDLGs for disinfectants are as follows: Disinfectant residual MRDLG(mg/L) Chlorine 4 (as Cl 2). Chloramines 4 (as Cl 2). Chlorine dioxide 0.8 (as ClO2) [63 FR 69465, Dec. 16, 1998] ...

A three-year surveillance of nosocomial infections by methicillin-resistant Staphylococcus haemolyticus in newborns reveals the disinfectant as a possible reservoir.

PubMed

Ben Saida, N; Marzouk, M; Ferjeni, A; Boukadida, J

2009-05-01

Study of the clonality of methicillin-resistant Staphylococcus haemolyticus responsible of epidemic infections in a neonatal intensive care unit. Methicillin-resistant Staphylococcus haemolyticus isolates were collected during the period from March 2004 to November 2006, from newborns, the clean hands of nurses and from disinfectant bottles used in the unit. Molecular typing by pulsed-field gel electrophoresis (PFGE) was achieved for all isolates. Forty-six isolates of S. haemolyticus resistant to methicillin were collected from 42 newborns, the hand of two nurses and from two disinfectant bottles used in the unit. PFGE analysis revealed five types (A, B, C, D and E) among newborns isolates. Types A and B were predominant. Nurses' isolates revealed PFGE types similar to types A and B. Disinfectant isolates were of type B. qacA/B PCR analysis revealed that the majority of type B isolates contain the disinfectant resistance gene qacA/B. No isolate of type A possessed this gene. These results suggest that MRSH neonatal infections are caused by a limited number of clones. Clone B was able to survive in disinfectant bottles and to conserve its ability to infect newborns. We therefore conclude that the disinfectant can serve as a reservoir for MRSH and point out the need to control all disinfectants used in a neonatal intensive care unit.

Capillary-tube-based micro-plasma system for disinfecting dental biofilm.

PubMed

Huang, Wen-Ke; Weng, Chih-Chiang; Liao, Jiunn-Der; Wang, Yi-Cheng; Chuang, Shu-Fen

2013-05-01

A low-temperature low-energy capillary-tube-based argon micro-plasma system was applied to disinfect Streptococcus mutans-containing biofilm. The micro-plasma system uses a hollow inner electrode that is ignited by a radio-frequency power supply with a matching network. The energy content was analyzed using optical emission spectroscopy. The micro-plasma-induced effect on a biofilm cultured for 24 or 48 h with a working distance of ≈3 mm at low temperature was evaluated. The morphologies of the treated live/dead bacteria and the produced polysaccharides after micro-plasma treatment were examined. Scanning electron microscopy images and staining results show that most of the S. mutans on the treated biofilm were acutely damaged within a micro-plasma treatment time of 300 s. The number of living bacteria underneath the treated biofilm greatly decreased with treatment time. The proposed micro-plasma system can thus disinfect S. mutans on/in biofilms.

Disinfection Addition and Disinfection Changes: What It Means to the LCR

EPA Science Inventory

This slide presentation’s general points are: Many protective pipe scales are vey dependent on ORP, and hence, state of disinfection. Adding disinfection to anoxic systems will likely cause big chemistry changes in DS and corrosion. Changing disinfectants could cause major l...

Biomarkers of end of shift exposure to disinfection byproducts in nurses.

PubMed

Ioannou, Solomon; Andrianou, Xanthi D; Charisiadis, Pantelis; Makris, Konstantinos C

2017-08-01

Increased disinfectant use commonly takes place in hospitals and other health care settings. A cross-sectional study among active nurses in two Cypriot public hospitals (n=179) was conducted to examine the prevalence of exposure to disinfection byproducts (DBPs), such as trihalomethanes (THMs) using both self-reported information and biomarker measurements. The objectives of this study were to: i) quantify the magnitude and variability of occupational exposure to disinfectants/DBPs in nurses, ii) generate job exposure matrices (JEM) and job task exposure matrices (JTEM) for disinfectants, and iii) assess the major determinants of urinary THMs in nurses. End of shift urinary total THM values showed high variability among the nurses, but did not differ between hospitals. The disinfectant group of alcohols/phenols was used by >98% of nurses, followed by octenidine (82%), iodine and chlorine (39%, each), chlorhexidine (25%), formaldehyde (12%), hydrogen peroxide (11%), and peracetic acid/ammonia/quaternary ammonium compounds (QACs), all being <8% each. Chlorine use during the past 24hr was associated with significantly (p<0.05) lower brominated THMs (BrTHMs) after adjusting for age, gender and BMI, while a positive association was shown for TCM and the sum of all THMs (TTHMs), albeit not significant. Nurses were exposed to nearly double the levels of TTHMs and BrTHMs (median and IQR, 1027 [560, 2475] ng/g and 323 [212, 497] ng/g, respectively) when compared to those of the general population (552 [309,989] ng/g and 152 [87,261] ng/g, respectively). This was the first occupational health dataset reporting measurements of biomarkers of end of shift exposures to disinfectants/DBPs. Copyright © 2017. Published by Elsevier B.V.

Reduction in infection risk through treatment of microbially contaminated surfaces with a novel, portable, saturated steam vapor disinfection system.

PubMed

Tanner, Benjamin D

2009-02-01

Surface-mediated infectious disease transmission is a major concern in various settings, including schools, hospitals, and food-processing facilities. Chemical disinfectants are frequently used to reduce contamination, but many pose significant risks to humans, surfaces, and the environment, and all must be properly applied in strict accordance with label instructions to be effective. This study set out to determine the capability of a novel chemical-free, saturated steam vapor disinfection system to kill microorganisms, reduce surface-mediated infection risks, and serve as an alternative to chemical disinfectants. High concentrations of Escherichia coli, Shigella flexneri, vancomycin-resistant Enterococcus faecalis (VRE), methicillin-resistant Staphylococcus aureus (MRSA), Salmonella enterica, methicillin-sensitive Staphylococcus aureus, MS2 coliphage (used as a surrogate for nonenveloped viruses including norovirus), Candida albicans, Aspergillus niger, and the endospores of Clostridium difficile were dried individually onto porous clay test surfaces. Surfaces were treated with the saturated steam vapor disinfection system for brief periods and then numbers of surviving microorganisms were determined. Infection risks were calculated from the kill-time data using microbial dose-response relationships published in the scientific literature, accounting for surface-to-hand and hand-to-mouth transfer efficiencies. A diverse assortment of pathogenic microorganisms was rapidly killed by the steam disinfection system; all of the pathogens tested were completely inactivated within 5 seconds. Risks of infection from the contaminated surfaces decreased rapidly with increasing periods of treatment by the saturated steam vapor disinfection system. The saturated steam vapor disinfection system tested for this study is chemical-free, broadly active, rapidly efficacious, and therefore represents a novel alternative to liquid chemical disinfectants.

Evaluation of the Efficacy of Different Mixing Techniques and Disinfection on Microbial Colonization of Polyether Impression Materials: A Comparative Study.

PubMed

Singla, Youginder; Pachar, Renu B; Poriya, Sangeeta; Mishra, Aalok; Sharma, Rajni; Garg, Anshu

2018-03-01

This study aims to determine the role of mixing techniques of polyether impression materials and efficacy of disinfection on microbial colonization of these impression materials. Polyether impression material was mixed using two methods: First by hand mixing (group I) and second using an automixer (group II) with a total of 100 samples. Four microbial strains were studied, which included Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. After incubation, the bacterial colonies were counted, and then, disinfectant solution was applied. The effect of disinfection solution was evaluated for each specimen. The surface of polyether impression materials mixed with an automixer has less number of voids and overall a smoother surface as compared with the hand-mixed ones. On comparing the disinfection procedures, i.e., specimens without any disinfection and specimens after disinfection, statistically highly significant difference was seen between all the groups. We can conclude that impression mixing procedures are important in determining the surface characteristics of the impression and ultimately the colonization of bacteria and also determine the importance of disinfection on microbial colonization. This study emphasises the deleterious role of nosocomial infections and specific measures that should be taken regarding the prevention of such diseases. Dental impressions are proved to be a source of such infections and may lead to transmission of such diseases. Thus, proper measures should be taken right from the first step of impression taking to minimizing and preventing such kind of contaminations in clinical practice.

Inactivation of an enterovirus by airborne disinfectants

PubMed Central

2013-01-01

Background The activity of airborne disinfectants on bacteria, fungi and spores has been reported. However, the issue of the virucidal effect of disinfectants spread by fogging has not been studied thoroughly. Methods A procedure has been developed to determine the virucidal activity of peracetic acid-based airborne disinfectants on a resistant non-enveloped virus poliovirus type 1. This virus was laid on a stainless carrier. The products were spread into the room by hot fogging at 55°C for 30 minutes at a concentration of 7.5 mL.m-3. Poliovirus inoculum, supplemented with 5%, heat inactivated non fat dry organic milk, were applied into the middle of the stainless steel disc and were dried under the air flow of a class II biological safety cabinet at room temperature. The Viral preparations were recovered by using flocked swabs and were titered on Vero cells using the classical Spearman-Kärber CPE reading method, the results were expressed as TCID50.ml-1. Results The infectious titer of dried poliovirus inocula was kept at 105 TCID50.mL-1 up to 150 minutes at room temperature. Dried inocula exposed to airborne peracetic acid containing disinfectants were recovered at 60 and 120 minutes post-exposition and suspended in culture medium again. The cytotoxicity of disinfectant containing medium was eliminated through gel filtration columns. A 4 log reduction of infectious titer of dried poliovirus inocula exposed to peracetic-based airborne disinfectant was obtained. Conclusion This study demonstrates that the virucidal activity of airborne disinfectants can be tested on dried poliovirus. PMID:23587047

Acute ethanol poisoning in a 4-year-old as a result of ethanol-based hand-sanitizer ingestion.

PubMed

Engel, Jeffrey S; Spiller, Henry A

2010-07-01

Alcohol-based hand sanitizers have become widely available because of widespread usage in schools, hospitals, and workplaces and by consumers. We report what we believe is the first unintentional ingestion in a small child producing significant intoxication. A 4-year-old 14-kg girl was brought to the emergency department with altered mental status after a history of ingesting an alcohol-based hand sanitizer. Physical examination revealed an obtunded child with periods of hypoventilation and a hematoma in the central portion of her forehead from a fall at home that occurred after the ingestion. Abnormal vital signs included a heart rate of 139 beats/min and temperature of 96.3 degrees F, decreasing to 93.6 degrees F. Abnormal laboratory values consisted of potassium of 2.6 mEq/L and a serum alcohol of 243 mg/dL. A computed tomography scan of her brain without contrast showed no acute intracranial abnormality. A urine drug screen for common drugs of abuse was reported as negative. The child was intubated, placed on mechanical ventilation, and admitted for medical care. She recovered over the next day without sequelae. As with other potentially toxic products, we would recommend caution and direct supervision of use when this product is available to young children.

The sensitivity to chlorhexidine and cetyl pyridinium chloride of staphylococci on the hands of dental students and theatre staff exposed to these disinfectants.

PubMed

Millns, B; Martin, M V; Field, E A

1994-02-01

The aim of this investigation was to study the possible emergence of resistant isolates of the genus Staphylococcus on the hands of dental personnel who use 'Hibiscrub' (chlorhexidine-detergent preparation) and cetyl pyridinium-coated gloves. Resistance was determined by a rate-of-kill technique. In four dental student groups (first, second, third and fourth years) no microorganisms survived 30 min exposure to cetyl pyridinium chloride (CPC) or to chlorhexidine diacetate (CDA). In a theatre staff group, no microorganisms survived 30 s exposure to CPC; and only one of 23 isolates survived 30 min exposure to CDA, but was killed after 60 min exposure. It is concluded that staphylococci resistant to either of these disinfectants do not present a problem in dental students or theatre staff.

Comparative testing of disinfectant efficacy on planktonic bacteria and bacterial biofilms using a new assay based on kinetic analysis of metabolic activity.

PubMed

Günther, F; Scherrer, M; Kaiser, S J; DeRosa, A; Mutters, N T

2017-03-01

The aim of our study was to develop a new reproducible method for disinfectant efficacy testing on bacterial biofilms and to evaluate the efficacy of different disinfectants against biofilms. Clinical multidrug-resistant strains were chosen as test isolates to ensure practical relevance. We compared the standard qualitative suspension assay for disinfectant testing, which does not take into account biofilm formation, to the new biofilm viability assay that uses kinetic analysis of metabolic activity in biofilms after disinfectant exposure to evaluate disinfectant efficacy. In addition, the efficacy of four standard disinfectants to clinical isolates was tested using both methods. All tested disinfectants were effective against test isolates when in planktonic state using the standard qualitative suspension assay, while disinfectants were only weakly effective against bacteria in biofilms. Disinfectant efficacy testing on planktonic organisms ignores biofilms and overestimates disinfectant susceptibility of bacteria. However, biofilm forming, e.g. on medical devices or hospital surfaces, is the natural state of bacterial living and needs to be considered in disinfectant testing. Although bacterial biofilms are the predominant manner of bacterial colonization, most standard procedures for antimicrobial susceptibility testing and efficacy testing of disinfectants are adapted for application to planktonic bacteria. To our knowledge, this is the first study to use a newly developed microplate-based biofilm test system that uses kinetic analysis of the metabolic activity in biofilms, after disinfectant exposure, to evaluate disinfectant efficacy. Our study shows that findings obtained from disinfectant efficacy testing on planktonic bacteria cannot be extrapolated to predict disinfectant efficacy on bacterial biofilms of clinically relevant multidrug-resistant organisms. © 2016 The Society for Applied Microbiology.

Intensified hand-hygiene campaign including soap-and-water wash may prevent acute infections in office workers, as shown by a recognized-exposure -adjusted analysis of a randomized trial.

PubMed

Hovi, Tapani; Ollgren, Jukka; Savolainen-Kopra, Carita

2017-01-09

Variable exposure to causative agents of acute respiratory (RTI) or gastrointestinal tract infections (GTI) is a significant confounding factor in the analysis of the efficacy of interventions concerning these infections. We had an exceptional opportunity to reanalyze a previously published dataset from a trial assessing the effect of enhanced hand hygiene on the occurrence of RTI or GTI in adults, after adjustment for reported exposure and other covariates. Twenty-one working units (designated clusters) each including at least 50 office employees, totaling 1,270 persons, were randomized into two intervention arms (either using water-and-soap or alcohol-rub in hand cleansing), or in the control arm. Self-reported data was collected through weekly emails and included own symptoms of RTI or GTI, and exposures to other persons with similar symptoms. Differences in the weekly occurrences of RTI and GTI symptoms between the arms were analyzed using multilevel binary regression model with log link with personal and cluster specific random effects, self-reported exposure to homologous disease, randomization triplet, and seasonality as covariates in the Bayesian framework. Over the 16 months duration of the trial, 297 persons in the soap and water arm, 238 persons in the alcohol-based hand rub arm, and 230 controls sent reports. The arms were similar in age distribution and gender ratios. A temporally-associated reported exposure strongly increased the risk of both types of infection in all trial arms. Persons in the soap-and-water arm reported a significantly - about 24% lower weekly prevalence of GTI than the controls whether they had observed an exposure or not during the preceding week, while for RTI, this intervention reduced the prevalence only during weeks without a reported exposure. Alcohol-rub did not affect the symptom prevalence. We conclude that while frequent and careful hand washing with soap and water partially protected office-working adults from GTI, the

UV-C decontamination of hand-held tablet devices in the healthcare environment using the Codonics D6000™ disinfection system.

PubMed

Muzslay, M; Yui, S; Ali, S; Wilson, A P R

2018-04-09

Mobile phones and tablet computers may be contaminated with microorganisms and become a potential reservoir for cross-transmission of pathogens between healthcare workers and patients. There is no generally accepted guidance how to reduce contamination on mobile devices in healthcare settings. Our aim was to determine the efficacy of the Codonics D6000™ UV-C disinfection device. Daily disinfection reduced contamination on screens and on protective cases (test) significantly, but not all cases (control) could be decontaminated. The median aerobic colony count on the control and the test cases was 52 (IQR 33-89) cfu/25cm 2 and 22 (IQR 10.5-41) cfu/25cm 2 respectively before disinfection. Copyright © 2018. Published by Elsevier Ltd.

Recent advances in drinking water disinfection: successes and challenges.

PubMed

Ngwenya, Nonhlanhla; Ncube, Esper J; Parsons, James

2013-01-01

Drinking water is the most important single source of human exposure to gastroenteric diseases, mainly as a result of the ingestion of microbial contaminated water. Waterborne microbial agents that pose a health risk to humans include enteropathogenic bacteria, viruses, and protozoa. Therefore, properly assessing whether these hazardous agents enter drinking water supplies, and if they do, whether they are disinfected adequately, are undoubtedly aspects critical to protecting public health. As new pathogens emerge, monitoring for relevant indicator microorganisms (e.g., process microbial indicators, fecal indicators, and index and model organisms) is crucial to ensuring drinking water safety. Another crucially important step to maintaining public health is implementing Water Safety Plans (WSPs), as is recommended by the current WHO Guidelines for Drinking Water Quality. Good WSPs include creating health-based targets that aim to reduce microbial risks and adverse health effects to which a population is exposed through drinking water. The use of disinfectants to inactivate microbial pathogens in drinking water has played a central role in reducing the incidence of waterborne diseases and is considered to be among the most successful interventions for preserving and promoting public health. Chlorine-based disinfectants are the most commonly used disinfectants and are cheap and easy to use. Free chlorine is an effective disinfectant for bacteria and viruses; however, it is not always effective against C. parvum and G. lamblia. Another limitation of using chlorination is that it produces disinfection by-products (DBPs), which pose potential health risks of their own. Currently, most drinking water regulations aggressively address DBP problems in public water distribution systems. The DBPs of most concern include the trihalomethanes (THMs), the haloacetic acids (HAAs), bromate, and chlorite. However, in the latest edition of the WHO Guidelines for Drinking Water Quality

Hand hygiene in the intensive care unit.

PubMed

Tschudin-Sutter, Sarah; Pargger, Hans; Widmer, Andreas F

2010-08-01

Healthcare-associated infections affect 1.4 million patients at any time worldwide, as estimated by the World Health Organization. In intensive care units, the burden of healthcare-associated infections is greatly increased, causing additional morbidity and mortality. Multidrug-resistant pathogens are commonly involved in such infections and render effective treatment challenging. Proper hand hygiene is the single most important, simplest, and least expensive means of preventing healthcare-associated infections. In addition, it is equally important to stop transmission of multidrug-resistant pathogens. According to the Centers for Disease Control and Prevention and World Health Organization guidelines on hand hygiene in health care, alcohol-based handrub should be used as the preferred means for routine hand antisepsis. Alcohols have excellent in vitro activity against Gram-positive and Gram-negative bacteria, including multidrug-resistant pathogens, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, Mycobacterium tuberculosis, a variety of fungi, and most viruses. Some pathogens, however, such as Clostridium difficile, Bacillus anthracis, and noroviruses, may require special hand hygiene measures. Failure to provide user friendliness of hand hygiene equipment and shortage of staff are predictors for noncompliance, especially in the intensive care unit setting. Therefore, practical approaches to promote hand hygiene in the intensive care unit include provision of a minimal number of handrub dispensers per bed, monitoring of compliance, and choice of the most attractive product. Lack of knowledge of guidelines for hand hygiene, lack of recognition of hand hygiene opportunities during patient care, and lack of awareness of the risk of cross-transmission of pathogens are barriers to good hand hygiene practices. Multidisciplinary programs to promote increased use of alcoholic handrub lead to an increased compliance of healthcare

Hand biometric recognition based on fused hand geometry and vascular patterns.

PubMed

Park, GiTae; Kim, Soowon

2013-02-28

A hand biometric authentication method based on measurements of the user's hand geometry and vascular pattern is proposed. To acquire the hand geometry, the thickness of the side view of the hand, the K-curvature with a hand-shaped chain code, the lengths and angles of the finger valleys, and the lengths and profiles of the fingers were used, and for the vascular pattern, the direction-based vascular-pattern extraction method was used, and thus, a new multimodal biometric approach is proposed. The proposed multimodal biometric system uses only one image to extract the feature points. This system can be configured for low-cost devices. Our multimodal biometric-approach hand-geometry (the side view of the hand and the back of hand) and vascular-pattern recognition method performs at the score level. The results of our study showed that the equal error rate of the proposed system was 0.06%.

Evaluation of Commonly Used Products for Disinfecting Clipper Blades in Veterinary Practices: A Pilot Study.

PubMed

Ley, Benjamin; Silverman, Edward; Peery, Kara; Dominguez, Delfina

2016-01-01

Nosocomial infections are a concern of growing interest in veterinary medicine. Clipper blades have been confirmed as fomites for numerous potential pathogens and, as such, may be associated with wound and surgical site infections. The goal of this study was to evaluate the disinfectant capabilities of several commonly used clipper blade cleaning products. Seventy sterile clipper blades were inoculated with strains of Pseudomonas aeruginosa , Escherichia coli , and Staphylococcus aureus . Blades were then subjected to one of seven treatment groups for disinfecting. Quantitative cultures of remaining bacteria were performed. All blades in the control group showed large amounts of bacterial recovery. Culture results showed no recovery in blades soaked in alcohol or chlorhexidine or those sprayed with an ethanol/o-phenylphenol product, while moderate recovery was seen with all other treatments. These results show that persistent contamination of clipper blades can occur with the use of several commonly used disinfectant products. Further research is necessary to evaluate fungicidal capabilities as well as the effect of disinfection on clipper blade maintenance.

Comparison of Standard Culture-Based Method to Culture-Independent Method for Evaluation of Hygiene Effects on the Hand Microbiome

PubMed Central

Leff, J.; Henley, J.; Tittl, J.; De Nardo, E.; Butler, M.; Griggs, R.; Fierer, N.

2017-01-01

ABSTRACT Hands play a critical role in the transmission of microbiota on one’s own body, between individuals, and on environmental surfaces. Effectively measuring the composition of the hand microbiome is important to hand hygiene science, which has implications for human health. Hand hygiene products are evaluated using standard culture-based methods, but standard test methods for culture-independent microbiome characterization are lacking. We sampled the hands of 50 participants using swab-based and glove-based methods prior to and following four hand hygiene treatments (using a nonantimicrobial hand wash, alcohol-based hand sanitizer [ABHS], a 70% ethanol solution, or tap water). We compared results among culture plate counts, 16S rRNA gene sequencing of DNA extracted directly from hands, and sequencing of DNA extracted from culture plates. Glove-based sampling yielded higher numbers of unique operational taxonomic units (OTUs) but had less diversity in bacterial community composition than swab-based sampling. We detected treatment-induced changes in diversity only by using swab-based samples (P < 0.001); we were unable to detect changes with glove-based samples. Bacterial cell counts significantly decreased with use of the ABHS (P < 0.05) and ethanol control (P < 0.05). Skin hydration at baseline correlated with bacterial abundances, bacterial community composition, pH, and redness across subjects. The importance of the method choice was substantial. These findings are important to ensure improvement of hand hygiene industry methods and for future hand microbiome studies. On the basis of our results and previously published studies, we propose recommendations for best practices in hand microbiome research. PMID:28351915

Disinfection in the laboratory: theory and practice in disinfection policy in late C19th and early C20th England.

PubMed

Whyte, Rebecca

2015-03-01

This article examines the relationship between theory and practice in nineteenth century English public health disinfection practice. Disinfection undertaken by local authorities and practised on objects, spaces and people became an increasingly common public health practice in the last quarter of the nineteenth century, and was part of a newly developed public health system of 'stamping out' disease as described by Hardy. Despite disinfection's key role in public health policy, it has thus far not received significant investigation or historiographical attending. This article explores the development of disinfection policy at local level, highlighting that despite commentators assumptions that increasingly exacting standards of disinfection required professional oversight rather than that of the 'amateur' public, there was a significant gap between laboratory based knowledge and evidence derived from practical experience. Laboratory conditions could not replicate those found in day-to-day disinfection, and there were myriad debates about how to create a mutually understandable scientific standard for testing. Despite increasing efforts to bring local disinfection in line with new ideas promulgated by central government and disinfection researchers, the mismatches between the two meant that there was greater divergence. This tension lay at the heart of the changes in disinfection theory and practice in the second half of the nineteenth century, and illustrate the complexities of the impact of germ theory on public health policy. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Infection control and hand hygiene in nursing homes in Oslo].

PubMed

Sie, Ingrid; Thorstad, Margrete; Andersen, Bjørg Marit

2008-06-26

Nosocomial infections and transmission can be substantially reduced by good infection control. The laws and regulations for infection control in heath care institutions emphasize establishment of infection control programs and improved hand hygiene. Our study reviews some factors that are important for practicing adequate hand hygiene (knowledge about infection control and hand-washing facilities). Health care workers (HCW) in nursing homes in Oslo participated in this study in 2006-2007. A questionnaire was made and SPSS was used to analyse the data . 70.7% of 324 HCW (in 42 nursing homes) answered the questionnaires. Nearly all of the respondents (95.6%) knew about the written procedures for hygiene and infection control; 88.5% knew that an infection control program was in place and about 50% had received information through internal education. Three of four had read the National guidelines for hand hygiene, 77.5% thought that hand disinfection was more effective than hand washing, and 97% reported hand hygiene after contact with a patient having an infection. Dispensers for hand disinfection were situated at central work places. At the same time, 17.9% informed that they worked in more than one place at the same time. This study confirms that most nursing homes in Oslo have an infection control program and training that improves the knowledge and awareness of hand hygiene among HCWs. However, the fact that nursing homes in Oslo have the resources, knowledge and education, is not the same as compliance.

Hand Biometric Recognition Based on Fused Hand Geometry and Vascular Patterns

PubMed Central

Park, GiTae; Kim, Soowon

2013-01-01

A hand biometric authentication method based on measurements of the user's hand geometry and vascular pattern is proposed. To acquire the hand geometry, the thickness of the side view of the hand, the K-curvature with a hand-shaped chain code, the lengths and angles of the finger valleys, and the lengths and profiles of the fingers were used, and for the vascular pattern, the direction-based vascular-pattern extraction method was used, and thus, a new multimodal biometric approach is proposed. The proposed multimodal biometric system uses only one image to extract the feature points. This system can be configured for low-cost devices. Our multimodal biometric-approach hand-geometry (the side view of the hand and the back of hand) and vascular-pattern recognition method performs at the score level. The results of our study showed that the equal error rate of the proposed system was 0.06%. PMID:23449119

Promoting hand hygiene and prudent use of antimicrobials in long-term care facilities.

PubMed

Rummukainen, Maija; Jakobsson, Aino; Karppi, Pertti; Kautiainen, Hannu; Lyytikäinen, Outi

2009-03-01

A multidisciplinary team visited all long-term care facilities (n = 123) for elderly persons in the Central Finland health care district (population, 265,000) during 2004-2005. Use of alcohol-based hand rubs and ongoing systematic antimicrobials were assessed. Thereafter, regional guidelines for prudent use of antimicrobials were published. One year after the visits, a significant increase in the mean amount of alcohol-based hand rubs used was detected while usage of antimicrobials for the prevention of urinary tract reinfections had decreased.

Kaiser Permanente National Hand Hygiene Program

PubMed Central

Barnes, Sue; Barron, Dana; Becker, Linda; Canola, Teresa; Salemi, Charles

2004-01-01

Objective: Hand hygiene has historically been identified as an important intervention for preventing infection acquired in health care settings. Recently, the advent of waterless, alcohol-based skin degermer and elimination of artificial nails have been recognized as other important interventions for preventing infection. Supplied with this information, the National Infection Control Peer Group convened a KP Hand Hygiene Work Group, which, in August 2001, launched a National Hand Hygiene Program initiative titled “Infection Control: It’s In Our Hands” to increase compliance with hand hygiene throughout the Kaiser Permanente (KP) organization. Design: The infection control initiative was designed to include employee and physician education as well as to implement standard hand hygiene products (eg, alcohol degermers), eliminate use of artificial nails, and monitor outcomes. Results: From 2001 through September 2003, the National KP Hand Hygiene Work Group coordinated implementation of the Hand Hygiene initiative throughout the KP organization. To date, outcome monitoring has shown a 26% increase in compliance with hand hygiene as well as a decrease in the number of bloodstream infections and methycillin-resistant Staphylococcus aureus (MRSA) infections. As of May 2003, use of artificial nails had been reduced by 97% nationwide. Conclusions: Endorsement of this Hand Hygiene Program initiative by KP leadership has led to implementation of the initiative at all medical centers throughout the KP organization. Outcome indicators to date suggest that the initiative has been successful; final outcome monitoring will be completed in December 2003. PMID:26704605

Status report on analytical methods to support the disinfectant/disinfection by-products regulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1992-08-01

The U.S. EPA is developng national regulations to control disinfectants and disinfection by-products in public drinking water supplies. Twelve disinfectants and disinfection by-products are identified for possible regulation under this rule. The document summarizes the analytical methods that EPA intends to propose as compliance monitoring methods. A discussion of surrogate measurements that are being considered for inclusion in the regulation is also provided.

The role of surface disinfection in infection prevention

PubMed Central

Gebel, Jürgen; Exner, Martin; French, Gary; Chartier, Yves; Christiansen, Bärbel; Gemein, Stefanie; Goroncy-Bermes, Peter; Hartemann, Philippe; Heudorf, Ursel; Kramer, Axel; Maillard, Jean-Yves; Oltmanns, Peter; Rotter, Manfred; Sonntag, Hans-Günther

2013-01-01

Background: The Rudolf Schuelke Foundation addresses topics related to hygiene, infection prevention and public health. In this context a panel of scientists from various European countries discussed “The Role of Surface Disinfection in Infection Prevention”. The most important findings and conclusions of this meeting are summarised in the present consensus paper. Aim: Although the relevance of surface disinfection is increasingly being accepted, there are still a number of issues which remain controversial. In particular, the following topics were addressed: Transferral of microbes from surface to patients as a cause of infection, requirements for surface disinfectants, biocidal resistance and toxicity, future challenges. Methods and findings: After discussion and review of current scientific literature the authors agreed that contaminated surfaces contribute to the transmission of pathogens and may thus pose an infection hazard. Targeted surface disinfection based on a risk profile is seen as an indispensable constituent in a multibarrier approach of universal infection control precautions. Resistance and cross-resistance depend on the disinfectant agent as well as on the microbial species. Prudent implementation of surface disinfection regimens tested to be effective can prevent or minimize adverse effects. Conclusions: Disinfection must be viewed as a holistic process. There is a need for defining standard principles for cleaning and disinfection, for ensuring compliance with these principles by measures such as written standard operating procedures, adequate training and suitable audit systems. Also, test procedures must be set up in order to demonstrate the efficacy of disinfectants including new application methods such as pre-soaked wipes for surface disinfection. PMID:23967396

Unrecorded alcohol consumption in Russia: toxic denaturants and disinfectants pose additional risks

PubMed Central

Solodun, Yuriy V.; Monakhova, Yulia B.; Kuballa, Thomas; Samokhvalov, Andriy V.; Rehm, Jürgen; Lachenmeier, Dirk W.

2011-01-01

In 2005, 30% of all alcohol consumption in Russia was unrecorded. This paper describes the chemical composition of unrecorded and low cost alcohol, including a toxicological evaluation. Alcohol products (n=22) from both recorded and unrecorded sources were obtained from three Russian cities (Saratov, Lipetsk and Irkutsk) and were chemically analyzed. Unrecorded alcohols included homemade samogons, medicinal alcohols and surrogate alcohols. Analysis included alcoholic strength, levels of volatile compounds (methanol, acetaldehyde, higher alcohols), ethyl carbamate, diethyl phthalate (DEP) and polyhexamethyleneguanidine hydrochloride (PHMG). Single samples showed contamination with DEP (275–1269 mg/l) and PHMG (515 mg/l) above levels of toxicological concern. Our detailed chemical analysis of Russian alcohols showed that the composition of vodka, samogon and medicinal alcohols generally did not raise major public health concerns other than for ethanol. It was shown, however, that concentration levels of DEP and PHMG in some surrogate alcohols make these samples unfit for human consumption as even moderate drinking would exceed acceptable daily intakes. PMID:22319254

Unrecorded alcohol consumption in Russia: toxic denaturants and disinfectants pose additional risks.

PubMed

Solodun, Yuriy V; Monakhova, Yulia B; Kuballa, Thomas; Samokhvalov, Andriy V; Rehm, Jürgen; Lachenmeier, Dirk W

2011-12-01

In 2005, 30% of all alcohol consumption in Russia was unrecorded. This paper describes the chemical composition of unrecorded and low cost alcohol, including a toxicological evaluation. Alcohol products (n=22) from both recorded and unrecorded sources were obtained from three Russian cities (Saratov, Lipetsk and Irkutsk) and were chemically analyzed. Unrecorded alcohols included homemade samogons, medicinal alcohols and surrogate alcohols. Analysis included alcoholic strength, levels of volatile compounds (methanol, acetaldehyde, higher alcohols), ethyl carbamate, diethyl phthalate (DEP) and polyhexamethyleneguanidine hydrochloride (PHMG). Single samples showed contamination with DEP (275-1269 mg/l) and PHMG (515 mg/l) above levels of toxicological concern. Our detailed chemical analysis of Russian alcohols showed that the composition of vodka, samogon and medicinal alcohols generally did not raise major public health concerns other than for ethanol. It was shown, however, that concentration levels of DEP and PHMG in some surrogate alcohols make these samples unfit for human consumption as even moderate drinking would exceed acceptable daily intakes.

40 CFR 141.72 - Disinfection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... PRIMARY DRINKING WATER REGULATIONS Filtration and Disinfection § 141.72 Disinfection. A public water... the direct influence of surface water and provides filtration treatment must provide disinfection...) Disinfection requirements for public water systems which provide filtration. Each public water system that...

Cleaning and disinfection of equipment for gastrointestinal flexible endoscopy: interim recommendations of a Working Party of the British Society of Gastroenterology.

PubMed

1988-08-01

1. All patients undergoing gastrointestinal endoscopy must be considered 'at risk' for HIV and appropriate cleaning/disinfection measures taken for endoscopes and accessories. 2. Thorough manual cleaning with detergent, of the instrument and its channels is the most important part of the cleaning/disinfection procedure. Without this, blood, mucus and organic material will prevent adequate penetration of disinfectant for inactivation of bacteria and viruses. 3. Aldehyde preparations (2% activated glutaraldehyde and related products) are the recommended first line antibacterial and antiviral disinfectant. A four minute soak is recommended as sufficient for inactivation of vegetative bacteria and viruses (including HIV and HBV). 4. Quaternary ammonium detergents (8% Dettox for two minutes for bacterial disinfection), followed by exposure of the endoscope shaft and channels to ethyl alcohol (70% for four minutes for viral inactivation), is an acceptable second-line disinfectant routine where staff sensitisation prevents the use of an aldehyde disinfectant. 5. Accessories, including mouthguards and cleaning brushes, require similarly careful cleaning/disinfection, before and after each use. Disposable products (especially injection needles) may be used and appropriate items can be sterilised by autoclaving and kept in sterile packs. 6. Closed circuit endoscope washing machines have advantages in maintaining standards and avoiding staff sensitisation to disinfectants. Improved ventilation including exhaust extraction facilities may be required. 7. Endoscopy staff should receive HBV vaccination, wear gloves and appropriate protective garments, cover wounds or abrasions and avoid needlestick injuries (including spiked forceps, etc). 8. Known HIV-infected or AIDS patients are managed as immunosuppressed, and require protection from atypical mycobacteria/cryptosporidia etc, by one hour aldehyde disinfection of endoscopic equipment before and after the procedure. A dedicated

Cleaning and disinfection of equipment for gastrointestinal flexible endoscopy: interim recommendations of a Working Party of the British Society of Gastroenterology.

PubMed Central

1988-01-01

1. All patients undergoing gastrointestinal endoscopy must be considered 'at risk' for HIV and appropriate cleaning/disinfection measures taken for endoscopes and accessories. 2. Thorough manual cleaning with detergent, of the instrument and its channels is the most important part of the cleaning/disinfection procedure. Without this, blood, mucus and organic material will prevent adequate penetration of disinfectant for inactivation of bacteria and viruses. 3. Aldehyde preparations (2% activated glutaraldehyde and related products) are the recommended first line antibacterial and antiviral disinfectant. A four minute soak is recommended as sufficient for inactivation of vegetative bacteria and viruses (including HIV and HBV). 4. Quaternary ammonium detergents (8% Dettox for two minutes for bacterial disinfection), followed by exposure of the endoscope shaft and channels to ethyl alcohol (70% for four minutes for viral inactivation), is an acceptable second-line disinfectant routine where staff sensitisation prevents the use of an aldehyde disinfectant. 5. Accessories, including mouthguards and cleaning brushes, require similarly careful cleaning/disinfection, before and after each use. Disposable products (especially injection needles) may be used and appropriate items can be sterilised by autoclaving and kept in sterile packs. 6. Closed circuit endoscope washing machines have advantages in maintaining standards and avoiding staff sensitisation to disinfectants. Improved ventilation including exhaust extraction facilities may be required. 7. Endoscopy staff should receive HBV vaccination, wear gloves and appropriate protective garments, cover wounds or abrasions and avoid needlestick injuries (including spiked forceps, etc). 8. Known HIV-infected or AIDS patients are managed as immunosuppressed, and require protection from atypical mycobacteria/cryptosporidia etc, by one hour aldehyde disinfection of endoscopic equipment before and after the procedure. A dedicated

Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs

PubMed Central

Kampf, Günter; Kramer, Axel

2004-01-01

The etiology of nosocomial infections, the frequency of contaminated hands with the different nosocomial pathogens, and the role of health care workers' hands during outbreaks suggest that a hand hygiene preparation should at least have activity against bacteria, yeasts, and coated viruses. The importance of efficacy in choosing the right hand hygiene product is reflected in the new Centers for Disease Control and Prevention guideline on hand hygiene (J. M. Boyce and D. Pittet, Morb. Mortal. Wkly. Rep. 51:1-45, 2002). The best antimicrobial efficacy can be achieved with ethanol (60 to 85%), isopropanol (60 to 80%), and n-propanol (60 to 80%). The activity is broad and immediate. Ethanol at high concentrations (e.g., 95%) is the most effective treatment against naked viruses, whereas n-propanol seems to be more effective against the resident bacterial flora. The combination of alcohols may have a synergistic effect. The antimicrobial efficacy of chlorhexidine (2 to 4%) and triclosan (1 to 2%) is both lower and slower. Additionally, both agents have a risk of bacterial resistance, which is higher for chlorhexidine than triclosan. Their activity is often supported by the mechanical removal of pathogens during hand washing. Taking the antimicrobial efficacy and the mechanical removal together, they are still less effective than the alcohols. Plain soap and water has the lowest efficacy of all. In the new Centers for Disease Control and Prevention guideline, promotion of alcohol-based hand rubs containing various emollients instead of irritating soaps and detergents is one strategy to reduce skin damage, dryness, and irritation. Irritant contact dermatitis is highest with preparations containing 4% chlorhexidine gluconate, less frequent with nonantimicrobial soaps and preparations containing lower concentrations of chlorhexidine gluconate, and lowest with well-formulated alcohol-based hand rubs containing emollients and other skin conditioners. Too few published data

The differential effects of heat-shocking on the viability of spores from Bacillus anthracis, Bacillus subtilis, and Clostridium sporogenes after treatment with peracetic acid- and glutaraldehyde-based disinfectants

PubMed Central

March, Jordon K; Pratt, Michael D; Lowe, Chinn-Woan; Cohen, Marissa N; Satterfield, Benjamin A; Schaalje, Bruce; O'Neill, Kim L; Robison, Richard A

2015-01-01

This study investigated (1) the susceptibility of Bacillus anthracis (Ames strain), Bacillus subtilis (ATCC 19659), and Clostridium sporogenes (ATCC 3584) spores to commercially available peracetic acid (PAA)- and glutaraldehyde (GA)-based disinfectants, (2) the effects that heat-shocking spores after treatment with these disinfectants has on spore recovery, and (3) the timing of heat-shocking after disinfectant treatment that promotes the optimal recovery of spores deposited on carriers. Suspension tests were used to obtain inactivation kinetics for the disinfectants against three spore types. The effects of heat-shocking spores after disinfectant treatment were also determined. Generalized linear mixed models were used to estimate 6-log reduction times for each spore type, disinfectant, and heat treatment combination. Reduction times were compared statistically using the delta method. Carrier tests were performed according to AOAC Official Method 966.04 and a modified version that employed immediate heat-shocking after disinfectant treatment. Carrier test results were analyzed using Fisher's exact test. PAA-based disinfectants had significantly shorter 6-log reduction times than the GA-based disinfectant. Heat-shocking B. anthracis spores after PAA treatment resulted in significantly shorter 6-log reduction times. Conversely, heat-shocking B. subtilis spores after PAA treatment resulted in significantly longer 6-log reduction times. Significant interactions were also observed between spore type, disinfectant, and heat treatment combinations. Immediately heat-shocking spore carriers after disinfectant treatment produced greater spore recovery. Sporicidal activities of disinfectants were not consistent across spore species. The effects of heat-shocking spores after disinfectant treatment were dependent on both disinfectant and spore species. Caution must be used when extrapolating sporicidal data of disinfectants from one spore species to another. Heat

Waterless Hand Rub Versus Traditional Hand Scrub Methods for Preventing the Surgical Site Infection in Orthopedic Surgery.

PubMed

Iwakiri, Kentaro; Kobayashi, Akio; Seki, Masahiko; Ando, Yoshiyuki; Tsujio, Tadao; Hoshino, Masatoshi; Nakamura, Hiroaki

2017-11-15

MINI: Fourteen hundred consecutive patients were investigated for evaluating the utility of waterless hand rub before orthopaedic surgery. The risk in the surgical site infection incidence was the same, but costs of liquids used for hand hygiene were cheaper and the hand hygiene time was shorter for waterless protocol, compared with traditional hand scrub. A retrospective cohort study with prospectively collected data. The aim of this study was to compare SSI incidences, the cost of hand hygiene agents, and hand hygiene time between the traditional hand scrub and the waterless hand rub protocols before orthopedic surgery. Surgical site infections (SSI) prolong hospitalization and are a leading nosocomial cause of morbidity and a source of excess cost. Recently, a waterless hand rub protocol comprising alcohol based chlorhexidine gluconate for use before surgery was developed, but no studies have yet examined its utility in orthopedic surgery. Fourteen hundred consecutive patients who underwent orthopedic surgery (spine, joint replacement, hand, and trauma surgeries) in our hospital since April 1, 2012 were included. A total of 712 cases underwent following traditional hand scrub between April 1, 2012 and April 30, 2013 and 688 cases underwent following waterless hand rub between June 1, 2013 and April 30, 2014. We compared SSI incidences within all and each subcategory between two hand hygiene protocols. All patients were screened for SSI within 1 year after surgery. We compared the cost of hand hygiene agents and hand hygiene time between two groups. The SSI incidences were 1.3% (9 of 712) following the traditional protocol (2 deep and 7 superficial infections) and 1.1% (8 of 688) following the waterless protocol (all superficial infections). There were no significant differences between the two groups. The costs of liquids used for one hand hygiene were about $2 for traditional hand scrub and less than $1 for waterless hand rub. The mean hand hygiene time was 264

Peracetic Acid as a Green Disinfectant for Combined Sewer ...

EPA Pesticide Factsheets

This cooperative research and development agreement between U.S. EPA, Solvay, MSDGC, and CB&I is evaluating the potential of PAA for disinfection of Muddy Creek CSO wastewater and comparing that with sodium hypochlorite disinfection. This presentation will document the effectiveness of sodium hypochlorite and PAA for the inactivation of E. coli in CSO wastewater using laboratory bench-scale jar tests and Muddy Creek field site studies based on the following items:•Storage, shelf life, and application of the disinfectants.•Effectiveness of the disinfectants in the inactivation of E. coli.•Formation of harmful byproducts by the disinfectants.•Operation and maintenance costs, including the cost of the disinfectant, its storage, application, and neutralizing agent for the disinfectant to maintain the Ohio EPA guideline for residual disinfectant at the discharge point. Like many cities in the USA, Cincinnati, Ohio is attempting to find the best way to meet state and federal requirements concerning combined sewer overflow (CSO) wastewater. The Muddy Creek CSO treatment facility was constructed to provide treatment for CSO Numbers 198 and 216 from the Westwood Trunk sewer. The Metropolitan Sewer District of Greater Cincinnati (MSDGC) is currently using sodium hypochlorite for disinfection in this treatment facility. Because of degradation of hypochlorite during storage and the formation of chlorinated disinfection byproducts (DBPs), MSDGC is evaluating alternat

A Novel Lactobacilli-Based Teat Disinfectant for Improving Bacterial Communities in the Milks of Cow Teats with Subclinical Mastitis

PubMed Central

Yu, Jie; Ren, Yan; Xi, XiaoXia; Huang, Weiqiang; Zhang, Heping

2017-01-01

Teat disinfection pre- and post-milking is important for the overall health and hygiene of dairy cows. The objective of this study was to evaluate the efficacy of a novel probiotic lactobacilli-based teat disinfectant based on changes in somatic cell count (SCC) and profiling of the bacterial community. A total of 69 raw milk samples were obtained from eleven Holstein-Friesian dairy cows over 12 days of teat dipping in China. Single molecule, real-time sequencing technology (SMRT) was employed to profile changes in the bacterial community during the cleaning protocol and to compare the efficacy of probiotic lactic acid bacteria (LAB) and commercial teat disinfectants. The SCC gradually decreased following the cleaning protocol and the SCC of the LAB group was slightly lower than that of the commercial disinfectant (CD) group. Our SMRT sequencing results indicate that raw milk from both the LAB and CD groups contained diverse microbial populations that changed over the course of the cleaning protocol. The relative abundances of some species were significantly changed during the cleaning process, which may explain the observed bacterial community differences. Collectively, these results suggest that the LAB disinfectant could reduce mastitis-associated bacteria and improve the microbial environment of the cow teat. It could be used as an alternative to chemical pre- and post-milking teat disinfectants to maintain healthy teats and udders. In addition, the Pacific Biosciences SMRT sequencing with the full-length 16S ribosomal RNA gene was shown to be a powerful tool for monitoring changes in the bacterial population during the cleaning protocol. PMID:29018412

40 CFR 141.72 - Disinfection.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Disinfection. 141.72 Section 141.72... PRIMARY DRINKING WATER REGULATIONS Filtration and Disinfection § 141.72 Disinfection. A public water... disinfection treatment specified in paragraph (a) of this section beginning December 30, 1991, unless the State...

40 CFR 141.72 - Disinfection.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 24 2012-07-01 2012-07-01 false Disinfection. 141.72 Section 141.72... PRIMARY DRINKING WATER REGULATIONS Filtration and Disinfection § 141.72 Disinfection. A public water... disinfection treatment specified in paragraph (a) of this section beginning December 30, 1991, unless the State...

Improving hand hygiene in a paediatric hospital: a multimodal quality improvement approach.

PubMed

Jamal, Ahmed; O'Grady, G; Harnett, E; Dalton, D; Andresen, D

2012-02-01

Effective hand hygiene has long been recognised as an important way to reduce the transmission of bacterial and viral pathogens in healthcare settings. However, many studies have shown that adherence to hand hygiene remains low, and improvement efforts have often not delivered sustainable results. The Children's Hospital at Westmead is the largest tertiary paediatric hospital in Sydney, Australia. The hospital participated in a state-wide 'Clean hands save lives' campaign which was initiated in 2006. Strong leadership, good stakeholder engagement, readily accessible alcohol-based hand rub at the point of patient care, a multifaceted education programme, monitoring of staff, adherence to recommended hand hygiene practices and contemporaneous feedback of performance data have significantly improved and maintained compliance with hand hygiene. Hand hygiene compliance has increased from 23% in 2006 to 87% in 2011 (p<0.001). Sustained improvement in compliance with hand hygiene has been evident in the last 4 years. A decline in a set of hospital-acquired infections (including rotavirus, multiresistant organism transmission, and nosocomial bacteraemia) has also been noted as hand hygiene rates have improved. Monthly usage of alcohol-based hand rub has increased from 16 litres/1000 bed days to 51 litres/1000 bed days during this same period. This project has delivered sustained improvement in hand hygiene compliance by establishing a framework of multimodal evidence-based strategies.

Effects of wastewater disinfection on waterborne bacteria and viruses

USGS Publications Warehouse

Blatchley, E. R.; Gong, W.-L.; Alleman, J.E.; Rose, J.B.; Huffman, D.E.; Otaki, M.; Lisle, J.T.

2007-01-01

Wastewater disinfection is practiced with the goal of reducing risks of human exposure to pathogenic microorganisms. In most circumstances, the efficacy of a wastewater disinfection process is regulated and monitored based on measurements of the responses of indicator bacteria. However, inactivation of indicator bacteria does not guarantee an acceptable degree of inactivation among other waterborne microorganisms (e.g., microbial pathogens). Undisinfected effluent samples from several municipal wastewater treatment facilities were collected for analysis. Facilities were selected to provide a broad spectrum of effluent quality, particularly as related to nitrogenous compounds. Samples were subjected to bench-scale chlorination and dechlorination and UV irradiation under conditions that allowed compliance with relevant discharge regulations and such that disinfectant exposures could be accurately quantified. Disinfected samples were subjected to a battery of assays to assess the immediate and long-term effects of wastewater disinfection on waterborne bacteria and viruses. In general, (viable) bacterial populations showed an immediate decline as a result of disinfectant exposure; however, incubation of disinfected samples under conditions that were designed to mimic the conditions in a receiving stream resulted in substantial recovery of the total bacterial community. The bacterial groups that are commonly used as indicators do not provide an accurate representation of the response of the bacterial community to disinfectant exposure and subsequent recovery in the environment. UV irradiation and chlorination/dechlorination both accomplished measurable inactivation of indigenous phage; however, the extent of inactivation was fairly modest under the conditions of disinfection used in this study. UV irradiation was consistently more effective as a virucide than chlorination/dechlorination under the conditions of application, based on measurements of virus (phage

Hand Hygiene Practices Among Indian Medical Undergraduates: A Questionnaire-Based Survey

PubMed Central

Modi, Pranav D; Solanki, Rajavi; Modi, Janhavi; Chandramani, Srinath; Gill, Niharika

2017-01-01

Background and objectives To prevent the spread of infections in all healthcare settings, hand hygiene must be routinely practiced. Appropriate hand hygiene techniques can go a long way in reducing nosocomial infections, cross-transmission of microorganisms and the risk of occupational exposure to infectious diseases. World Health Organisation (WHO) has taken an incredible approach called “My Five Moments for Hand Hygiene" which defines the key moments when health-care workers should perform hand hygiene. We thus carried out a survey to assess knowledge of hand hygiene practices among undergraduate medical students.  Materials and methods A cross-sectional survey was conducted among 523 Indian medical undergraduates. The questionnaire used was adapted from the WHO hand hygiene knowledge questionnaire for health-care workers and was distributed both, in print and online formats. The response to each question was examined using percentages. Results Nearly 57% (n=298) of medical students who participated in this study did not receive any formal training in hand hygiene. Only 27% (n=141) students knew that the most frequent source of germs responsible for health-care associated infections were the germs already present on or within the patient. Nearly 68.6% (n= 359) students were unaware of the sequence of hand washing and hand rubbing. Although 71.9% (n=376 ) students claimed that they use an alcohol-based hand rub routinely, only 36.1% (n=189 ) students knew the time required for a hand rub to kill the germs on the hands. Overall hand hygiene knowledge was low in 6.9% (n=36), moderate in 80.9% (n=423) and good in 12.2% (n=23) of respondents.  Conclusions The awareness about hand hygiene practices among medical students is low. Nearly 57% (n=298) of the respondents never received any formal training in hand hygiene throughout their course of medical undergraduate study. To prevent the spread of infections in healthcare settings, medical students should be given

Disinfection by-products in baby lettuce irrigated with electrolysed water.

PubMed

López-Gálvez, Francisco; Andújar, Silvia; Marín, Alicia; Tudela, Juan A; Allende, Ana; Gil, María I

2018-06-01

Irrigation water disinfection reduces the microbial load but it might lead to the formation and accumulation of disinfection by-products (DBPs) in the crop. If DBPs are present in the irrigation water, they can accumulate in the crop, particularly after the regrowth, and be affected by the postharvest handling such as washing and storage. To evaluate the potential accumulation of DBPs, baby lettuce was grown using irrigation water treated with electrolysed water (EW) in a commercial greenhouse over three consecutive harvests and regrowths. The impact of postharvest practices such as washing and storage on DBP content was also assessed. Use of EW caused the accumulation of chlorates in irrigation water (0.02-0.14 mg L -1 ), and in the fresh produce (0.05-0.10 mg kg -1 ). On the other hand, the disinfection treatment had minor impact regarding the presence of trihalomethanes (THMs) in water (0.3-8.7 μg L -1 max), and in baby lettuce (0.3-2.9 μg kg -1 max). Disinfection of irrigation water with EW caused the accumulation of chlorates in the crop reaching levels higher than the current maximum residual limit established in the EU legislation for leafy greens. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

A new approach to hand-based authentication

NASA Astrophysics Data System (ADS)

Amayeh, G.; Bebis, G.; Erol, A.; Nicolescu, M.

2007-04-01

Hand-based authentication is a key biometric technology with a wide range of potential applications both in industry and government. Traditionally, hand-based authentication is performed by extracting information from the whole hand. To account for hand and finger motion, guidance pegs are employed to fix the position and orientation of the hand. In this paper, we consider a component-based approach to hand-based verification. Our objective is to investigate the discrimination power of different parts of the hand in order to develop a simpler, faster, and possibly more accurate and robust verification system. Specifically, we propose a new approach which decomposes the hand in different regions, corresponding to the fingers and the back of the palm, and performs verification using information from certain parts of the hand only. Our approach operates on 2D images acquired by placing the hand on a flat lighting table. Using a part-based representation of the hand allows the system to compensate for hand and finger motion without using any guidance pegs. To decompose the hand in different regions, we use a robust methodology based on morphological operators which does not require detecting any landmark points on the hand. To capture the geometry of the back of the palm and the fingers in suffcient detail, we employ high-order Zernike moments which are computed using an effcient methodology. The proposed approach has been evaluated on a database of 100 subjects with 10 images per subject, illustrating promising performance. Comparisons with related approaches using the whole hand for verification illustrate the superiority of the proposed approach. Moreover, qualitative comparisons with state-of-the-art approaches indicate that the proposed approach has comparable or better performance.

The differential effects of heat-shocking on the viability of spores from Bacillus anthracis, Bacillus subtilis, and Clostridium sporogenes after treatment with peracetic acid- and glutaraldehyde-based disinfectants.

PubMed

March, Jordon K; Pratt, Michael D; Lowe, Chinn-Woan; Cohen, Marissa N; Satterfield, Benjamin A; Schaalje, Bruce; O'Neill, Kim L; Robison, Richard A

2015-10-01

This study investigated (1) the susceptibility of Bacillus anthracis (Ames strain), Bacillus subtilis (ATCC 19659), and Clostridium sporogenes (ATCC 3584) spores to commercially available peracetic acid (PAA)- and glutaraldehyde (GA)-based disinfectants, (2) the effects that heat-shocking spores after treatment with these disinfectants has on spore recovery, and (3) the timing of heat-shocking after disinfectant treatment that promotes the optimal recovery of spores deposited on carriers. Suspension tests were used to obtain inactivation kinetics for the disinfectants against three spore types. The effects of heat-shocking spores after disinfectant treatment were also determined. Generalized linear mixed models were used to estimate 6-log reduction times for each spore type, disinfectant, and heat treatment combination. Reduction times were compared statistically using the delta method. Carrier tests were performed according to AOAC Official Method 966.04 and a modified version that employed immediate heat-shocking after disinfectant treatment. Carrier test results were analyzed using Fisher's exact test. PAA-based disinfectants had significantly shorter 6-log reduction times than the GA-based disinfectant. Heat-shocking B. anthracis spores after PAA treatment resulted in significantly shorter 6-log reduction times. Conversely, heat-shocking B. subtilis spores after PAA treatment resulted in significantly longer 6-log reduction times. Significant interactions were also observed between spore type, disinfectant, and heat treatment combinations. Immediately heat-shocking spore carriers after disinfectant treatment produced greater spore recovery. Sporicidal activities of disinfectants were not consistent across spore species. The effects of heat-shocking spores after disinfectant treatment were dependent on both disinfectant and spore species. Caution must be used when extrapolating sporicidal data of disinfectants from one spore species to another. Heat

Reducing absenteeism from gastrointestinal and respiratory illness in elementary school students: a randomized, controlled trial of an infection-control intervention.

PubMed

Sandora, Thomas J; Shih, Mei-Chiung; Goldmann, Donald A

2008-06-01

Students often miss school because of gastrointestinal and respiratory illnesses. We assessed the effectiveness of a multifactorial intervention, including alcohol-based hand-sanitizer and surface disinfection, in reducing absenteeism caused by gastrointestinal and respiratory illnesses in elementary school students. We performed a school-based cluster-randomized, controlled trial at a single elementary school. Eligible students in third to fifth grade were enrolled. Intervention classrooms received alcohol-based hand sanitizer to use at school and quaternary ammonium wipes to disinfect classroom surfaces daily for 8 weeks; control classrooms followed usual hand-washing and cleaning practices. Parents completed a preintervention demographic survey. Absences were recorded along with the reason for absence. Swabs of environmental surfaces were evaluated by bacterial culture and polymerase chain reaction for norovirus, respiratory syncytial virus, influenza, and parainfluenza 3. The primary outcomes were rates of absenteeism caused by gastrointestinal or respiratory illness. Days absent were modeled as correlated Poisson variables and compared between groups by using generalized estimating equations. Analyses were adjusted for family size, race, health status, and home sanitizer use. We also compared the presence of viruses and the total bacterial colony counts on several classroom surfaces. A total of 285 students were randomly assigned; baseline demographics were similar in the 2 groups. The adjusted absenteeism rate for gastrointestinal illness was significantly lower in the intervention-group subjects compared with control subjects. The adjusted absenteeism rate for respiratory illness was not significantly different between groups. Norovirus was the only virus detected and was found less frequently on surfaces in intervention classrooms compared with control classrooms (9% vs 29%). A multifactorial intervention including hand sanitizer and surface disinfection

Advances in photocatalytic disinfection of bacteria: Development of photocatalysts and mechanisms.

PubMed

Wang, Wanjun; Huang, Guocheng; Yu, Jimmy C; Wong, Po Keung

2015-08-01

Photocatalysis has attracted worldwide attention due to its potential in solar energy conversion. As a "green" advanced oxidation technology, it has been extensively used for water disinfection and wastewater treatment. This article provides a review of the recent progress in solar energy-induced photocatalytic disinfection of bacteria, focusing on the development of highly efficient photocatalysts and their underlying mechanisms in bacterial inactivation. The photocatalysts are classified into TiO2-based and non-TiO2-based systems, as TiO2 is the most investigated photocatalyst. The synthesis methods, modification strategies, bacterial disinfection activities and mechanisms of different types of photocatalysts are reviewed in detail. Emphasis is given to the modified TiO2, including noble metal deposition, non-metal doping, dye sensitization and composite TiO2, along with typical non-TiO2-based photocatalysts for bacterial disinfection, including metal oxides, sulfides, bismuth metallates, graphene-based photocatalysts, carbon nitride-based photocatalysts and natural photocatalysts. A simple and versatile methodology by using a partition system combined with scavenging study is introduced to study the photocatalytic disinfection mechanisms in different photocatalytic systems. This review summarizes the current state of the work on photocatalytic disinfection of bacteria, and is expected to offer useful insights for the future development in the field. Copyright © 2015. Published by Elsevier B.V.

Comparative study of disinfectants for use in low-cost gravity driven household water purifiers.

PubMed

Patil, Rajshree A; Kausley, Shankar B; Balkunde, Pradeep L; Malhotra, Chetan P

2013-09-01

Point-of-use (POU) gravity-driven household water purifiers have been proven to be a simple, low-cost and effective intervention for reducing the impact of waterborne diseases in developing countries. The goal of this study was to compare commonly used water disinfectants for their feasibility of adoption in low-cost POU water purifiers. The potency of each candidate disinfectant was evaluated by conducting a batch disinfection study for estimating the concentration of disinfectant needed to inactivate a given concentration of the bacterial strain Escherichia coli ATCC 11229. Based on the concentration of disinfectant required, the size, weight and cost of a model purifier employing that disinfectant were estimated. Model purifiers based on different disinfectants were compared and disinfectants which resulted in the most safe, compact and inexpensive purifiers were identified. Purifiers based on bromine, tincture iodine, calcium hypochlorite and sodium dichloroisocyanurate were found to be most efficient, cost effective and compact with replacement parts costing US$3.60-6.00 for every 3,000 L of water purified and are thus expected to present the most attractive value proposition to end users.

Reduction of risk of Salmonella infection from kitchen cleaning clothes by use of sodium hypochlorite disinfectant cleaner.

PubMed

Chaidez, C; Soto-Beltran, M; Gerba, C P; Tamimi, A H

2014-11-01

The objective of this study was to evaluate the reduction of infection risk due to exposure to Salmonella sp. in kitchen cleaning clothes by the use of a bleach (sodium hypochlorite) cleaner utilizing a continuous-time dynamic exposure model. The only route of exposure considered was hand contamination during cloth use. The occurrence and numbers of Salmonella was studied in 60 homes over a 6-week period in which half disinfected kitchen cleaning clothes with a sodium hypochlorite based disinfectant cleaner. This study demonstrated that a significant risk exists for Salmonella infection from kitchen cleaning clothes in Mexican homes and that this risk can be reduced by almost 100-fold by soaking cleaning clothes in a bleach product. The risks of infection and illness could likely be further reduced by developing a more effective procedure for reducing Salmonella in cleaning clothes treated twice a day with a sodium hypochlorite disinfectant (i.e. longer soaking time) or using a greater concentration of the disinfectant. Hygiene intervention is a key strategy to reduce the potential risk of disease-causing micro-organisms in households. There is a lack of understanding of the human health risk associated with the use of contaminated kitchen cleaning cloths. The study used a quantitative microbial risk assessment to estimate the risk associated with the use of kitchen cleaning clothes by using disinfectant products. The results showed that the use of prescribe protocols can reduce the risk of Salmonella infections in household kitchens. © 2014 The Society for Applied Microbiology.

Disinfectant Susceptibility Profiling of Glutaraldehyde-Resistant Nontuberculous Mycobacteria.

PubMed

Burgess, Winona; Margolis, Alyssa; Gibbs, Sara; Duarte, Rafael Silva; Jackson, Mary

2017-07-01

OBJECTIVE Activated alkaline glutaraldehyde (GTA) remains one of the most widely used high-level disinfectants worldwide. However, several reports have highlighted the potential for nontuberculous mycobacteria to develop high-level resistance to this product. Because aldehyde resistance may lead to cross-resistance to other biocides, we investigated the susceptibility profile of GTA-resistant Mycobacterium chelonae and M. abscessus isolates to various disinfectant chemistries. METHODS High-level disinfectants commonly used in the reprocessing of endoscopes and other heat-sensitive, semicritical medical equipment, including different formulations of aldehyde-based products and oxidizing agents, were tested against 10 slow- and fast-growing, GTA-susceptible and GTA-resistant, Mycobacterium isolates in suspension tests and carrier tests at different temperatures. RESULTS While peracetic acid- and hydrogen peroxide-based disinfectants (S40, Resert XL, Reliance DG) efficiently killed all of the Mycobacterium isolates, GTA- and ortho-phthalaldehyde-based products (ie, Cidex, Aldahol, Cidex OPA) showed variable efficacy against GTA-resistant strains despite the ability of some formulations (Aldahol) to overcome the resistance of some of these isolates, especially when the temperature was increased from 20°C to 25°C. CONCLUSIONS Application permitting, oxidizing chemistries may provide a safe alternative to aldehyde-based products, particularly in GTA-resistant mycobacterial outbreaks. Infect Control Hosp Epidemiol 2017;38:784-791.

PubMed Central

TATARELLI, P.; LORENZI, I.; CAVIGLIA, I.; SACCO, R.A.; LA MASA, D.

2016-01-01

Summary Introduction. Hand decontamination with alcohol-based antiseptic agents is considered the best practise to reduce healthcare associated infections. We present a new method to monitor hand hygiene, introduced in a tertiary care pediatric hospital in Northern Italy, which estimates the mean number of daily hand decontamination procedures performed per patient. Methods. The total amount of isopropyl alcohol and chlorhexidine solution supplied in a trimester to each hospital ward was put in relation with the number of hospitalization days, and expressed as litres/1000 hospitalization-days (World Health Organization standard method). Moreover, the ratio between the total volume of hand hygiene products supplied and the effective amount of hand disinfection product needed for a correct procedure was calculated. Then, this number was divided by 90 (days in a quarter) and then by the mean number of bed active in each day in a Unit, resulting in the mean estimated number of hand hygiene procedures per patient per day (new method). Results. The two methods had similar performance for estimating the adherence to correct hand disinfection procedures. The new method identified wards and/or periods with high or low adherence to the procedure and indicated where to perform interventions and their effectiveness. The new method could result easy-to understand also for non-infection control experts. Conclusions. This method can help non-infection control experts to understand adherence to correct hand-hygiene procedures and improve quality standards. PMID:28167854

Hand-Based Biometric Analysis

NASA Technical Reports Server (NTRS)

Bebis, George

2013-01-01

Hand-based biometric analysis systems and techniques provide robust hand-based identification and verification. An image of a hand is obtained, which is then segmented into a palm region and separate finger regions. Acquisition of the image is performed without requiring particular orientation or placement restrictions. Segmentation is performed without the use of reference points on the images. Each segment is analyzed by calculating a set of Zernike moment descriptors for the segment. The feature parameters thus obtained are then fused and compared to stored sets of descriptors in enrollment templates to arrive at an identity decision. By using Zernike moments, and through additional manipulation, the biometric analysis is invariant to rotation, scale, or translation or an input image. Additionally, the analysis uses re-use of commonly seen terms in Zernike calculations to achieve additional efficiencies over traditional Zernike moment calculation.

9 CFR 71.11 - Cresylic disinfectant as permitted disinfectant; specifications.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Cresylic disinfectant as permitted disinfectant; specifications. 71.11 Section 71.11 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND...

9 CFR 71.11 - Cresylic disinfectant as permitted disinfectant; specifications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Cresylic disinfectant as permitted disinfectant; specifications. 71.11 Section 71.11 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND...

9 CFR 71.11 - Cresylic disinfectant as permitted disinfectant; specifications.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Cresylic disinfectant as permitted disinfectant; specifications. 71.11 Section 71.11 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND...

9 CFR 71.11 - Cresylic disinfectant as permitted disinfectant; specifications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Cresylic disinfectant as permitted disinfectant; specifications. 71.11 Section 71.11 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND...

STOPFLU: is it possible to reduce the number of days off in office work by improved hand-hygiene?

PubMed Central

2010-01-01

Background Acute infectious diseases are major causes of short periods of days off from work, day care and school. These diseases are mainly caused by viruses and hands have a key role in their transmission. Thus, hypothetically, they can be controlled with means of intensified hand hygiene. In this study we aim to elucidate the effect of acute infectious diseases on the work contribution in common office work and study the influence of improved hand hygiene on possible reduction of infectious disease episodes and days off from work due to acute infectious diseases. Design The voluntary participants have been recruited from six companies in the Helsinki region. The designated 21 study clusters were identified as operationally distinct working units each containing at least 50 people. The clusters were matched and randomized based on results of a pre-trial contagion risk survey. Improved hand hygiene is being executed with guided hand-washing with soap and water in one intervention arm and with alcohol based hand rubbing disinfectant in the other. Participants in both arms have received guidance on how to avoid infections and how to implement contagion stopping habits. A control arm is acting as before regarding hand hygiene. Data collection for evaluation of the efficacy of the interventions is based on self-reporting through weekly electronic reports. The questionnaire is enquiring about possible respiratory or gastrointestinal symptoms during the preceding week, and requests a daily report of presence of symptoms and working capacity. Etiology of the symptoms is not searched for individually, but contribution of different viruses is evaluated by sentinel surveillance, where occupational health clinics located in the premises of the participating companies collect specimens from employees visiting the clinic. Common causative agents of the diseases are being searched for using real-time PCR techniques. The duration of the intervention will be 16 months. Primary

Influence of ultrasound enhancement on chlorine dioxide consumption and disinfection by-products formation for secondary effluents disinfection.

PubMed

Zhou, Xiaoqin; Zhao, Junyuan; Li, Zifu; Lan, Juanru; Li, Yajie; Yang, Xin; Wang, Dongling

2016-01-01

Chlorine dioxide (ClO2) has been promoted as an alternative disinfectant because of its high disinfection efficiency and less formation of organic disinfection by-products (DBPs). However, particle-associated microorganisms could be protected during the disinfection process, which decreases the disinfection efficiency or increases the required dosage. Besides, the formation of inorganic disinfection by-products is a significant concern in environment health. Ultrasound (US)-combined disinfection methods are becoming increasingly attractive because they are efficient and environmentally friendly. In this study, US was introduced as an enhancement method to identify its influence on ClO2 demand reduction and to minimize the production of potential DBPs for secondary effluents disinfection. Fecal coliform was used as an indicator, and DBPs, including trichloromethane (TCM), dichloroacetic acid (DCAA), trichloroacetic acid (TCAA), chlorite (ClO2(-)), and chlorate (ClO3(-)), were analyzed to observe the potential DBPs formation. Results show that US pretreatment could reduce half of ClO2 dosage compared with ClO2 disinfection alone for the same disinfection efficiency, and that an input power density of 2.64 kJ/L pretreatment with the 1.5mg/L ClO2 was enough to meet the discharge requirement in China (i.e., fecal coliform below 1000 CFU/L for Class 1A) for secondary effluent disinfection, and the ClO2(-) concentration in the disinfection effluent was only 1.37 mg/L at the same time. Furthermore, the different effects of US on the two processes (US as pretreatment and simultaneous US/ClO2 disinfection) were also analyzed, including deagglomerating, cell damage, and synergistic disinfection as well as degasing/sonolysis. It was proved that the production of TCM, DCAA, and TCAA was insignificantly influenced with the introduction of US, but US pretreatment did reduce the production of ClO2(-) and ClO3(-) effectually. In general, US pretreatment could be a better option for

Improved contact lens disinfection by exposure to violet radiation.

PubMed

Hoenes, Katharina; Stangl, Felix; Gross, Andrej; Hessling, Martin

2016-01-01

Conventional procedures for contact lens disinfection, based on solutions with aggressive chemical ingredients, not only affect microorganisms but operate likewise damaging towards the epithelial eye surface. The aim of this study was to evaluate the applicability of an alternative or complementary disinfection procedure for contact lenses based on irradiation within the visible wavelength range. Suspensions of S. auricularis, B. subtilis and E. coli were exposed to 405 nm irradiation, for determining the disinfection efficacy. Surviving rates were analyzed by membrane filtration as well as a semi-quantitative analysis using DipSlides. A significant antibacterial effect of the 405 nm irradiation is verifiable for all probed bacteria. Using S. auricularis, there has been no colony forming after an irradiation exposure of 2 hours. The hitherto existing results give reason for the assumption that violet LEDs integrated in contact lens cases will provide a subsidiary disinfection activity and maybe even offer the reduction of chemical ingredients in lens cleaning solutions to become gentler to the eye. In addition the danger of a rerise of the germ concentration after the completion of the disinfection procedure will be reduced.

Pilot study to evaluate 3 hygiene protocols on the reduction of bacterial load on the hands of veterinary staff performing routine equine physical examinations.

PubMed

Traub-Dargatz, Josie L; Weese, J Scott; Rousseau, Joyce D; Dunowska, Magdalena; Morley, Paul S; Dargatz, David A

2006-07-01

Reduction factors (RFs) for bacterial counts on examiners' hands were compared when performing a standardized equine physical examination, followed by the use of one of 3 hand-hygiene protocols (washing with soap, ethanol gel application, and chlorohexidine-ethanol application). The mean RFs were 1.29 log10 and 1.44 log10 at 2 study sites for the alcohol-gel (62% ethyl alcohol active ingredient) protocols and 1.47 log10 and 1.94 log10 at 2 study sites for the chlorhexidine-alcohol (61% ethyl alcohol plus 1% chlorhexidine active ingredients) protocols, respectively. The RFs were significantly different (P < 0.0001) between the hand-washing group and the other 2 treatment groups (the alcohol-gel and the chlorhexidine-alcohol lotion). The use of alcohol-based gels or chlorhexidine-alcohol hand hygiene protocols must still be proven effective in equine practice settings, but in this study, these protocols were equivalent or superior to hand washing for reduction in bacterial load on the hands of people after they perform routine physical examinations.

Pilot study to evaluate 3 hygiene protocols on the reduction of bacterial load on the hands of veterinary staff performing routine equine physical examinations

PubMed Central

Traub-Dargatz, Josie L.; Weese, J. Scott; Rousseau, Joyce D.; Dunowska, Magdalena; Morley, Paul S.; Dargatz, David A.

2006-01-01

Abstract Reduction factors (RFs) for bacterial counts on examiners’ hands were compared when performing a standardized equine physical examination, followed by the use of one of 3 hand-hygiene protocols (washing with soap, ethanol gel application, and chlorohexidine-ethanol application). The mean RFs were 1.29 log10 and 1.44 log10 at 2 study sites for the alcohol-gel (62% ethyl alcohol active ingredient) protocols and 1.47 log10 and 1.94 log10 at 2 study sites for the chlorhexidine-alcohol (61% ethyl alcohol plus 1% chlorhexidine active ingredients) protocols, respectively. The RFs were significantly different (P < 0.0001) between the hand-washing group and the other 2 treatment groups (the alcohol-gel and the chlorhexidine-alcohol lotion). The use of alcohol-based gels or chlorhexidine-alcohol hand hygiene protocols must still be proven effective in equine practice settings, but in this study, these protocols were equivalent or superior to hand washing for reduction in bacterial load on the hands of people after they perform routine physical examinations. PMID:16898109

Divergent opinions on surface disinfection: myths or prevention? A review of the literature

PubMed Central

Exner, Martin

2007-01-01

Virtually no prevention strategy in hospital hygiene has been the focus of such frequent controversial discussions as the role of surface disinfection. Set against that background, the Commission for Hospital Hygiene and Infection Prevention at the Robert Koch Institute founded a working group comprising members with divergent views of risk evaluation as regards the role of disinfection. This working group produced a most carefully drafted guideline on how to deal with various risk areas and also incorporated a new provision into the guideline, stating that: “Cleaning and disinfection procedures must be organized and implemented such that there is no increase in the microbial load or spread of facultatively pathogenic or pathogenic microorganisms on surfaces.” Numerous studies have come to the conclusion that surface disinfection constitutes a basic infection control measure with which the spread of pathogens can be controlled. Conversely, when using only detergents such a form of control is not possible, something that must be taken into account in future when engaging in risk evaluation and formulating infection control measures. In view of the burgeoning trend in, for example, norovirus outbreaks, also in hospitals and nursing homes, such insights are of paramount importance and attest to the need for disinfection of surfaces and of areas with frequent hand and skin contacts. This discussion about the need for surface disinfection has, in addition to causing confusion among users, led to a decline in the willingness to accept hygienic practices, thus increasing the risk of occurrence of nosocomial infections as well as of antibiotic-resistant microorganisms. PMID:20200680

Divergent opinions on surface disinfection: myths or prevention? A review of the literature.

PubMed

Exner, Martin

2007-09-13

Virtually no prevention strategy in hospital hygiene has been the focus of such frequent controversial discussions as the role of surface disinfection. Set against that background, the Commission for Hospital Hygiene and Infection Prevention at the Robert Koch Institute founded a working group comprising members with divergent views of risk evaluation as regards the role of disinfection. This working group produced a most carefully drafted guideline on how to deal with various risk areas and also incorporated a new provision into the guideline, stating that: "Cleaning and disinfection procedures must be organized and implemented such that there is no increase in the microbial load or spread of facultatively pathogenic or pathogenic microorganisms on surfaces."Numerous studies have come to the conclusion that surface disinfection constitutes a basic infection control measure with which the spread of pathogens can be controlled. Conversely, when using only detergents such a form of control is not possible, something that must be taken into account in future when engaging in risk evaluation and formulating infection control measures. In view of the burgeoning trend in, for example, norovirus outbreaks, also in hospitals and nursing homes, such insights are of paramount importance and attest to the need for disinfection of surfaces and of areas with frequent hand and skin contacts. This discussion about the need for surface disinfection has, in addition to causing confusion among users, led to a decline in the willingness to accept hygienic practices, thus increasing the risk of occurrence of nosocomial infections as well as of antibiotic-resistant microorganisms.

Inactivation kinetics of spores of Bacillus cereus strains treated by a peracetic acid-based disinfectant at different concentrations and temperatures.

PubMed

Sudhaus, Nadine; Pina-Pérez, Maria Consuelo; Martínez, Antonio; Klein, Günter

2012-05-01

The purpose of this study was to assess the effect of a commercial peracetic acid-based disinfectant against spores of Bacillus cereus, to identify the most influential factor for the final number of microorganisms after different disinfection procedures, and to evaluate the nature of the inactivation kinetics. The spores of four different strains of B. cereus (DSM 318, 4312, 4313, and 4384) were treated with five different disinfectant concentrations (0.25%, 0.5%, 1.0%, 1.5%, and 2.0% [w/v]) at three different temperatures (10°C, 15°C, and 20°C) with or without protein load. A higher temperature and PES 15/23 concentration resulted in a higher inactivation. Inactivation of B. cereus strain 4312 was around 2 log₁₀ cycles at 10°C and around 7 log₁₀ at 20°C (conc=1% [w/v] PAA; t=60 min; without protein). The protein load at higher concentrations did not significantly reduce the efficacy of the disinfectant (p>0.05). This article indicates the applicability of the Weibull model to fit the B. cereus disinfectant survival curves. A Monte Carlo simulation was used to carry out a sensitivity analysis, which revealed the most influential factors affecting the final number of microorganisms after the disinfection process.

Hand-Based Biometric Analysis

NASA Technical Reports Server (NTRS)

Bebis, George (Inventor); Amayeh, Gholamreza (Inventor)

2015-01-01

Hand-based biometric analysis systems and techniques are described which provide robust hand-based identification and verification. An image of a hand is obtained, which is then segmented into a palm region and separate finger regions. Acquisition of the image is performed without requiring particular orientation or placement restrictions. Segmentation is performed without the use of reference points on the images. Each segment is analyzed by calculating a set of Zernike moment descriptors for the segment. The feature parameters thus obtained are then fused and compared to stored sets of descriptors in enrollment templates to arrive at an identity decision. By using Zernike moments, and through additional manipulation, the biometric analysis is invariant to rotation, scale, or translation or an in put image. Additionally, the analysis utilizes re-use of commonly-seen terms in Zernike calculations to achieve additional efficiencies over traditional Zernike moment calculation.

A PC-based software test for measuring alcohol and drug effects in human subjects.

PubMed

Mills, K C; Parkman, K M; Spruill, S E

1996-12-01

A new software-based visual search and divided-attention test of cognitive performance was developed and evaluated in an alcohol dose-response study with 24 human subjects aged 21-62 years. The test used language-free, color, graphic displays to represent the visuospatial demands of driving. Cognitive demands were increased over previous hardware-based tests, and the motor skills required for the test involved minimal eye movements and eye-hand coordination. Repeated performance on the test was evaluated with a latin-square design by using a placebo and two alcohol doses, low (0.48 g/kg/LBM) and moderate (0.72 g/kg/LBM). The data on 7 females and 17 males yielded significant falling and rising impairment effects coincident with moderate rising and falling breath alcohol levels (mean peak BrALs = 0.045 g/dl and 0.079 g/dl). None of the subjects reported eye-strain or psychomotor fatigue as compared with previous tests. The high sensitivity/variance relative to use in basic and applied research, and worksite fitness-for-duty testing, was discussed. The most distinct advantage of a software-based test that operates on readily available PCs is that it can be widely distributed to researchers with a common reference to compare a variety of alcohol and drug effects.

Anti-bacterial efficacy of alcoholic hand rubs in the Kenyan market, 2015.

PubMed

Ochwoto, Missiani; Muita, Lucy; Talaam, Keith; Wanjala, Cecilia; Ogeto, Frank; Wachira, Faith; Osman, Saida; Kimotho, James; Ndegwa, Linus

2017-01-01

Hand hygiene is known to be effective in preventing hospital and community-acquired infections. The increasing number of hand sanitizer brands in Kenyan hospitals and consumer outlets is of concern. Thus the main aim of this study was to evaluate the anti-bacterial efficacy and organoleptic properties of these hand sanitizers in Kenya. This was an experimental, laboratory-based study of 14 different brands of hand sanitizers (coded HS1-14) available in various retail outlets and hospitals in Kenya. Efficacy was evaluated using standard non-pathogenic Escherichia coli (ATCC 25922), Staphylococcus aureus (ATCC 25923) and Pseudomonas aeruginosa (ATCC 27853) as per the European Standard (EN). The logarithmic reduction factors (RF) were assessed at baseline and after treatment, and log reduction then calculated. Ten and 25 healthy volunteers participated in the efficacy and organoleptic studies respectively. Four (28.6%) hand sanitizers (HS12, HS9, HS13 and HS14) showed a 5.9 reduction factor on all the three bacteria strains. Seven (50%) hand sanitizers had efficacies of <3 against all the three bacteria strains used. Efficacy on E. Coli was higher compared to the other pathogens. Three hand sanitizers were efficacious on one of the pathogens and not the other. In terms of organoleptic properties, gel-based formulations were rated far higher than the liquid based formulations brands. Fifty percent (50%) of the selected hand sanitizers in the Kenyan market have efficacy that falls below the World Health Organization (WHO) and DIN EN 1500:2013. Of the 14 hand sanitizers found in the Kenyan market, only four showed efficacies that were comparable to the WHO-formulation. There is a need to evaluate how many of these products with <3 efficacy that have been incorporated into the health system for hand hygiene and the country's policy on regulations on their usage.

Effect of peracetic acid, ultraviolet radiation, nanofiltration-chlorine in the disinfection of a non conventional source of water (Tula Valley).

PubMed

Trujillo, J; Barrios, J A; Jimenez, B

2008-01-01

Water supply for human consumption requires certain quality that reduces health risks to consumers. In this sense, the process of disinfection plays an important role in the elimination of pathogenic microorganisms. Even though chlorination is the most applied process based on its effectiveness and cost, its application is being questioned considering the formation of disinfection by-products (DBPs). Therefore, alternative disinfectants are being evaluated and some treatment processes have been proposed to remove DBPs precursors (organic matter. This paper reports the results of disinfection of a non conventional source of water (aquifer recharged unintentionally with raw wastewater) with peracetic acid (PAA) and ultraviolet radiation (UV) as well as nanofiltration (NF) followed by chlorination to produce safe drinking water. The results showed that a dose of 2 mg/L PAA was needed to eliminate total and faecal coliforms. For UV light, a dose of 12.40 mWs/cm2 reduced total and faecal coliforms below the detection limit. On the other hand, chlorine demand of water before NF was 1.1-1.3 mg/L with a trihalomethane formation potential (THMFP) of 118.62 microg/L, in contrast with chlorination after NF where the demand was 0.5 mg/L and THMFP of 17.64 microg/L. The recommended scheme is nanofiltration + chlorination.

Innovative Plasma Disinfection Technique with the Reduced-pH Method and the Plasma-Treated Water (PTW) -Safety and Powerful Disinfection with Cryopreserved PTW-

NASA Astrophysics Data System (ADS)

Kitano, Katsuhisa; Ikawa, Satoshi; Nakashima, Yoichi; Tani, Atsushi; Yokoyama, Takashi; Ohshima, Tomoko

2015-09-01

Among the applications of the plasma disinfection to human body, plasma sterilization in liquid is crucial. We found that the plasma-treated water (PTW) has strong bactericidal activity under low pH condition and the half-lives of its activity depend on temperature. Lower temperature brings longer half-life and the bactericidal activity of PTW can be kept by cryopreservation. These physicochemical properties were in accordance with Arrhenius equation both in liquid and solid states. From the experimental results of ESR (Electron Spin Resonance) measurement of O2-in liquid against PTW with spin trapping method, half-lives of PTW were also in accordance with Arrhenius equation. It suggests that high concentration PTW as integrated value can be achieved by cooling of plasma apparatus. Pure PTW has disinfection power of 22 log reduction (B. subtilis). This corresponds to 65% H2O2, 14% hypochlorous acid and 0.33% peracetic acid, which are deadly poison for human. On the other hand, PTW is deactivated soon at body temperature. This indicates that toxicity to human body seems to be low. PTW, which is a sort of indirect plasma exposure, with pH and temperature controls could be applied for safety and powerful disinfection. MEXT (15H03583, 23340176, 25108505). NCCE (23-A-15).

DISINFECTION OF NEW WATER MAINS

EPA Science Inventory

The 'AWWA Standard for Disinfecting Water Mains' (AWWA C601-68) has fallen into disuse by a number of water utilities because of repeated bacteriological failures following initial disinfection with the recommended high-dose chlorination. Other methods of disinfection, including ...

Fetal alcohol effects in alcoholic veteran patients.

PubMed

Tishler, P V; Henschel, C E; Ngo, T A; Walters, E E; Worobec, T G

1998-11-01

Fetal alcohol syndrome is often associated with severe physical and neuropsychiatric maldevelopment. On the other hand, some offspring of women who drank during pregnancy appear to be affected in minimal ways and function relatively well within society. We questioned whether this effect of prenatal alcohol in the adult is generally minimal. To bear on this, we determined whether we could distinguish alcohol-exposed from nonexposed individuals in a population of male veterans, selected because of both their accepted level of function within society (e.g., honorable discharge from the military) and their admission to an alcohol treatment unit (thus, a greater likelihood of parental alcoholism, because of its familial aggregation). Consecutively admitted alcoholics (cases; n = 77) with likely maternal alcohol ingestion during their pregnancy or the first 10 years of life were matched with alcoholics with no maternal alcohol exposure during these periods (controls; n = 161). Each subject completed questionnaires regarding personal birthweight, alcohol, drug, educational and work histories, and family (including parental) alcohol and drug histories. We measured height, weight, and head circumference; checked for facial and hand anomalies; and took a frontal facial photograph, from which measurements of features were made. Data were analyzed by univariate statistics and stepwise logistic regression. No case had bona fide fetal alcohol syndrome. With univariate statistical analyses, the cases differed from the controls in 10 variables, including duration of drinking, width of alae nasae, being hyperactive or having a short attention span, and being small at birth. By stepwise logistic regression, the variables marital status, small size at birth, duration of drinking, and the presence of a smooth philtrum were marginally (the first two) or definitely (the last two) significant predictors of case status. Analysis of only the 37 cases in whom maternal prenatal drinking was

Quest for a Realistic In Vivo Test Method for Antimicrobial Hand-Rub Agents: Introduction of a Low-Volume Hand Contamination Procedure▿

PubMed Central

Macinga, David R.; Beausoleil, Christopher M.; Campbell, Esther; Mulberry, Gayle; Brady, Ann; Edmonds, Sarah L.; Arbogast, James W.

2011-01-01

A novel method has been developed for the evaluation of alcohol-based hand rubs (ABHR) that employs a hand contamination procedure that more closely simulates the in-use conditions of ABHR. Hands of human subjects were contaminated with 0.2 ml of a concentrated suspension of Serratia marcescens (ATCC 14756) to achieve baseline contamination between 8 and 9 log10 CFU/hand while allowing product to be applied to dry hands with minimal soil load. Evaluation of 1.5 ml of an ABHR gel containing 62% ethanol produced log10 reductions of 2.66 ± 0.96, 2.40 ± 0.50, 2.41 ± 0.61, and 2.33 ± 0.49 (means ± standard deviations) after 1, 3, 7, and 10 successive contamination/product application cycles. In a study comparing this low-volume contamination (LVC) method to ASTM E1174, product dry times were more realistic and log10 reductions achieved by the ABHR were significantly greater when LVC was employed (P < 0.05). These results indicate that a novel low-volume hand contamination procedure, which more closely represents ABHR use conditions, provides more realistic estimates of in-use ABHR efficacies. Based on the LVC method, log10 reductions produced by ABHR were strongly dependent on the test product application volume (P < 0.0001) but were not influenced by the alcohol concentration when it was within the range of 62 to 85% (P = 0.378). PMID:22003004

An environmental disinfection odyssey: evaluation of sequential interventions to improve disinfection of Clostridium difficile isolation rooms.

PubMed

Sitzlar, Brett; Deshpande, Abhishek; Fertelli, Dennis; Kundrapu, Sirisha; Sethi, Ajay K; Donskey, Curtis J

2013-05-01

OBJECTIVE. Effective disinfection of hospital rooms after discharge of patients with Clostridium difficile infection (CDI) is necessary to prevent transmission. We evaluated the impact of sequential cleaning and disinfection interventions by culturing high-touch surfaces in CDI rooms after cleaning. DESIGN. Prospective intervention. SETTING. A Veterans Affairs hospital. INTERVENTIONS. During a 21-month period, 3 sequential tiered interventions were implemented: (1) fluorescent markers to provide monitoring and feedback on thoroughness of cleaning facility-wide, (2) addition of an automated ultraviolet radiation device for adjunctive disinfection of CDI rooms, and (3) enhanced standard disinfection of CDI rooms, including a dedicated daily disinfection team and implementation of a process requiring supervisory assessment and clearance of terminally cleaned CDI rooms. To determine the impact of the interventions, cultures were obtained from CDI rooms after cleaning and disinfection. RESULTS. The fluorescent marker intervention improved the thoroughness of cleaning of high-touch surfaces (from 47% to 81% marker removal; P < .0001). Relative to the baseline period, the prevalence of positive cultures from CDI rooms was reduced by 14% (P=.024), 48% (P <.001), and 89% (P=.006) with interventions 1, 2, and 3, respectively. During the baseline period, 67% of CDI rooms had positive cultures after disinfection, whereas during interventions periods 1, 2, and 3 the percentages of CDI rooms with positive cultures after disinfection were reduced to 57%, 35%, and 7%, respectively. CONCLUSIONS. An intervention that included formation of a dedicated daily disinfection team and implementation of a standardized process for clearing CDI rooms achieved consistent CDI room disinfection. Culturing of CDI rooms provides a valuable tool to drive improvements in environmental disinfection.

Outbreak of human metapneumovirus infection in psychiatric inpatients: implications for directly observed use of alcohol hand rub in prevention of nosocomial outbreaks.

PubMed

Cheng, V C C; Wu, A K L; Cheung, C H Y; Lau, S K P; Woo, P C Y; Chan, K H; Li, K S M; Ip, I K S; Dunn, E L W; Lee, R A; Yam, L Y C; Yuen, K Y

2007-12-01

Nosocomial outbreaks of infectious diseases in psychiatric facilities are not uncommon but the implementation of infection control measures is often difficult. Here, we report an outbreak of an acute respiratory illness in a psychiatric ward between 29 July and 20 August 2005 involving 31 patients. Human metapneumovirus was detected in seven (23%) patients by reverse transcription-polymerase chain reaction and nucleotide sequencing. A review of outbreak surveillance records showed that six nosocomial outbreaks occurred in the year 2005, of which four (67%) were confirmed or presumably related to a respiratory viral infection. Directly observed deliveries of alcohol hand rub 4-hourly during daytime to all psychiatric patients was instituted in December 2005. Only one nosocomial respiratory viral outbreak occurred in the following year. The total number of patients and staff involved in nosocomial outbreaks due to presumed or proven respiratory virus infections decreased significantly from 60 to six (P<0.001), whereas those due to all types of nosocomial outbreaks also decreased from 70 to 24 (P=0.004). Alcohol hand rub has been shown to have potent bactericidal and virucidal activity against a wide range of nosocomial pathogens. Regular use of directly observed alcohol hand rub may decrease the incidence and scale of nosocomial outbreaks due to enveloped respiratory viruses especially in mentally incapacitated patients.

Effect of well disinfection on arsenic in ground water

USGS Publications Warehouse

Gotkowitz, M.; Ellickson, K.; Clary, A.; Bowman, G.; Standridge, J.; Sonzogni, W.

2008-01-01

Domestic water wells are routinely subjected to in situ chemical disinfection treatments to control nuisance or pathogenic bacteria. Most treatments are chlorine based and presumably cause strongly oxidizing conditions in the wellbore. Water resource managers in Wisconsin were concerned that such treatments might facilitate release of arsenic from sulfide minerals disseminated within a confined sandstone aquifer. To test this hypothesis, a well was subjected to four disinfection treatments over 9 months time. The first treatment consisted of routine pumping of the well without chemical disinfection; three subsequent treatments included chlorine disinfection and pumping. Pretreatment arsenic concentrations in well water ranged from 7.4 to 18 ??g/L. Elevated arsenic concentrations up to 57 ??g/L in the chemical treatment solutions purged from the well are attributed to the disintegration or dissolution of biofilms or scale. Following each of the four treatments, arsenic concentrations decreased to less than 10 ??g/L during a period of pumping. Arsenic concentrations generally returned to pretreatment levels under stagnant, nonpumping conditions imposed following each treatment. Populations of iron-oxidizing, heterotrophic, and sulfate-reducing bacteria decreased following chemical treatments but were never fully eradicated from the well. Strongly oxidizing conditions were induced by the chlorine-based disinfections, but the treatments did not result in sustained increases in well water arsenic. Results suggest that disruption of biofilm and mineral deposits in the well and the water distribution system in tandem with chlorine disinfection can improve water quality in this setting. ?? 2008 The Author(s).

Multicenter intervention program to increase adherence to hand hygiene recommendations and glove use and to reduce the incidence of antimicrobial resistance.

PubMed

Trick, William E; Vernon, Michael O; Welbel, Sharon F; Demarais, Patricia; Hayden, Mary K; Weinstein, Robert A

2007-01-01

To determine whether a multimodal intervention could improve adherence to hand hygiene and glove use recommendations and decrease the incidence of antimicrobial resistance in different types of healthcare facilities. Prospective, observational study performed from October 1, 1999, through December 31, 2002. We monitored adherence to hand hygiene and glove use recommendations and the incidence of antimicrobial-resistant bacteria among isolates from clinical cultures. We evaluated trends in and predictors for adherence and preferential use of alcohol-based hand rubs, using multivariable analyses. Three intervention hospitals (a 660-bed acute and long-term care hospital, a 120-bed community hospital, and a 600-bed public teaching hospital) and a control hospital (a 700-bed university teaching hospital).Intervention. At the intervention hospitals, we introduced or increased the availability of alcohol-based hand rub, initiated an interactive education program, and developed a poster campaign; at the control hospital, we only increased the availability of alcohol-based hand rub. We observed 6,948 hand hygiene opportunities. The frequency of hand hygiene performance or glove use significantly increased during the study period at the intervention hospitals but not at the control hospital; the maximum quarterly frequency of hand hygiene performance or glove use at intervention hospitals (74%, 80%, and 77%) was higher than that at the control hospital (59%). By multivariable analysis, preferential use of alcohol-based hand rubs rather than soap and water for hand hygiene was more likely among workers at intervention hospitals compared with nonintervention hospitals (adjusted odds ratio, 4.6 [95% confidence interval, 3.3-6.4]) and more likely among physicians (adjusted odds ratio, 1.4 [95% confidence interval, 1.2-1.8]) than among nurses at intervention hospitals. A significantly reduced incidence of antimicrobial-resistant bacteria among isolates from clinical culture was

Risk assessment of waste-water disinfection. Report for October 1979-January 1984

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hubly, D.; Chappell, W.; Lanning, J.

A risk-assessment data base is presented for several waste-water disinfection alternatives, including chlorination, ozonation, chlorination/dechlorination, and ultraviolet radiation. The data base covers hazards and consequences related to onsite use and transportation of the disinfectants and ultimate disposal of disinfected effluents. A major segment of the data base deals with the effects of chlorination products in aquatic ecosystems. Energy consumption and cost analyses are also presented for chlorination and ozonation. Example risk calculations are presented for two hypothetical waste-water treatment plants. The usefulness of the data base for risk assessment is also discussed.

[Improvement of effectivity of photo disinfection of water from bacterial contaminants in the presence of heterogeneous sensitizers based on phthalocyanines grafted to aminopropyl silicagel].

PubMed

Maksimkina, T N; Artemova, T Z; Kuznetsova, N A; Sinitsyna, O O; Gipp, E K; Zagaĭnova, A V; Butorina, N N; Iuzhakova, O A; Krasniak, A V

2012-01-01

The possibility of using 12 heterogeneous sensitizers (HS) based on phthalocyanines covalently grafted to aminopropyl silicagel for disinfection of water from bacteria has been studied. For reliable water quality control the technique of performing bacteriological analysis in the presence of HS beads in the sample has been elaborated. The conditions increasing the efficiency of photo disinfection in the presence of HS were studied. Algorithm for estimation of photo disinfectant effect of HS against bacteria was substantiated. Obtained data confirm the perspective of further studies on the substantiation of the possibility of the application of HS for water disinfection.

Commercial Ethyl Glucuronide (EtG) and Ethyl Sulfate (EtS) Testing is Not Vulnerable to Incidental Alcohol Exposure in Pregnant Women.

PubMed

Ondersma, Steven J; Beatty, Jessica R; Rosano, Thomas G; Strickler, Ronald C; Graham, Amy E; Sokol, Robert J

2016-01-02

Ethyl Glucoronide (EtG) and Ethyl Sulfate (EtS) have shown promise as biomarkers for alcohol and may be sensitive enough for use with pregnant women in whom even low-level alcohol use is important. However, there have been reports of over-sensitivity of EtG and EtS to incidental exposure to sources such as alcohol-based hand sanitizer. Further, few studies have evaluated these biomarkers among pregnant women, in whom the dynamics of these metabolites may differ. This study evaluated whether commercial EtG-EtS testing was vulnerable to high levels of environmental exposure to alcohol in pregnant women. Two separate samples of five nurses-one pregnant and the other postpartum, all of whom reported high levels of alcohol-based hand sanitizer use-provided urine samples before and 4-8 hours after rinsing with alcohol-based mouthwash and using hand sanitizer. The five pregnant nurses provided urine samples before, during, and after an 8-hour nursing shift, during which they repeatedly cleansed with alcohol-based hand sanitizer (mean 33.8 uses). The five postpartum nurses used hand sanitizer repeatedly between baseline and follow-up urine samples. No urine samples were positive for EtG-EtS at baseline or follow-up, despite use of mouthwash and-in the pregnant sample-heavy use of hand sanitizer (mean of 33.8 uses) throughout the 8-hour shift. Current, commercially available EtG-EtS testing does not appear vulnerable to even heavy exposure to incidental sources of alcohol among pregnant and postpartum women.

Commercial Ethyl Glucuronide (EtG) and Ethyl Sulfate (EtS) Testing is not Vulnerable to Incidental Alcohol Exposure in Pregnant Women

PubMed Central

Beatty, Jessica R.; Rosano, Thomas G.; Strickler, Ronald C.; Graham, Amy E.; Sokol, Robert J.

2016-01-01

Background Ethyl Glucoronide (EtG) and Ethyl Sulfate (EtS) have shown promise as biomarkers for alcohol and may be sensitive enough for use with pregnant women in whom even low-level alcohol use is important. However, there have been reports of over-sensitivity of EtG and EtS to incidental exposure to sources such as alcohol-based hand sanitizer. Further, few studies have evaluated these biomarkers among pregnant women, in whom the dynamics of these metabolites may differ. Objectives This study evaluated whether commercial EtG-EtS testing was vulnerable to high levels of environmental exposure to alcohol in pregnant women. Methods Two separate samples of five nurses—one pregnant and the other postpartum, all of whom reported high levels of alcohol-based hand sanitizer use—provided urine samples before and 4–8 hours after rinsing with alcohol-based mouthwash and using hand sanitizer. The five pregnant nurses provided urine samples before, during, and after an 8-hour nursing shift, during which they repeatedly cleansed with alcohol-based hand sanitizer (mean 33.8 uses). The five postpartum nurses used hand sanitizer repeatedly between baseline and follow-up urine samples. Results No urine samples were positive for EtG-EtS at baseline or follow-up, despite use of mouthwash and—in the pregnant sample—heavy use of hand sanitizer (mean of 33.8 uses) throughout the 8-hour shift. Conclusions/Importance Current, commercially available EtG-EtS testing does not appear vulnerable to even heavy exposure to incidental sources of alcohol among pregnant and postpartum women. PMID:26771303

A randomized controlled trial of household-based flocculant-disinfectant drinking water treatment for diarrhea prevention in rural Guatemala.

PubMed

Reller, Megan E; Mendoza, Carlos E; Lopez, M Beatriz; Alvarez, Maricruz; Hoekstra, Robert M; Olson, Christy A; Baier, Kathleen G; Keswick, Bruce H; Luby, Stephen P

2003-10-01

We conducted a study to determine if use of a new flocculant-disinfectant home water treatment reduced diarrhea. We randomly assigned 492 rural Guatemalan households to five different water treatment groups: flocculant-disinfectant, flocculant-disinfectant plus a customized vessel, bleach, bleach plus a vessel, and control. During one year of observation, residents of control households had 4.31 episodes of diarrhea per 100 person-weeks, whereas the incidence of diarrhea was 24% lower among residents of households receiving flocculant-disinfectant, 29% lower among those receiving flocculant-disinfectant plus vessel, 25% lower among those receiving bleach, and 12% lower among households receiving bleach plus vessel. In unannounced evaluations of home drinking water, free chlorine was detected in samples from 27% of flocculant-disinfectant households, 35% of flocculant-disinfectant plus vessel households, 35% of bleach households, and 43% of bleach plus vessel households. In a setting where diarrhea was a leading cause of death, intermittent use of home water treatment with flocculant-disinfectant decreased the incidence of diarrhea.

Comparison of Standard Culture-Based Method to Culture-Independent Method for Evaluation of Hygiene Effects on the Hand Microbiome.

PubMed

Zapka, C; Leff, J; Henley, J; Tittl, J; De Nardo, E; Butler, M; Griggs, R; Fierer, N; Edmonds-Wilson, S

2017-03-28

Hands play a critical role in the transmission of microbiota on one's own body, between individuals, and on environmental surfaces. Effectively measuring the composition of the hand microbiome is important to hand hygiene science, which has implications for human health. Hand hygiene products are evaluated using standard culture-based methods, but standard test methods for culture-independent microbiome characterization are lacking. We sampled the hands of 50 participants using swab-based and glove-based methods prior to and following four hand hygiene treatments (using a nonantimicrobial hand wash, alcohol-based hand sanitizer [ABHS], a 70% ethanol solution, or tap water). We compared results among culture plate counts, 16S rRNA gene sequencing of DNA extracted directly from hands, and sequencing of DNA extracted from culture plates. Glove-based sampling yielded higher numbers of unique operational taxonomic units (OTUs) but had less diversity in bacterial community composition than swab-based sampling. We detected treatment-induced changes in diversity only by using swab-based samples ( P < 0.001); we were unable to detect changes with glove-based samples. Bacterial cell counts significantly decreased with use of the ABHS ( P < 0.05) and ethanol control ( P < 0.05). Skin hydration at baseline correlated with bacterial abundances, bacterial community composition, pH, and redness across subjects. The importance of the method choice was substantial. These findings are important to ensure improvement of hand hygiene industry methods and for future hand microbiome studies. On the basis of our results and previously published studies, we propose recommendations for best practices in hand microbiome research. IMPORTANCE The hand microbiome is a critical area of research for diverse fields, such as public health and forensics. The suitability of culture-independent methods for assessing effects of hygiene products on microbiota has not been demonstrated. This is the

iHand: an interactive bare-hand-based augmented reality interface on commercial mobile phones

NASA Astrophysics Data System (ADS)

Choi, Junyeong; Park, Jungsik; Park, Hanhoon; Park, Jong-Il

2013-02-01

The performance of mobile phones has rapidly improved, and they are emerging as a powerful platform. In many vision-based applications, human hands play a key role in natural interaction. However, relatively little attention has been paid to the interaction between human hands and the mobile phone. Thus, we propose a vision- and hand gesture-based interface in which the user holds a mobile phone in one hand but sees the other hand's palm through a built-in camera. The virtual contents are faithfully rendered on the user's palm through palm pose estimation, and reaction with hand and finger movements is achieved that is recognized by hand shape recognition. Since the proposed interface is based on hand gestures familiar to humans and does not require any additional sensors or markers, the user can freely interact with virtual contents anytime and anywhere without any training. We demonstrate that the proposed interface works at over 15 fps on a commercial mobile phone with a 1.2-GHz dual core processor and 1 GB RAM.

Enhancement effects of ultrasound on secondary wastewater effluent disinfection by sodium hypochlorite and disinfection by-products analysis.

PubMed

Zhou, Xiaoqin; Zhao, Junyuan; Li, Zifu; Song, Jianing; Li, Xueying; Yang, Xin; Wang, Dongling

2016-03-01

Since fecal coliforms was introduced as a standard indicator of pollutants in effluents of municipal wastewater treatment plants in China in 2003, chlorine had been widely used in many wastewater treatment plants. However, concerns about the disinfection by-products (DBPs) of chlorine have been increasing. One of the effective way to reduce the production of DBPs is to reduce the effective chlorine dosage by improving the utilization rate of disinfectant. Ultrasound (US) is proved to be effective in wastewater treatment for its multiple chemical and physical effects produced by cavitation, which could favor the disinfection process accordingly. For the purpose of improving disinfection efficiency with the help of US, following points are addressed in the current study: (1) investigate the enhancement effects of US on the disinfection efficiency of sodium hypochlorite (NaClO) for real secondary effluents of municipal wastewater treatment plants; (2) evaluate the possibility of using US specific energy consumption (kJ/L) as an parameter for disinfection efficiency evaluation; and (3) quantify the reduction in chlorine-DBPs through US application. Results demonstrated that sonication could reduce two-thirds (US pretreatment) or one-third (simultaneous US and NaClO disinfection) of the required concentrations of NaClO (available chlorine) for 4 log reduction of fecal coliforms, which could meet the Class 1A (fecal coliforms less than 1000 CFU/L) discharge standard of China. In addition, US pretreatment with NaClO disinfection performed better enhancement in disinfection efficiency compared with simultaneous US and NaClO disinfection. Furthermore, analysis on DBPs showed that US application as pretreatment could obviously reduce the contents of trichloromethane (TCM) and trichloroacetic acid (TCAA) by more than 85% and 50%, respectively, compared with NaClO disinfection alone for the same disinfection efficiency. Meanwhile, the experimental results also showed that the

Intracellular mechanisms of solar water disinfection

NASA Astrophysics Data System (ADS)

Castro-Alférez, María; Polo-López, María Inmaculada; Fernández-Ibáñez, Pilar

2016-12-01

Solar water disinfection (SODIS) is a zero-cost intervention measure to disinfect drinking water in areas of poor access to improved water sources, used by more than 6 million people in the world. The bactericidal action of solar radiation in water has been widely proven, nevertheless the causes for this remain still unclear. Scientific literature points out that generation of reactive oxygen species (ROS) inside microorganisms promoted by solar light absorption is the main reason. For the first time, this work reports on the experimental measurement of accumulated intracellular ROS in E. coli during solar irradiation. For this experimental achievement, a modified protocol based on the fluorescent probe dichlorodihydrofluorescein diacetate (DCFH-DA), widely used for oxidative stress in eukaryotic cells, has been tested and validated for E. coli. Our results demonstrate that ROS and their accumulated oxidative damages at intracellular level are key in solar water disinfection.

Intracellular mechanisms of solar water disinfection

PubMed Central

Castro-Alférez, María; Polo-López, María Inmaculada; Fernández-Ibáñez, Pilar

2016-01-01

Solar water disinfection (SODIS) is a zero-cost intervention measure to disinfect drinking water in areas of poor access to improved water sources, used by more than 6 million people in the world. The bactericidal action of solar radiation in water has been widely proven, nevertheless the causes for this remain still unclear. Scientific literature points out that generation of reactive oxygen species (ROS) inside microorganisms promoted by solar light absorption is the main reason. For the first time, this work reports on the experimental measurement of accumulated intracellular ROS in E. coli during solar irradiation. For this experimental achievement, a modified protocol based on the fluorescent probe dichlorodihydrofluorescein diacetate (DCFH-DA), widely used for oxidative stress in eukaryotic cells, has been tested and validated for E. coli. Our results demonstrate that ROS and their accumulated oxidative damages at intracellular level are key in solar water disinfection. PMID:27909341

Intracellular mechanisms of solar water disinfection.

PubMed

Castro-Alférez, María; Polo-López, María Inmaculada; Fernández-Ibáñez, Pilar

2016-12-02

Solar water disinfection (SODIS) is a zero-cost intervention measure to disinfect drinking water in areas of poor access to improved water sources, used by more than 6 million people in the world. The bactericidal action of solar radiation in water has been widely proven, nevertheless the causes for this remain still unclear. Scientific literature points out that generation of reactive oxygen species (ROS) inside microorganisms promoted by solar light absorption is the main reason. For the first time, this work reports on the experimental measurement of accumulated intracellular ROS in E. coli during solar irradiation. For this experimental achievement, a modified protocol based on the fluorescent probe dichlorodihydrofluorescein diacetate (DCFH-DA), widely used for oxidative stress in eukaryotic cells, has been tested and validated for E. coli. Our results demonstrate that ROS and their accumulated oxidative damages at intracellular level are key in solar water disinfection.

Is it time for brushless scrubbing with an alcohol-based agent?

PubMed

Gruendemann, B J; Bjerke, N B

2001-12-01

The practice of surgical scrubbing in perioperative settings is changing rapidly. This article presents information about eliminating the traditional scrub brush technique and using an alcohol formulation for surgical hand scrubs. Also covered are antimicrobial agents, relevant US Food and Drug Administration classifications, skin and fingernail care, and implementation of changes. The article challenges surgical team members to evaluate a new and different approach to surgical hand scrubbing.

Comparative efficacy of contact lens disinfection solutions.

PubMed

Lowe, R; Vallas, V; Brennan, N A

1992-01-01

Using the D value method of analysis, we evaluated the relative antimicrobial effectiveness of eight contact lens disinfection solutions against a standard population of challenge organisms as defined in the Microbiological Guidelines proposed by the Food and Drug Administration (FDA). Six bacteria (Escherichia coli, Staphylococcus aureus, S. epidermidis, Streptococcus pneumoniae, Pseudomonas aeruginosa, and Serratia marcescens) and two fungi (Aspergillus fumigatus, Candida albicans) were investigated. The disinfectants included hydrogen peroxide (AOSept, MiraSept, Oxysept), chlorine-based solutions (Aerotab and Softab), soaking solutions containing synthetic, high molecular weight preservatives (ReNu and Opti-Free) and a thimerosal preserved soaking solution (Hydrocare Cleaning and Soaking Solution). The one-step hydrogen peroxide system (AOSept) was evaluated both with and without the catalytic disk. To facilitate comparison of the disinfecting solutions, we defined a new measure of performance, namely "power" of solution. This has an advantage over the "safety factor" because the solution power is independent of the size of the initial inoculum. Because different approaches to analysis may yield a wide range of D values for one set of survival data we call for adoption of a standardized approach. Our results suggest that one of the chlorine-based solutions fails to meet the FDA recommendations for bacterial challenge. Most solutions performed poorly against mycotic challenge. However, when used over longer disinfecting periods, 3% hydrogen peroxide and the Hydrocare solution gave adequate performance against fungi.

COMPONENT-BASED AND WHOLE-MIXTURE TECHNIQUES FOR ADDRESSING THE TOXICITY OF DRINKING-WATER DISINFECTION BY-PRODUCT MIXTURES

EPA Science Inventory

Chemical disinfection of water is of direct public health benefit as it results in decreased waterborne illness. The chemicals used to disinfect water react with naturally occurring organic matter, bromide and iodide in the source water, resulting in the formation of disinfection...

[Products for hand hygiene and antisepsis: use by health professionals and relationship with hand eczema].

PubMed

Batalla, A; García-Doval, I; de la Torre, C

2012-04-01

Hand hygiene is the most important measure for the prevention of nosocomial infection. We describe the different products available for hygiene and antisepsis of the hands and the use of these products in daily practice. Hand hygiene products such as soaps and detergents are a cause of irritant dermatitis in health professionals. This irritation is one of the principal factors affecting their use in clinical practice. Alcohol-based products are better tolerated and less irritant than soap and water; irritation should not therefore be a limiting factor in the use of these products and they are to be recommended in place of soap and water. Informative and continued education programs could increase their use. Copyright © 2011 Elsevier España, S.L. and AEDV. All rights reserved.

Sensitivity to disinfection of bacterial indicator organisms for monitoring the Salmonella Enteritidis status of layer farms after cleaning and disinfection.

PubMed

Dewaele, I; Ducatelle, R; Herman, L; Heyndrickx, M; De Reu, K

2011-06-01

The present study evaluated Escherichia coli, Enterococcus faecalis, and Enterococcus hirae as potential indicator organisms for the possible Salmonella Enteritidis (SE) presence in layer farms after cleaning and disinfection by comparing their susceptibility to disinfection. A quantitative suspension disinfection test according to European Standard EN1656 was performed using disinfection products CID20 and Virocid (both from CID Lines, Ieper, Belgium). In a preliminary test, the sensitivity to both disinfection products was compared between ATCC strains of SE, E. coli, En. faecalis, and En. hirae. The sensitivity of SE to disinfection was most comparable to that of E. coli. A second disinfection test compared the elimination of E. coli to SE ATCC strains as well as field strains. Results showed no significant effect regarding the strain (P > 0.05 for CID20 and Virocid), meaning that no difference was detected in sensitivity toward disinfection. When comparing the sensitivity in general at species level for all concentrations of disinfectant used, no significant difference was found between E. coli and SE in sensitivity to Virocid (P > 0.05). In conclusion, because of its similar response to disinfection in a suspension disinfection test, E. coli could be used as an indicator for possible Salmonella presence after cleaning and disinfection.

DISINFECTION BY-PRODUCT FORMATION BY ALTERNATIVE DISINFECTANTS AND REMOVAL BY GRANULAR ACTIVATED CARBON

EPA Science Inventory

The effects of the use of the alternative disinfectants on the formation of halogenated disinfection by–products (DBPs) including total organic halide, trihalomethanes, haloacetic acids, haloacetonitriles, haloketones, chloral hydrate, and chloropicrin, were examined along ...

Disinfection of water in recirculating aquaculture systems with peracetic acid

USDA-ARS?s Scientific Manuscript database

Peracetic acid (PAA) has become a favoured alternative to chlorination in the disinfection of municipal waste water in recent years. It is also commonly used in the food industry as a disinfectant. Based on PAA concentration, the disulfide linkage in enzymes and proteins of microorganisms can be bro...

DISINFECTION BY-PRODUCT FORMATION BY ALTERNATIVE DISINFECTANTS AND REMOVAL BY GRANULAR ACTIVATED CARBON

EPA Science Inventory

The effects of the use of the alternative disinfectants on the formation of halogenated disinfection by-products (DBPS) including total organic halide, trihalomethanes, haloacetic acids, haloacentonitriles, haloketones, chloral hydrate, and chloropicrin, were examined along with ...

Ozone disinfection of home nebulizers effectively kills common cystic fibrosis bacterial pathogens.

PubMed

Towle, Dana; Baker, Vanisha; Schramm, Craig; O'Brien, Matthew; Collins, Melanie S; Feinn, Richard; Murray, Thomas S

2018-05-01

The Cystic Fibrosis Foundation (CFF) recommends routine nebulizer disinfection for patients but compliance is challenging due to the heavy burden of home care. SoClean® is a user friendly ozone based home disinfection device currently for home respiratory equipment. The objective of this study was to determine whether SoClean® has potential as a disinfection device for families with CF by killing CF associated bacteria without altering nebulizer output. Ozone based disinfection effectively kills bacterial pathogens inoculated to home nebulizer equipment without gross changes in nebulizer function. Common bacterial pathogens associated with CF were inoculated onto the PariLC® jet nebulizer and bacterial recovery compared with or without varied ozone exposure. In separate experiments, nebulizer output was estimated after repeated ozone exposure by weighing the nebulizer. Ozone disinfection was time dependent with a 5 min infusion time and 120 min dwell time effectively killing >99.99% bacteria tested including Pseudomonas aeruginosa and Staphylococcus aureus. Over 250 h of repeat ozone exposure did not alter nebulizer output. This suggests SoClean® has potential as a user-friendly disinfection technique for home respiratory equipment. © 2018 Wiley Periodicals, Inc.

COMPARATIVE DISINFECTION EFFICIENCY OF PULSED AND CONTINUOUS-WAVE UV IRRADIATION TECHNOLOGIES

EPA Science Inventory

Pulsed UV (PUV) is novel UV irradiation system that is a non-mercury lamp based alternative to currently used continuous-wave systems for water disinfection. To compare the polychromatic PUV irradiation disinfection efficiency with that from continuous wave monochromatic low-pre...

Electrochemical alternatives for drinking water disinfection.

PubMed

Martínez-Huitle, Carlos A; Brillas, Enric

2008-01-01

Chlorination is the most common method worldwide for the disinfection of drinking water. However, the identification of potentially toxic products from this method has encouraged the development of alternative disinfection technologies. Among them, electrochemical disinfection has emerged as one of the more feasible alternatives to chlorination. This article reviews electrochemical systems that can contribute to drinking water disinfection and underscores the efficiency of recently developed diamond films in chlorine-free electrochemical systems.

9 CFR 96.9 - Casings admitted on disinfection; sealing; transfer and disinfection.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Casings admitted on disinfection; sealing; transfer and disinfection. 96.9 Section 96.9 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE EXPORTATION AND IMPORTATION OF ANIMALS (INCLUDING POULTRY) AND...

9 CFR 96.9 - Casings admitted on disinfection; sealing; transfer and disinfection.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Casings admitted on disinfection; sealing; transfer and disinfection. 96.9 Section 96.9 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE EXPORTATION AND IMPORTATION OF ANIMALS (INCLUDING POULTRY) AND...

Disinfectants used for environmental disinfection and new room decontamination technology.

PubMed

Rutala, William A; Weber, David J

2013-05-01

Environmental contamination plays an important role in the transmission of several key health care-associated pathogens. Effective and thorough cleaning/disinfecting of the patient environment is essential. Room decontamination units (such as ultraviolet-C and hydrogen peroxide systems) aid in reducing environmental contamination after terminal room cleaning and disinfection. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Effectiveness of Four Disinfectants against Ebola Virus on Different Materials

PubMed Central

Smither, Sophie; Phelps, Amanda; Eastaugh, Lin; Ngugi, Sarah; O’Brien, Lyn; Dutch, Andrew; Lever, Mark Stephen

2016-01-01

The West Africa Ebola virus (EBOV) outbreak has highlighted the need for effective disinfectants capable of reducing viral load in a range of sample types, equipment and settings. Although chlorine-based products are widely used, they can also be damaging to equipment or apparatus that needs continuous use such as aircraft use for transportation of infected people. Two aircraft cleaning solutions were assessed alongside two common laboratory disinfectants in a contact kill assay with EBOV on two aircraft relevant materials representative of a porous and non-porous surface. A decimal log reduction of viral titre of 4 is required for a disinfectant to be deemed effective and two of the disinfectants fulfilled this criteria under the conditions tested. One product, Ardrox 6092, was found to perform similarly to sodium hypochlorite, but as it does not have the corrosive properties of sodium hypochlorite, it could be an alternative disinfectant solution to be used for decontamination of EBOV on sensitive apparatus. PMID:27399759

Evaluation of mycobactericidal activity of selected chemical disinfectants and antiseptics according to European standards

PubMed Central

Bocian, Ewa; Grzybowska, Wanda; Tyski, Stefan

2014-01-01

Background The history of the investigation of standardized mycobactericidal activity of disinfectants and antiseptics is not very long. There is growing interest among the manufacturers of disinfectants in carrying out research on the antimicrobial activities in accordance with European standards (EN). This research could facilitate the introduction of high-quality disinfectants to the market. The aim of this study was to evaluate the mycobactericidal activity of selected chemical disinfectants and antiseptics used in the medical and veterinary fields. Material/Methods This study included 19 products submitted to the National Medicines Institute in Poland for evaluation of mycobactericidal activity. These products contain in their composition active substances belonging to different chemical groups, including aldehydes, alcohols, amines, quaternary ammonium compounds, phenols, guanidine, and oxidizing compounds. This study, conducted according to the manufacturers’ description of the preparations, was carried out in accordance with European standards, which also met the Polish standards: PN-EN 14204: 2013, PN-EN 14348: 2006, and PN-EN 14563: 2012. Results Tested products for disinfection and antiseptics containing active substances from different chemical groups showed high mycobactericidal activity and met the requirements of the appropriate European standards in most cases. In the case of products containing guanidine and amine compounds, the concentration of active ingredients used in the test and the test conditions specified by the manufacturer did not provide the mycobactericidal activity required by the standards. Conclusions Prior to the launch of a new product on the market, it is important to establish the appropriate usage and testing conditions of the preparation, such as its practical concentration, contact time, and environment condition (clean or dirty). PMID:24755666

Tracking sources of Staphylococcus aureus hand contamination in food handlers by spa typing.

PubMed

Ho, Jeffery; Boost, Maureen V; O'Donoghue, Margaret M

2015-07-01

We aimed to identify the source of Staphylococcus aureus contaminating hands of food handlers. Nasal samples and direct fingertip imprints were collected on 2 occasions from food handlers and characterized to determine likely sources of hand contamination. Most hand contamination was attributable to nasal isolates of persistently colonized coworkers who had presumably contaminated the environment. Regular handwashing should be supplemented by effective environmental disinfection. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

UV disinfection in drinking water supplies.

PubMed

Hoyer, O

2000-01-01

UV disinfection has become a practical and safely validatable disinfection procedure by specifying the requirements for testing and monitoring in DVGW standard W 294. A standardized biodosimetric testing procedure and monitoring with standardized UV sensors is introduced and successfully applied. On-line monitoring of irradiance can be counterchecked with handheld reference sensors and makes it possible that UV systems can be used for drinking water disinfection with the same level of confidence and safety as is conventional chemical disinfection.

Factors associated with hand hygiene practices in two neonatal intensive care units.

PubMed

Cohen, Bevin; Saiman, Lisa; Cimiotti, Jeannie; Larson, Elaine

2003-06-01

To determine whether hand hygiene practices differ between levels of contact with neonates; to characterize the hand hygiene practices of different types of personnel; and to compare hand hygiene practices in neonatal intensive care units (NICUs) using different products. Research assistants observed staff hand hygiene practices during 38 sessions in two NICUs. Patient touches were categorized as touching within the neonates' environment but only outside the Isolette (Level 1), touching within the Isolette but not the neonate directly (Level 2) or directly touching the neonate (Level 3). Hand hygiene practices for each touch were categorized into five groups: cleaned hands and new gloves; uncleaned hands and new gloves; used gloves; clean hands and no gloves; uncleaned hands and no gloves. Research assistants observed 1472 touches. On average each neonate or his or her immediate environment was touched 78 times per shift. Nurses (P = 0.001), attending physicians (P = 0.02) and physicians-in-training (P = 0.03) were more likely to use appropriate practices during Level 3 touches, but only 22.8% of all touches were with cleaned and/or newly gloved hands. The mean number of direct touches by staff members with cleaned hands was greater in the NICU using an alcohol-based hand rub than in the NICU using antimicrobial soap (P < 0.01). Hand hygiene was suboptimal in this high risk setting; administrative action and improved products may be needed to assure acceptable practice. In this study use of an alcohol-based product was associated with significantly improved hand hygiene and should be encouraged, as recommended in the new CDC hand hygiene guideline.

RADIOPATHIES IN THE HAND OF THE SURGEON

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marino, H.

1962-03-01

Several cases are described in which severe radiation injuries occurred in the hands of surgeons during operative procedures requiring fluoroscopy. The radiation lesions appeared to be aggravated by the various mechanical traumas accompanying washing-up processes preceding surgery including brushing the fingers, use of strong disinfectants and detergents, and sprinkling the hands with talcum before donning rubber gloves. These routine measures may cause acute eruptions of old radiation lesions. Various phases in the development of radiation burns on the hands, from the initial dermatitis to the late necrotic changes, are discussed. Fraquently, the early lesions are erroneously diagnosed as allergic eczemamore » so that effective therapeutic measures may not be instituted soon enough. Plastic surgical rapairs of finger lesions, in the cases described, are illustrated. (H.H.D.)« less

Testing the Carcinogenic Potential of Water Disinfectant Byproducts in a Human Colon Mucosal Culture System

EPA Science Inventory

Epidemiological studies have linked the consumption of disinfected surface waters to an increased risk of colorectal cancer. Approximately 600 disinfection byproducts (DBPs) have been identified for a number of disinfectants currently in use. An in-depth mechanism-based structure...

Determining Exposure Factors of Anti-Fogging, Dye, Disinfectant, Repellent, and Preservative Products in Korea.

PubMed

Lee, Daeyeop; Kim, Joo-Hyon; Kim, Taksoo; Yoon, Hyojung; Jo, Areum; Lee, Byeongwoo; Lim, Hyunwoo; Kim, Pilje; Seo, Jungkwan

2018-01-30

Reliable exposure factors are essential to determine health risks posed by chemicals in consumer products. We analyzed five risk-concerned product categories (anti-fogging, dye, disinfectant, repellent, and preservative products) for 13 products (three car anti-fogging products, a lens anti-fogging product, two car dye products, two drain disinfectants, an air conditioner disinfectant, a chlorine-based disinfectant, a fabric repellent, an insect repellent for food, and a wood preservative) considered to be of high risk in order to determine exposure factors via web surveys and estimation of amount of product. Among the 3000 participants (1482 (49%) men) aged ≥19 years, drain disinfectants were used most frequently (38.2%); the rate of usage of the other products ranged between 1.1-24.0%. The usage rates for the consumer products differed by sex, age, income, and education. Some consumer products such as car and lens anti-fogging products, chlorine-based disinfectants, fabric repellents, and drain disinfectants were regularly used more than once a month, while car dye products, air conditioner disinfectants, insect repellents for food, and wood preservatives were not regularly used owing to the specific product purposes and seasonal needs. Our results could be used for managing or controlling chemical substances in consumer products and conducting accurate exposure assessments.

Predicting the disinfection efficiency range in chlorine contact tanks through a CFD-based approach.

PubMed

Angeloudis, Athanasios; Stoesser, Thorsten; Falconer, Roger A

2014-09-01

In this study three-dimensional computational fluid dynamics (CFD) models, incorporating appropriately selected kinetic models, were developed to simulate the processes of chlorine decay, pathogen inactivation and the formation of potentially carcinogenic by-products in disinfection contact tanks (CTs). Currently, the performance of CT facilities largely relies on Hydraulic Efficiency Indicators (HEIs), extracted from experimentally derived Residence Time Distribution (RTD) curves. This approach has more recently been aided with the application of CFD models, which can be calibrated to predict accurately RTDs, enabling the assessment of disinfection facilities prior to their construction. However, as long as it depends on HEIs, the CT design process does not directly take into consideration the disinfection biochemistry which needs to be optimized. The main objective of this study is to address this issue by refining the modelling practices to simulate some reactive processes of interest, while acknowledging the uneven contact time stemming from the RTD curves. Initially, the hydraulic performances of seven CT design variations were reviewed through available experimental and computational data. In turn, the same design configurations were tested using numerical modelling techniques, featuring kinetic models that enable the quantification of disinfection operational parameters. Results highlight that the optimization of the hydrodynamic conditions facilitates a more uniform disinfectant contact time, which correspond to greater levels of pathogen inactivation and a more controlled by-product accumulation. Copyright © 2014 Elsevier Ltd. All rights reserved.

A comparison of disinfection by-products formation during sequential or simultaneous disinfection of surface waters with chlorine dioxide and chlor(am)ine.

PubMed

Shi, Yanwei; Ling, Wencui; Qiang, Zhimin

2013-01-01

The effect of chlorine dioxide (ClO2) oxidation on the formation of disinfection by-products (DBPs) during sequential (ClO2 pre-oxidation for 30 min) and simultaneous disinfection processes with free chlorine (FC) or monochloramine (MCA) was investigated. The formation of DBPs from synthetic humic acid (HA) water and three natural surface waters containing low bromide levels (11-27 microg/L) was comparatively examined in the FC-based (single FC, sequential ClO2-FC, and simultaneous ClO2/FC) and MCA-based (single MCA, ClO2-MCA, and ClO2/MCA) disinfection processes. The results showed that much more DBPs were formed from the synthetic HA water than from the three natural surface waters with comparative levels of dissolved organic carbon. In the FC-based processes, ClO2 oxidation could reduce trihalomethanes (THMs) by 27-35% and haloacetic acids (HAAs) by 14-22% in the three natural surface waters, but increased THMs by 19% and HAAs by 31% in the synthetic HA water after an FC contact time of 48 h. In the MCA-based processes, similar trends were observed although DBPs were produced at a much lower level. There was an insignificant difference in DBPs formation between the sequential and simultaneous processes. The presence of a high level of bromide (320 microg/L) remarkably promoted the DBPs formation in the FC-based processes. Therefore, the simultaneous disinfection process of ClO2/MCA is recommended particularly for waters with a high bromide level.

Activity of disinfectants against foodborne pathogens in suspension and adhered to stainless steel surfaces

PubMed Central

Cabeça, Tatiane Karen; Pizzolitto, Antonio Carlos; Pizzolitto, Elisabeth Loshchagin

2012-01-01

The purpose of this study was to investigate and compare the efficacy of various disinfectants on planktonic cells and biofilm cells of Listeria monocytogenes, Staphylococcus aureus and Escherichia coli. Numbers of viable biofilm cells decreased after treatment with all tested disinfectants (iodine, biguanide, quaternary ammonium compounds, peracetic acid and sodium hypochlorite). Sodium hypochlorite was the most effective disinfectant against biofilm cells, while biguanide was the least effective. Scanning electron microscopy observations revealed that cells adhered on stainless steel surface after treatment with the disinfectants. No viable planktonic cells were observed after treatment with the same disinfectants. Based on our findings, we concluded that biofilm cells might be more resistant to disinfectants than plancktonic cells. PMID:24031935

Systemic mistakes in hand hygiene practice in Ukraine: detection, consequences and ways of elimination

PubMed Central

Klymenko, Iryna; Kampf, Günter

2015-01-01

Aim: Every year, millions of people around the world suffer from different infectious diseases, considerable part of which are hospital-acquired infections. WHO considers hand hygiene as a priority measure aimed to reduce the level of infection. We evaluated various aspects related to the situational behavior and prioritization regarding hand hygiene measures among the healthcare workers of Ukraine. Method: Identification of system mistakes in hand hygiene was carried out first of all by direct and indirect observation of the activities of medical and pharmaceutical personnel in their everyday practice as well as during their participation in trainings on routine hand hygiene. Questionnaires also were used to estimate the level of hand hygiene compliance of participants of the study. During this period 112 training courses, 315 master-classes and presentations on proper hand hygiene were realized. The target audience included health care workers of medical centers, clinics, maternity hospitals, health care organizations and staff of pharmacies and pharmaceutical manufacturing enterprises in all regions of Ukraine. 638 respondents took part in anonymous survey on hand hygiene practice. Results: The most common mistakes were to regard hand washing and hand disinfection equally, to wash hands before doing a hand disinfection, to neglect the five moments for hand hygiene and to ignore hand hygiene before and after wearing protective gloves. Practitioners, medical attendants, pharmacy and pharmaceutical industry workers highlighted the need for practical and understandable instructions of various hand hygiene procedures, including the clarification of the possible technical mistakes. This became a ground for us to create individual master classes on hand hygiene for each cluster of healthcare workers. Conclusions: Changing hand hygiene behavior and attitude is possible by beginning to observe clinical practice and by involving healthcare workers in teaching and training

Fibrous Catalyst-Enhanced Acanthamoeba Disinfection by Hydrogen Peroxide.

PubMed

Kilvington, Simon; Winterton, Lynn

2017-11-01

Hydrogen peroxide (H2O2) disinfection systems are contact-lens-patient problem solvers. The current one-step, criterion-standard version has been widely used since the mid-1980s, without any significant improvement. This work identifies a potential next-generation, one-step H2O2, not based on the solution formulation but rather on a case-based peroxide catalyst. One-step H2O2 systems are widely used for contact lens disinfection. However, antimicrobial efficacy can be limited because of the rapid neutralization of the peroxide from the catalytic component of the systems. We studied whether the addition of an iron-containing catalyst bound to a nonfunctional propylene:polyacryonitrile fabric matrix could enhance the antimicrobial efficacy of these one-step H2O2 systems. Bausch + Lomb PeroxiClear and AOSept Plus (both based on 3% H2O2 with a platinum-neutralizing disc) were the test systems. These were tested with and without the presence of the catalyst fabric using Acanthamoeba cysts as the challenge organism. After 6 hours' disinfection, the number of viable cysts was determined. In other studies, the experiments were also conducted with biofilm formed by Stenotrophomonas maltophilia and Elizabethkingia meningoseptica bacteria. Both control systems gave approximately 1-log10 kill of Acanthamoeba cysts compared with 3.0-log10 kill in the presence of the catalyst (P < .001). In the biofilm studies, no viable bacteria were recovered following disinfection in the presence of the catalyst compared with ≥3.0-log10 kill when it was omitted. In 30 rounds' recurrent usage, the experiments, in which the AOSept Plus system was subjected to 30 rounds of H2O2 neutralization with or without the presence of catalytic fabric, showed no loss in enhanced biocidal efficacy of the material. The catalytic fabric was also shown to not retard or increase the rate of H2O2 neutralization. We have demonstrated the catalyst significantly increases the efficacy of one-step H2O2

Web-based healthcare hand drawing management system.

PubMed

Hsieh, Sheau-Ling; Weng, Yung-Ching; Chen, Chi-Huang; Hsu, Kai-Ping; Lin, Jeng-Wei; Lai, Feipei

2010-01-01

The paper addresses Medical Hand Drawing Management System architecture and implementation. In the system, we developed four modules: hand drawing management module; patient medical records query module; hand drawing editing and upload module; hand drawing query module. The system adapts windows-based applications and encompasses web pages by ASP.NET hosting mechanism under web services platforms. The hand drawings implemented as files are stored in a FTP server. The file names with associated data, e.g. patient identification, drawing physician, access rights, etc. are reposited in a database. The modules can be conveniently embedded, integrated into any system. Therefore, the system possesses the hand drawing features to support daily medical operations, effectively improve healthcare qualities as well. Moreover, the system includes the printing capability to achieve a complete, computerized medical document process. In summary, the system allows web-based applications to facilitate the graphic processes for healthcare operations.

40 CFR 141.709 - Developing the disinfection profile and benchmark.

Code of Federal Regulations, 2010 CFR

2010-07-01

... flow or at an alternative location approved by the State. (2) For systems using chlorine, the pH of the... peak hourly flow or at an alternative location approved by the State. (3) The disinfectant contact time... plant based on a protocol approved by the State. (b) Systems with a single point of disinfectant...

Evaluating the Sporicidal Activity of Disinfectants against Clostridium difficile and Bacillus amyloliquefaciens Spores by Using the Improved Methods Based on ASTM E2197-11

PubMed Central

Uwamahoro, Marie Christine; Massicotte, Richard; Hurtubise, Yves; Gagné-Bourque, François; Mafu, Akier Assanta; Yahia, L’Hocine

2018-01-01

Spore-forming pathogenic bacteria, such as Clostridium difficile, are associated with nosocomial infection, leading to the increased use of sporicidal disinfectants, which impacts socioeconomic costs. However, C. difficile can be prevented using microorganisms such as Bacillus amyloliquefaciens, a prophylactic agent that has been proven to be effective against it in recent tests or it can be controlled by sporicidal disinfectants. These disinfectants against spores should be evaluated according to a known and recommended standard. Unfortunately, some newly manufactured disinfectants like Bioxy products have not yet been tested. ASTM E2197-11 is a standard test that uses stainless steel disks (1 cm in diameter) as carriers, and the performance of the test formulation is calculated by comparing the number of viable test organisms to that on the control carriers. Surface tests are preferable for evaluating disinfectants with sporicidal effects on hard surfaces. This study applies improved methods, based on the ASTM E2197-11 standard, for evaluating and comparing the sporicidal efficacies of several disinfectants against spores of C. difficile and B. amyloliquefaciens, which are used as the test organisms. With the improved method, all spores were recovered through vortexing and membrane filtration. The results show that chlorine-based products are effective in 5 min and Bioxy products at 5% w/v are effective in 10 min. Although Bioxy products may take longer to prove their effectiveness, their non-harmful effects to hospital surfaces and people have been well established in the literature. PMID:29459891

Evaluating the Sporicidal Activity of Disinfectants against Clostridium difficile and Bacillus amyloliquefaciens Spores by Using the Improved Methods Based on ASTM E2197-11.

PubMed

Uwamahoro, Marie Christine; Massicotte, Richard; Hurtubise, Yves; Gagné-Bourque, François; Mafu, Akier Assanta; Yahia, L'Hocine

2018-01-01

Spore-forming pathogenic bacteria, such as Clostridium difficile , are associated with nosocomial infection, leading to the increased use of sporicidal disinfectants, which impacts socioeconomic costs. However, C. difficile can be prevented using microorganisms such as Bacillus amyloliquefaciens , a prophylactic agent that has been proven to be effective against it in recent tests or it can be controlled by sporicidal disinfectants. These disinfectants against spores should be evaluated according to a known and recommended standard. Unfortunately, some newly manufactured disinfectants like Bioxy products have not yet been tested. ASTM E2197-11 is a standard test that uses stainless steel disks (1 cm in diameter) as carriers, and the performance of the test formulation is calculated by comparing the number of viable test organisms to that on the control carriers. Surface tests are preferable for evaluating disinfectants with sporicidal effects on hard surfaces. This study applies improved methods, based on the ASTM E2197-11 standard, for evaluating and comparing the sporicidal efficacies of several disinfectants against spores of C. difficile and B. amyloliquefaciens , which are used as the test organisms. With the improved method, all spores were recovered through vortexing and membrane filtration. The results show that chlorine-based products are effective in 5 min and Bioxy products at 5% w/v are effective in 10 min. Although Bioxy products may take longer to prove their effectiveness, their non-harmful effects to hospital surfaces and people have been well established in the literature.

To disinfect or not to disinfect in postharvest research on the fungal decay of apple?

PubMed

Naets, Matthias; van Dael, Mattias; Vanstreels, Els; Daelemans, Dirk; Verboven, Pieter; Nicolaï, Bart; Keulemans, Wannes; Geeraerd, Annemie

2018-02-02

Postharvest losses of fruit and vegetables can reach up to 30%, the main cause being microbial decay. For apple fruit, mostly fungal pathogens, such as Penicillium expansum, Colletotrichum spp., Neofabraea spp. and Botrytis cinerea, are important. As such losses are unsustainable in many ways, it is necessary that research is conducted to prevent them. Generally, for plants and fruit grown under non-sterile field conditions, disinfection is carried out prior to the start of a phytopathological experiment. The motivation for this practice is the removal of background contamination so that it will not affect the experimental outcome and its interpretation. In literature, a plethora of disinfection methods exists, differing in disinfectant, strength and duration. The following two disinfectants are commonly used: sodium hypochlorite (NaOCl) and ethanol. This article presents a targeted investigation into the effects of these two disinfectants on apple fruit surface and physiology. The results clearly demonstrate that both were affected by both disinfectants. NaOCl caused oxidative damage to the apple's wax layer, causing it to crack. Ethanol affected a redistribution of the wax on the fruit surface and altered the wax composition and/or metabolism. Both NaOCl and ethanol treatment resulted in an increased respiration rate. Therefore, apple and possibly other fruit should not be disinfected in phytopathological studies. A negative control, as is typically used, is not solving this issue, as we clearly demonstrate that the living tissue shows metabolic effects following disinfection, and hence the study objects are changed, hampering a clear interpretation of the experimental outcomes. Moreover, fungal inoculation during experiments is typically taking place at rather large levels in wounded tissue (as infection success is the exception), outnumbering the variable levels of background population, if present. Copyright © 2017 Elsevier B.V. All rights reserved.

Pre-disinfection columns to improve the performance of the direct electro-disinfection of highly faecal-polluted surface water.

PubMed

Isidro, J; Llanos, J; Sáez, C; Lobato, J; Cañizares, P; Rodrigo, M A

2018-09-15

This work presents the design and evaluation of a new concept of pre-disinfection treatment that is especially suited for highly polluted surface water and is based on the combination of coagulation-flocculation, lamellar sedimentation and filtration into a single-column unit, in which the interconnection between treatments is an important part of the overall process. The new system, the so-called PREDICO (PRE-DIsinfection Column) system, was built with low-cost consumables from hardware stores (in order to promote in-house construction of the system in poor countries) and was tested with a mixture of 20% raw wastewater and 80% surface water (in order to simulate an extremely bad situation). The results confirmed that the PREDICO system helps to avoid fouling in later electro-disinfection processes and attains a remarkable degree of disinfection (3-4 log units), which supplements the removal of pathogens attained by the electrolytic cell (more than 4 log units). The most important sizing parameters for the PREDICO system are the surface loading rate (SLR) and the hydraulic residence time (HRT); SLR values under 20 cm min -1 and HRT values over 13.6 min in the PREDICO system are suitable to warrant efficient performance of the system. Copyright © 2018 Elsevier Ltd. All rights reserved.

Evaluation of two disinfection/sterilization methods on silicon rubber-based composite finishing instruments.

PubMed

Lacerda, Vánia A; Pereira, Leandro O; Hirata JUNIOR, Raphael; Perez, Cesar R

2015-12-01

To evaluate the effectiveness of disinfection/sterilization methods and their effects on polishing capacity, micomorphology, and composition of two different composite fiishing and polishing instruments. Two brands of finishing and polishing instruments (Jiffy and Optimize), were analyzed. For the antimicrobial test, 60 points (30 of each brand) were used for polishing composite restorations and submitted to three different groups of disinfection/sterilization methods: none (control), autoclaving, and immersion in peracetic acid for 60 minutes. The in vitro tests were performed to evaluate the polishing performance on resin composite disks (Amelogen) using a 3D scanner (Talyscan) and to evaluate the effects on the points' surface composition (XRF) and micromorphology (MEV) after completing a polishing and sterilizing routine five times. Both sterilization/disinfection methods were efficient against oral cultivable organisms and no deleterious modification was observed to point surface.

Differences in disinfection protocols for root canal treatments between general dentists and endodontists: A Web-based survey.

PubMed

de Gregorio, Cesar; Arias, Ana; Navarrete, Natalia; Cisneros, Rafael; Cohenca, Nestor

2015-07-01

The purpose of this study was to determine whether differences exist in disinfection protocols between endodontists and general dentists. The authors sent an invitation to participate in a Web-based survey to 950 dentists affiliated with the Spanish Board of Dentistry. Participants responded to 9 questions about irrigation protocols and other factors related to disinfection during root canal therapy. A total of 238 (25.05%) study participants successfully completed and returned the surveys. Among these participants, 50% were general dentists and 50% were endodontists. The authors found no statistically significant differences in respondents' first choice of an irrigant solution (that is, sodium hypochlorite), but they noted statistically significant differences in the protocols used by general dentists and by endodontists in relation to the concentration of sodium hypochlorite (P = .0003), the use and type of irrigant used to remove the smear layer (P = 5.39 × 10(-10)), the use of adjuncts to irrigation (P = 5.98 × 10(-8)), the enlargement of the apical preparation when shaping a necrotic tooth (P = .001), and the maintenance of apical patency throughout the debridement and shaping procedure (P = .04). General dentists and endodontists embrace different disinfection protocols. The results of the survey demonstrated that endodontists keep up to date with protocols published in the literature, whereas general dentists use protocols learned during their dental training. Both groups of clinicians should be aware of the importance of disinfection techniques and their relationship to treatment outcomes. Controlling microorganisms during a root canal treatment, especially in cases with necrotic pulp, is essential to improve treatment outcomes. Clinicians should update their protocols and also consider referring patients to a specialist when their protocols are based on traditional techniques, especially in those cases with necrotic pulp. Copyright © 2015

Roof-harvested rainwater for potable purposes: application of solar collector disinfection (SOCO-DIS).

PubMed

Amin, M T; Han, M Y

2009-12-01

The efficiency of solar disinfection (SODIS), recommended by the World Health Organization, has been determined for rainwater disinfection, and potential benefits and limitations discussed. The limitations of SODIS have now been overcome by the use of solar collector disinfection (SOCO-DIS), for potential use of rainwater as a small-scale potable water supply, especially in developing countries. Rainwater samples collected from the underground storage tanks of a rooftop rainwater harvesting (RWH) system were exposed to different conditions of sunlight radiation in 2-L polyethylene terephthalate bottles in a solar collector with rectangular base and reflective open wings. Total and fecal coliforms were used, together with Escherichia coli and heterotrophic plate counts, as basic microbial and indicator organisms of water quality for disinfection efficiency evaluation. In the SOCO-DIS system, disinfection improved by 20-30% compared with the SODIS system, and rainwater was fully disinfected even under moderate weather conditions, due to the effects of concentrated sunlight radiation and the synergistic effects of thermal and optical inactivation. The SOCO-DIS system was optimized based on the collector configuration and the reflective base: an inclined position led to an increased disinfection efficiency of 10-15%. Microbial inactivation increased by 10-20% simply by reducing the initial pH value of the rainwater to 5. High turbidities also affected the SOCO-DIS system; the disinfection efficiency decreased by 10-15%, which indicated that rainwater needed to be filtered before treatment. The problem of microbial regrowth was significantly reduced in the SOCO-DIS system compared with the SODIS system because of residual sunlight effects. Only total coliform regrowth was detected at higher turbidities. The SOCO-DIS system was ineffective only under poor weather conditions, when longer exposure times or other practical means of reducing the pH were required for the

UV disinfection for reuse applications in North America.

PubMed

Sakamoto, G; Schwartzel, D; Tomowich, D

2001-01-01

In an effort to conserve and protect limited water resources, the States of Florida and California have actively promoted wastewater reclamation and have implemented comprehensive regulations covering a range of reuse applications. Florida has a semi-tropical climate with heavy summer rains that are lost due to run off and evaporation. Much of California is arid and suffers periodic droughts, low annual rainfall and depleted ground water supplies. The high population density combined with heavy irrigation demands has depleted ground water supplies resulting in salt-water intrusion. During the past decade, Florida reuse sites have increased dramatically from 118 to 444 plants representing a total flow capacity of 826 MGD. California presently has over 250 plants producing 1 BGD with a projected increase of 160 sites over the next 20 years. To prevent the transmission of waterborne diseases, disinfection of reclaimed water is controlled by stringent regulations. Many states regulate wastewater treatment processes, nutrient removal, final effluent quality and disinfection criteria based upon the specific reuse application. As a rule, the resulting effluents have low turbidity and suspended solids. For such effluents, UV technology can economically achieve the most stringent disinfection targets that are required by the States of California and Florida for restricted and unrestricted reuse. This paper compares UV disinfection for wastewater reuse sites in California and Florida and discusses the effect of effluent quality on UV disinfection.

[Genotoxicity of drinking water during chlorine and chloramine disinfection and the influence of disinfection conditions using the umu-test].

PubMed

Liu, Qing; Zhang, Li-Ping; Liu, Wen-Jun; Nie, Xue-Biao; Zhang, Su-Xia; Zhang, Shun

2010-01-01

In this study, the effects of disinfectant dosage, reaction time and the ratio of Cl2 to N of disinfectant on genotoxicity of effluent of ozone-biological activated carbon (O3-BAC) during chlorine or chloramine disinfection were investigated using umu-test. It was found that, the genotoxicity of effluent of O3-BAC before disinfection ranged from 20-70 ng/L, and it increased after disinfection by chlorine or chloramines. With the same reaction time(24 h), genotoxicity after chlorination (40-95 ng/L) was higher than that after chloramination (20-40 ng/L) under same initial dosage. For chlorination, with initial dosage increasing from 0 mg/L to 10 mg/L, genotoxicity increased firstly, and got the maximum value at about 0.5-1 mg/L dosage, then decreased and got the minimum value at about 3-5 mg/L dosage, and finally increased again. For chloramination, genotoxicity didn't change that much. With the dosage of 3 mg/L and reaction time increasing from 0 h to 72 h, no matter for chlorine or chloramines disinfection, genotoxicity of effluent of O3-BAC both increased firstly, and got the maximum value at about 2 h, then decreased and got the minimum value at about 18 h, and finally increased again, and genotoxicity after chlorine disinfection (83-120 ng/L) was higher than that after chloramines disinfection (20-62 ng/L) under same reaction time. Further more, effects of the different ratios of Cl2 to N of disinfectant on genotoxicity of effluent of O3-BAC were also studied. Results of this study demonstrate that under test conditions, chloramine disinfection is safer than chlorine disinfection in the aspect of genotoxicity for drinking water, and the changes of genotoxicity are different from those of total HAAs.

Comparing irradiation parameters on disinfecting enterrecoccus faecalis in root canal disinfection

NASA Astrophysics Data System (ADS)

Sarp, Ayşe. S.; Gülsoy, Murat

2016-02-01

Although conventional method carries all the debris, studies on persisting infections in root canals show bacteria and their toxins spread from the root canal and contaminate the apical region. Thus developes apical periodontitis or symptoms, and loss of tooth. Even if the treatment has adequate success, anatomy of root canal system can be very complexwith accessory canals. The disinfecting effect of laser radiation has only recently been used in dentistry. Laser irradiation has a bactericidal effect. Each wavelength has its own advantages and limitations according to their different absorption characteristics, depending on their 'absorption coefficient'. The sterilizing efficiency of two types of wavelengths, a new fiber laser 1940- nm Thulium fiber Laser and an 2940 nm Er:YAG Laser were compared in this study. Irradiation with a power of 0.50 W with 1940- nm Thulium fiber Laser disinfected 95,15% of bacteria, however irradiation with same laser power with Er:YAG Laser caused a reduction of 96,48 %. But there was no significant difference in the disinfection effect of two different laser groups ( p < 0.05, Mann- U-Whitney Test). In addition to this, Er :YAG Laser caused three times more reduction from its own positive control group where 1940- nm Thulium fiber Laser caused 2,5 times effective disinfection.

Predictors of stethoscope disinfection among pediatric health care providers.

PubMed

Muniz, Jeanette; Sethi, Rosh K V; Zaghi, Justin; Ziniel, Sonja I; Sandora, Thomas J

2012-12-01

Stethoscopes are contaminated with bacteria, but predictors of stethoscope disinfection frequency are unknown. We sought to describe health care provider stethoscope disinfection attitudes and practices and determine predictors of frequent disinfection. We used an anonymous online survey of nurses, nurse practitioners, and physicians at a pediatric hospital. We assessed frequency and methods of disinfection, perceptions of contamination, and barriers to disinfection. Multivariate logistic regression models were used to identify independent predictors of disinfecting after every use. One thousand four hundred one respondents completed the survey: 76% believed that infection transmission occurs via stethoscopes, but only 24% reported disinfecting after every use. In multivariate analyses, belief that infection transmission occurs via stethoscopes significantly increased the odds of disinfection after every use (odds ratio [OR], 2.06 [95% confidence interval (CI): 1.38-3.06]). The odds of disinfection after every use were significantly decreased in those who perceived the following barriers: lack of time (OR, 0.31 [95% CI: 0.18-0.54]), lack of access to disinfection material (OR, 0.41 [95% CI: 0.29-0.57]), or lack of visual reminders to disinfect (OR, 0.22 [95% CI: 0.14-0.34]). Only a minority of pediatric health care providers reported disinfecting their stethoscopes after every use. Increasing access to disinfection materials and visual reminders in health care facilities may improve stethoscope disinfection practices. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Virus Sensitivity Index of UV disinfection.

PubMed

Tang, Walter Z; Sillanpää, Mika

2015-01-01

scenarios such as under sunlight and different virus aggregates. The correlation analysis shows that viruses will be about 40% more sensitive to sunlight than to UV254. On the other hand, virus size of 500 nm will reduce their VSI by 10%. This is the first attempt to use VSI to predict the required fluence at any given Log I. The equation can be used to quantitatively evaluate other parameters influencing UV disinfection. These factors include environmental species, antibiotic-resistant bacteria or genes, photo and dark repair, water quality such as suspended solids, and UV transmittance.

Resistance of bacterial biofilms formed on stainless steel surface to disinfecting agent.

PubMed

Królasik, Joanna; Zakowska, Zofia; Krepska, Milena; Klimek, Leszek

2010-01-01

The natural ability of microorganisms for adhesion and biofilm formation on various surfaces is one of the factors causing the inefficiency of a disinfection agent, despite its proven activity in vitro. The aim of the study was to determine the effectiveness of disinfecting substances on bacterial biofilms formed on stainless steel surface. A universally applied disinfecting agent was used in the tests. Bacterial strains: Listeria innocua, Pseudomonas putida, Micrococcus luteus, Staphylococcus hominis strains, were isolated from food contact surfaces, after a cleaning and disinfection process. The disinfecting agent was a commercially available acid specimen based on hydrogen peroxide and peroxyacetic acid, the substance that was designed for food industry usage. Model tests were carried out on biofilm formed on stainless steel (type 304, no 4 finish). Biofilms were recorded by electron scanning microscope. The disinfecting agent in usable concentration, 0.5% and during 10 minutes was ineffective for biofilms. The reduction of cells in biofilms was only 1-2 logarithmic cycles. The use of the agent in higher concentration--1% for 30 minutes caused reduction of cell number by around 5 logarithmic cycles only in the case of one microorganism, M. luteus. For other types: L. innocua, P. putida, S. hominis, the requirements placed on disinfecting agents were not fulfilled. The results of experiments proved that bacterial biofilms are resistant to the disinfectant applied in its operational parameters. Disinfecting effectiveness was achieved after twofold increase of the agent's concentration.

Emergency Disinfection of Drinking Water

EPA Pesticide Factsheets

How to boil and disinfect water to kill most disease-causing microorganisms during emergency situations where regular water service has been interrupted and local authorities recommend using only bottled water, boiled water, or disinfected water.

Substantivity of hypochlorous acid-based disinfectant against biofilm formation in the dental unit waterlines

PubMed Central

Shajahan, Irfana Fathima; Kandaswamy, Deivanayagam; Lakshminarayanan, L.; Selvarajan, R.

2017-01-01

Objective: The purpose of the study was to examine the substantivity of a new disinfectant against biofilm formation in the dental unit waterlines. Materials and Methods: Twenty dental units were selected for the study and divided into two groups: Group A (dental unit waterlines treated with the disinfectant) and Group B (untreated dental unit waterlines). Biofilm formation was monitored in both groups by removing the one dental unit waterline from each group for the period of 10 days. One inch of the dental unit waterline tube was cut at random site, and the inner lumen of the cut sections was analyzed using the scanning electron microscope (SEM) (TESCAN VEGA3 SBU). Results: On examination, SEM images showed that there was no slime layer or bacterial cells seen in cut section for the period of 7 days in the treated dental waterlines, which means that there is no evident of biofilm formation. In the untreated dental unit waterline cut section, slime layer was observed from day 1. Conclusion: Disinfectant solution was proved to be effective for 7 days against biofilm formation. This technique could be used as a valid method for disinfection of dental unit waterlines. PMID:28761244

[Experiments for physiologic improvement of disinfectants].

PubMed

Beyer, C; Wozniak, K D; Höhne, K; Laub, R

1990-11-01

The use of customary trade disinfectants lead to occupational disease no. 80 in many employers of public health. For that reason our aim is to improve the skin compatibility of this disinfectants. Its possible to achieve a pH-shift to a more physiological level eighter by buffer salt addition or by neutralization. Following this, disinfectants were investigated in a microbiological test.

An in vitro comparison of standard cleaning to a continuous passive disinfection cap for the decontamination of needle-free connectors.

PubMed

Casey, Anna L; Karpanen, Tarja J; Nightingale, Peter; Elliott, Tom S J

2018-01-01

The optimal decontamination method for needle-free connectors is still unresolved. The objective of this study was to determine if a continuous passive disinfection cap is as effective as standard cleaning for the microbial decontamination of injection ports of two types of needle-free connectors. The injection ports of needle-free connectors were inoculated with Staphylococcus aureus and allowed to dry. Disinfection caps containing 70% ( v / v ) isopropyl alcohol (IPA) were attached to the connectors for one, three or 7 days and were compared with needle-free connectors cleaned with 2% ( w / v ) chlorhexidine gluconate (CHG) in 70% ( v/v ) IPA. The number of S. aureus remaining on the injection ports was evaluated. Median log 10 reductions and 95% confidence interval (CI) were calculated and data analyzed using the Mann-Whitney test. The application of the disinfection cap resulted in a significantly higher reduction in S. aureus than the 2% ( w / v ) CHG in 70% ( v / v ) IPA wipe, achieving a > 5 Log 10 reduction in CFU at each time point. The disinfection caps resulted in a significantly higher reduction in S.aureus on the injection ports when compared to the use of a 2% ( w/v ) CHG in 70% ( v/v ) IPA wipe. This offers an explanation for the lower rates of central-line associated bloodstream infection (CLABSI) associated with the use of disinfection caps reported in clinical studies.

Recurrent lactic acidosis secondary to hand sanitizer ingestion.

PubMed

Wilson, M E; Guru, P K; Park, J G

2015-01-01

Due to their ability to decrease the spread of infection, hand sanitizers are now ubiquitous in health care settings. We present the case of a 50-year-old woman who was admitted with acute alcohol intoxication and had near complete recovery in 12 hrs. Subsequently, she was found unresponsive on the floor of her hospital room on two separate occasions. Evaluations revealed repeatedly elevated levels of ethanol, acetone, and lactate as well as increased anion gap and hypotension, requiring intensive care unit evaluation and intubation for airway protection. During the second episode, she was found next to an empty bottle of ethanol-based hospital hand sanitizer. She confirmed ingesting hand sanitizer in order to become intoxicated.

Recurrent lactic acidosis secondary to hand sanitizer ingestion

PubMed Central

Wilson, M. E.; Guru, P. K.; Park, J. G.

2015-01-01

Due to their ability to decrease the spread of infection, hand sanitizers are now ubiquitous in health care settings. We present the case of a 50-year-old woman who was admitted with acute alcohol intoxication and had near complete recovery in 12 hrs. Subsequently, she was found unresponsive on the floor of her hospital room on two separate occasions. Evaluations revealed repeatedly elevated levels of ethanol, acetone, and lactate as well as increased anion gap and hypotension, requiring intensive care unit evaluation and intubation for airway protection. During the second episode, she was found next to an empty bottle of ethanol-based hospital hand sanitizer. She confirmed ingesting hand sanitizer in order to become intoxicated. PMID:25684875

Modern technologies for improving cleaning and disinfection of environmental surfaces in hospitals.

PubMed

Boyce, John M

2016-01-01

Experts agree that careful cleaning and disinfection of environmental surfaces are essential elements of effective infection prevention programs. However, traditional manual cleaning and disinfection practices in hospitals are often suboptimal. This is often due in part to a variety of personnel issues that many Environmental Services departments encounter. Failure to follow manufacturer's recommendations for disinfectant use and lack of antimicrobial activity of some disinfectants against healthcare-associated pathogens may also affect the efficacy of disinfection practices. Improved hydrogen peroxide-based liquid surface disinfectants and a combination product containing peracetic acid and hydrogen peroxide are effective alternatives to disinfectants currently in widespread use, and electrolyzed water (hypochlorous acid) and cold atmospheric pressure plasma show potential for use in hospitals. Creating "self-disinfecting" surfaces by coating medical equipment with metals such as copper or silver, or applying liquid compounds that have persistent antimicrobial activity surfaces are additional strategies that require further investigation. Newer "no-touch" (automated) decontamination technologies include aerosol and vaporized hydrogen peroxide, mobile devices that emit continuous ultraviolet (UV-C) light, a pulsed-xenon UV light system, and use of high-intensity narrow-spectrum (405 nm) light. These "no-touch" technologies have been shown to reduce bacterial contamination of surfaces. A micro-condensation hydrogen peroxide system has been associated in multiple studies with reductions in healthcare-associated colonization or infection, while there is more limited evidence of infection reduction by the pulsed-xenon system. A recently completed prospective, randomized controlled trial of continuous UV-C light should help determine the extent to which this technology can reduce healthcare-associated colonization and infections. In conclusion, continued efforts to

A Toxicological Perspective on Disinfection ByProducts

EPA Science Inventory

Disinfection of water is essential for reduction of microbes harmful to human health and chemical disinfection is considered one of the major public health triumphs of the 20th Century. An unintended consequence of disinfection with oxidizing chemicals is formation of disinfectio...

Cleaning and Disinfection of Bacillus cereus Biofilm.

PubMed

Deal, Amanda; Klein, Dan; Lopolito, Paul; Schwarz, John Spencer

2016-01-01

Methodology has been evolving for the testing of disinfectants against bacterial single-species biofilms, as the difficulty of biofilm remediation continues to gain much-needed attention. Bacterial single-species biofilm contamination presents a real risk to good manufacturing practice-regulated industries. However, mixed-species biofilms and biofilms containing bacterial spores remain an even greater challenge for cleaning and disinfection. Among spore-forming microorganisms frequently encountered in pharmaceutical manufacturing areas, the spores of Bacillus cereus are often determined to be the hardest to disinfect and eradicate. One of the reasons for the low degree of susceptibility to disinfection is the ability of these spores to be encapsulated within an exopolysachharide biofilm matrix. In this series of experiments, we evaluated the disinfectant susceptibility of B. cereus biofilms relative to disassociated B. cereus spores and biofilm from a non-spore-forming species. Further, we assessed the impact that pre-cleaning has on increasing that susceptibility. Methodology has been evolving for the testing of disinfectants against bacterial single-species biofilms, as the difficulty of biofilm remediation continues to gain much-needed attention. Bacterial single-species biofilm contamination presents a real risk to good manufacturing practice-regulated industries. However, mixed-species biofilms and biofilms containing bacterial spores remain an even greater challenge for cleaning and disinfection. Among spore-forming microorganisms frequently encountered in pharmaceutical manufacturing areas, the spores of Bacillus cereus are often determined to be the hardest to disinfect and eradicate. One of the reasons for the low degree of susceptibility to disinfection is the ability of these spores to be encapsulated within an exopolysachharide biofilm matrix. In this series of experiments, we evaluated the disinfectant susceptibility of B. cereus biofilms relative to

Application of the pentaiodide strong base resin disinfectant to the U.S. space program

NASA Technical Reports Server (NTRS)

Marchin, George L.

1990-01-01

A pentaiodide resin is described which has 70 percent of its weight composed of elemental iodine, has a relatively low iodine residual, and may offer superior disinfection capability for applications on long-duration space vehicles. Such a disinfectant is crucial for use on spacecraft for long periods of time where water would be recycled through various systems. The pentaiodide resin is capable of devitalizing 1 x 10 to the 9th bacteria per ml in aqueous suspension within 10 seconds of contact with the resin bed. A number of organisms have already been tested and the resin continues to prove effective. Resin properties and composition are discussed and a detailed account of the first investigation of the pentaiodide resin as a disinfectant against the intestinal parasite Giardia lamblia is provided.

Delayed norovirus epidemic in the 2009-2010 season in Japan: potential relationship with intensive hand sanitizer use for pandemic influenza.

PubMed

Inaida, S; Shobugawa, Y; Matsuno, S; Saito, R; Suzuki, H

2016-09-01

Norovirus (NoV) epidemics normally peak in December in Japan; however, the peak in the 2009-2010 season was delayed until the fourth week of January 2010. We suspected intensive hand hygiene that was conducted for a previous pandemic influenza in 2009 as the cause of this delay. We analysed the NoV epidemic trend, based on national surveillance data, and its associations with monthly output data for hand hygiene products, including alcohol-based skin antiseptics and hand soap. The delayed peak in the NoV incidence in the 2009-2010 season had the lowest number of recorded cases of the five seasons studied (2006-2007 to 2010-2011). GII.4 was the most commonly occurring genotype. The monthly relative risk of NoV and monthly output of both alcohol-based skin antiseptics and hand soap were significantly and negatively correlated. Our findings suggest an association between hand hygiene using these products and prevention of NoV transmission.

Comparison of Riboflavin and Toluidine Blue O as Photosensitizers for Photoactivated Disinfection on Endodontic and Periodontal Pathogens In Vitro.

PubMed

Nielsen, Henrik Krarup; Garcia, Javier; Væth, Michael; Schlafer, Sebastian

2015-01-01

Photoactivated disinfection has a strong local antimicrobial effect. In the field of dentistry it is an emerging adjunct to mechanical debridement during endodontic and periodontal treatment. In the present study, we investigate the effect of photoactivated disinfection using riboflavin as a photosensitizer and blue LED light for activation, and compare it to photoactivated disinfection with the widely used combination of toluidine blue O and red light. Riboflavin is highly biocompatible and can be activated with LED lamps at hand in the dental office. To date, no reports are available on the antimicrobial effect of photoactivated disinfection using riboflavin/blue light on oral microorganisms. Planktonic cultures of eight organisms frequently isolated from periodontal and/or endodontic lesions (Aggregatibacter actinomycetemcomitans, Candida albicans, Enterococcus faecalis, Escherischia coli, Lactobacillus paracasei, Porphyromonas gingivalis, Prevotella intermedia and Propionibacterium acnes) were subjected to photoactivated disinfection with riboflavin/blue light and toluidine blue O/red light, and survival rates were determined by CFU counts. Within the limited irradiation time of one minute, photoactivated disinfection with riboflavin/blue light only resulted in minor reductions in CFU counts, whereas full kills were achieved for all organisms when using toluidine blue O/red light. The black pigmented anaerobes P. gingivalis and P. intermedia were eradicated completely by riboflavin/blue light, but also by blue light treatment alone, suggesting that endogenous chromophores acted as photosensitizers in these bacteria. On the basis of our results, riboflavin cannot be recommended as a photosensitizer used for photoactivated disinfection of periodontal or endodontic infections.

A natural approach to convey numerical digits using hand activity recognition based on hand shape features

NASA Astrophysics Data System (ADS)

Chidananda, H.; Reddy, T. Hanumantha

2017-06-01

This paper presents a natural representation of numerical digit(s) using hand activity analysis based on number of fingers out stretched for each numerical digit in sequence extracted from a video. The analysis is based on determining a set of six features from a hand image. The most important features used from each frame in a video are the first fingertip from top, palm-line, palm-center, valley points between the fingers exists above the palm-line. Using this work user can convey any number of numerical digits using right or left or both the hands naturally in a video. Each numerical digit ranges from 0 to9. Hands (right/left/both) used to convey digits can be recognized accurately using the valley points and with this recognition whether the user is a right / left handed person in practice can be analyzed. In this work, first the hand(s) and face parts are detected by using YCbCr color space and face part is removed by using ellipse based method. Then, the hand(s) are analyzed to recognize the activity that represents a series of numerical digits in a video. This work uses pixel continuity algorithm using 2D coordinate geometry system and does not use regular use of calculus, contours, convex hull and datasets.

Possible monitoring requirements for the disinfectants and disinfection by-products (D/DBP) regulations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1993-01-01

The monitoring requirements presented in the report were developed by EPA before a negotiated Disinfectants and Disinfection By-Products (D/DBP) rule was considered. The framework described herein may be substantially changed as a result of the negotiated rulemaking process. The document is useful to consider in developing various monitoring options during the negotiated rulemaking process.

Electrochemical disinfection of toilet wastewater using wastewater electrolysis cell

PubMed Central

Huang, Xiao; Qu, Yan; Cid, Clément A.; Finke, Cody; Hoffmann, Michael R.; Lim, Keahying; Jiang, Sunny C.

2016-01-01

The paucity of proper sanitation facilities has contributed to the spread of waterborne diseases in many developing countries. The primary goal of this study was to demonstrate the feasibility of using a wastewater electrolysis cell (WEC) for toilet wastewater disinfection. The treated wastewater was designed to reuse for toilet flushing and agricultural irrigation. Laboratory-scale electrochemical (EC) disinfection experiments were performed to investigate the disinfection efficiency of the WEC with four seeded microorganisms (Escherichia coli, Enterococcus, recombinant adenovirus serotype 5, and bacteriophage MS2). In addition, the formation of organic disinfection byproducts (DBPs) trihalomethanes (THMs) and haloacetic acids (HAA5) at the end of the EC treatment was also investigated. The results showed that at an applied cell voltage of +4 V, the WEC achieved 5-log10 reductions of all four seeded microorganisms in real toilet wastewater within 60 min. In contrast, chemical chlorination (CC) disinfection using hypochlorite [NaClO] was only effective for the inactivation of bacteria. Due to the rapid formation of chloramines, less than 0.5-log10 reduction of MS2 was observed in toilet wastewater even at the highest [NaClO] dosage (36 mg/L, as Cl2) over a 1 h reaction. Experiments using laboratory model waters showed that free reactive chlorine generated in situ during EC disinfection process was the main disinfectant responsible for the inactivation of microorganisms. However, the production of hydroxyl radicals [•OH], and other reactive oxygen species by the active bismuth-doped TiO2 anode were negligible under the same electrolytic conditions. The formation of THMs and HAA5 were found to increase with higher applied cell voltage. Based on the energy consumption estimates, the WEC system can be operated using solar energy stored in a DC battery as the sole power source. PMID:26854604

Hand sanitizer dispensers and associated hospital-acquired infections: friend or fomite?

PubMed

Eiref, Simon D; Leitman, I Michael; Riley, William

2012-06-01

Waterless alcohol-based hand sanitizers are an increasingly popular method of hand hygiene and help prevent hospital-acquired infection (HAI). Whether hand sanitizer dispensers (HSDs) may themselves harbor pathogens or act as fomites has not been reported. All HSDs in the surgical intensive care unit of an urban teaching hospital were cultured at three sites: The dispenser lever, the rear underside, and the area surrounding the dispensing nozzle. All HSDs yielded one or more bacterial species, including commensal skin flora and enteric gram-negative bacilli. Colonization was greatest on the lever, where there is direct hand contact. Hand sanitizer dispensers can become contaminated with pathogens that cause HAI and thus are potential fomites.

Disinfection of Human Teeth for Educational Purposes.

ERIC Educational Resources Information Center

Tate, William H.; White, Robert S.

1991-01-01

A study investigated the efficacy of glutaraldehyde and several other disinfectants for disinfecting teeth to be used for teaching and research, as an alternative to autoclaving for teeth with amalgam restorations. Results indicate that formalin was the only disinfectant that penetrated tooth pulp chambers in effective antimicrobial…

Solar Disinfection of Pseudomonas aeruginosa in Harvested Rainwater: A Step towards Potability of Rainwater

PubMed Central

Amin, Muhammad T.; Nawaz, Mohsin; Amin, Muhammad N.; Han, Mooyoung

2014-01-01

Efficiency of solar based disinfection of Pseudomonas aeruginosa (P. aeruginosa) in rooftop harvested rainwater was evaluated aiming the potability of rainwater. The rainwater samples were exposed to direct sunlight for about 8–9 hours and the effects of water temperature (°C), sunlight irradiance (W/m2), different rear surfaces of polyethylene terephthalate bottles, variable microbial concentrations, pH and turbidity were observed on P. aeruginosa inactivation at different weathers. In simple solar disinfection (SODIS), the complete inactivation of P. aeruginosa was obtained only under sunny weather conditions (>50°C and >700 W/m2) with absorptive rear surface. Solar collector disinfection (SOCODIS) system, used to improve the efficiency of simple SODIS under mild and weak weather, completely inactivated the P. aeruginosa by enhancing the disinfection efficiency of about 20% only at mild weather. Both SODIS and SOCODIS systems, however, were found inefficient at weak weather. Different initial concentrations of P. aeruginosa and/or Escherichia coli had little effects on the disinfection efficiency except for the SODIS with highest initial concentrations. The inactivation of P. aeruginosa increased by about 10–15% by lowering the initial pH values from 10 to 3. A high initial turbidity, adjusted by adding kaolin, adversely affected the efficiency of both systems and a decrease, about 15–25%; in inactivation of P. aeruginosa was observed. The kinetics of this study was investigated by Geeraerd Model for highlighting the best disinfection system based on reaction rate constant. The unique detailed investigation of P. aeruginosa disinfection with sunlight based disinfection systems under different weather conditions and variable parameters will help researchers to understand and further improve the newly invented SOCODIS system. PMID:24595188

Ozone-initiated disinfection kinetics of Escherichia coli in water.

PubMed

Zuma, Favourite; Lin, Johnson; Jonnalagadda, Sreekanth B

2009-01-01

The effect of ozonation on the rate of disinfection of Escherichia coli was investigated as a function of ozone concentration, ozonation duration and flow rates. Ozone was generated in situ using Corona discharge method using compressed oxygen stream and depending on the oxygen flux the ozone concentrations ranged from 0.91-4.72 mg/L. The rate of disinfection of all the three microbes followed pseudo-first-order kinetics with respect to the microbe count and first order with respect to ozone concentration. The influence of pH and temperature the aqueous systems on the rate of ozone initiated disinfection of the microbe was investigated. The inactivation was faster at lower pH than at basic pH. Molecular ozone is found more effective in disinfection than hydroxyl radicals. Two reported mechanisms for antimicrobial activity of ozone in water systems from the literature are discussed. Based on the experimental findings a probable rate law and mechanism are proposed. Ozonation of natural waters significantly decreased the BOD levels of the control and microbe contaminated waters.

Formulation of glutaraldehyde disinfectant for alginate impressions.

PubMed

Unemori, M; Matsuya, Y; Matsuya, S; Akashi, A; Mizuno, K; Akamine, A

1999-12-01

The effect of buffer agents incorporated in glutaraldehyde disinfectants on the surface quality of dental models was examined by the measurement of surface roughness, X-ray diffraction analysis and SEM observation. Seven experimental glutaraldehyde disinfectants were prepared using two buffer agents, potassium acetate alone or potassium acetate and sodium hydrogen carbonate in combination. Four kinds of sulfate--zinc, calcium, potassium and magnesium sulfate--were added to these disinfectants in order to accelerate the hydration of calcium sulfate hemihydrate. The impressions treated with the experimental disinfectants for 1 h produced stone surfaces which had significantly lower surface roughness values than those treated with the commercial disinfectants (p < 0.05). The X-ray diffraction analysis and SEM observation showed that these superior surfaces were produced as a result of significant reductions in the amount of residual calcium sulfate hemihydrate. Replacement of buffer agents in commercial glutaraldehyde disinfectants with chemicals such as those studied in the present study will improve the surface quality of dental stone.

Effect of hand sanitizer use on elementary school absenteeism.

PubMed

Hammond, B; Ali, Y; Fendler, E; Dolan, M; Donovan, S

2000-10-01

Several studies have indicated a connection between handwashing and illness-related absenteeism in school settings. The difficulty of ensuring consistent and effective handwashing among student populations has also been noted. The purpose of this study was to assess the effectiveness of the use of an alcohol gel hand sanitizer in the classroom to help decrease the illness-related absentee rate for elementary school students. This study involved 5 individual school districts, 16 individual schools, and more than 6000 students in Delaware, Ohio, Tennessee, and California. Individual schools in each district were paired into product and control groups. In the product group schools, an alcohol gel hand sanitizer was used by the students and staff when entering and leaving the classroom. Absenteeism due to infection was recorded, and the data were statistically analyzed. The overall reduction in absenteeism due to infection in the schools included in this study was 19.8% for schools that used an alcohol gel hand sanitizer compared with the control schools (P <.05). Data from the school system with the largest teacher population (n = 246) showed that teacher absenteeism decreased 10.1% (trend) in the schools where sanitizer was used. Elementary school absenteeism due to infection is significantly reduced when an alcohol gel hand sanitizer is used in the classroom as part of a hand hygiene program.

High-level disinfection of gastrointestinal endoscope reprocessing

PubMed Central

Chiu, King-Wah; Lu, Lung-Sheng; Chiou, Shue-Shian

2015-01-01

High level disinfection (HLD) of the gastrointestinal (GI) endoscope is not simply a slogan, but rather is a form of experimental monitoring-based medicine. By definition, GI endoscopy is a semicritical medical device. Hence, such medical devices require major quality assurance for disinfection. And because many of these items are temperature sensitive, low-temperature chemical methods, such as liquid chemical germicide, must be used rather than steam sterilization. In summarizing guidelines for infection prevention and control for GI endoscopy, there are three important steps that must be highlighted: manual washing, HLD with automated endoscope reprocessor, and drying. Strict adherence to current guidelines is required because compared to any other medical device, the GI endoscope is associated with more outbreaks linked to inadequate cleaning or disinfecting during HLD. Both experimental evaluation on the surveillance bacterial cultures and in-use clinical results have shown that, the monitoring of the stringent processes to prevent and control infection is an essential component of the broader strategy to ensure the delivery of safe endoscopy services, because endoscope reprocessing is a multistep procedure involving numerous factors that can interfere with its efficacy. Based on our years of experience in the surveillance of culture monitoring of endoscopic reprocessing, we aim in this study to carefully describe what details require attention in the GI endoscopy disinfection and to share our experience so that patients can be provided with high quality and safe medical practices. Quality management encompasses all aspects of pre- and post-procedural care including the efficiency of the endoscopy unit and reprocessing area, as well as the endoscopic procedure itself. PMID:25699232

[Hand hygiene technique assessment using electronic equipment in 26 Hungarian healthcare institutions].

PubMed

Lehotsky, Ákos; Morvai, Júlia; Szilágyi, László; Bánsághi, Száva; Benkó, Alíz; Haidegger, Tamás

2017-07-01

Hand hygiene is probably the most effective tool of nosocomial infection prevention, however, proper feedback and control is needed to develop the individual hand hygiene practice. Assessing the efficiency of modern education tools, and digital demonstration and verification equipment during their wide-range deployment. 1269 healthcare workers took part in a training organized by our team. The training included the assessment of the participants' hand hygiene technique to identify the most often missed areas. The hand hygiene technique was examined by a digital device. 33% of the participants disinfected their hands incorrectly. The most often missed sites are the fingertips (33% on the left hand, 37% on the right hand) and the thumbs (42% on the left hand, 32% on the right hand). The feedback has a fundamental role in the development of the hand hygiene technique. With the usage of electronic devices feedback can be provided efficiently and simply. Orv Hetil. 2017; 158(29): 1143-1148.

Efficacy of surface disinfectant cleaners against emerging highly resistant gram-negative bacteria

PubMed Central

2014-01-01

Background Worldwide, the emergence of multidrug-resistant gram-negative bacteria is a clinical problem. Surface disinfectant cleaners (SDCs) that are effective against these bacteria are needed for use in high risk areas around patients and on multi-touch surfaces. We determined the efficacy of several SDCs against clinically relevant bacterial species with and without common types of multidrug resistance. Methods Bacteria species used were ATCC strains; clinical isolates classified as antibiotic-susceptible; and multi-resistant clinical isolates from Klebsiella oxytoca, Klebsiella pneumoniae, and Serratia marcescens (all OXA-48 and KPC-2); Acinetobacter baumannii (OXA-23); Pseudomonas aeruginosa (VIM-1); and Achromobacter xylosoxidans (ATCC strain). Experiments were carried out according to EN 13727:2012 in quadruplicate under dirty conditions. The five evaluated SDCs were based on alcohol and an amphoteric substance (AAS), an oxygen-releaser (OR), surface-active substances (SAS), or surface-active-substances plus aldehydes (SASA; two formulations). Bactericidal concentrations of SDCs were determined at two different contact times. Efficacy was defined as a log10 ≥ 5 reduction in bacterial cell count. Results SDCs based on AAS, OR, and SAS were effective against all six species irrespective of the degree of multi-resistance. The SASA formulations were effective against the bacteria irrespective of degree of multi-resistance except for one of the four P. aeruginosa isolates (VIM-1). We found no general correlation between SDC efficacy and degree of antibiotic resistance. Conclusions SDCs were generally effective against gram-negative bacteria with and without multidrug resistance. SDCs are therefore suitable for surface disinfection in the immediate proximity of patients. Single bacterial isolates, however, might have reduced susceptibility to selected biocidal agents. PMID:24885029

Effect of disinfecting teats post-milking or pre- and post-milking on intramammary infection and somatic cell count.

PubMed

Williamson, J H; Lacy-Hulbert, S J

2013-09-01

To determine the effects of (a) post-milking teat disinfection compared with no disinfection and (b) pre- and post-milking teat disinfection compared with post-milking disinfection alone, on the incidence of new intramammary infection (IMI), somatic cell count (SCC) and teat skin abnormalities in dairy cows. In Experiment 1, dairy cows in five dairy herds were randomly allocated to a post-milking teat disinfection group (n=230), that was sprayed with an iodine-based disinfectant (TeatguardPlus) for a complete lactation, or to a non-disinfected group (n=239). In Experiment 2, cows were randomly allocated to post-milking teat disinfection (n=239) or both pre- and post-milking teat disinfection (n=235), using a chloramine-T-based disinfectant (Teatsweet) for both treatments, from calving to 118-127 days in milk. The incidence of new IMI was determined by aseptic sampling of all quarters at calving, during lactation, and at trial end or at drying-off, with clinical mastitis cases sampled on detection. SCC and teat skin abnormalities were measured at 2-monthly intervals during lactation. In both experiments, disinfectant was applied by spray application. Cows that received post-milking teat disinfection had a lower incidence of new IMI caused by Staphylococcus aureus, Streptococcus uberis, Corynebacterium spp and coagulase negative staphylococci, had lower bulk milk SCC during lactation, and had fewer teat skin abnormalities compared with the non-disinfected cows (p < 0.05). Pre-milking teat disinfection, in addition to post-milking teat disinfection, did not reduce the incidence of new IMI for any pathogens and did not reduce SCC (p> 0.05). Post-milking teat disinfection applied as a spray is a key component in mastitis control in New Zealand. There was no benefit from the addition of pre-milking disinfection. This study confirms previous findings of the effectiveness of post-milking teat disinfection in reducing the incidence of IMI caused by the common mastitis

Quaternary ammonium compounds: an alternative disinfection method for fresh produce wash water.

PubMed

Chaidez, Cristobal; Lopez, Javier; Castro-del Campo, Nohelia

2007-06-01

Irrigation water can serve as a vehicle for transporting pathogenic microorganisms, and numerous cases of bacterial infections from consumption of irrigated fresh produce have been reported in recent years. Chlorine-based disinfectants applied when produce is packed are widely used to control microorganisms. When applied properly, the chlorine products are effective. However, hazardous disinfection breakdown products can be formed, and chlorine disinfectants have high oxidant activity that can affect produce quality and pose a risk to food handlers. Quaternary Ammonium Compounds (QACs) are a disinfectant alternative for the washing of fruits and vegetables. They can control a great number of microorganisms, have low toxicity when used at recommended doses, and are stable in storage. The purpose of this work was to assess the disinfectant activity of QACs against Escherichia coli and Staphylococcus aureus under worst-case and average-case turbidity conditions, (2 and 100 nephelometric units); two disinfectant concentrations (100 and 200 mg/L; and two contact times (30 and 120 seconds). Our research showed that QACs were effective against both bacteria. The percentage reduction of Escherichia coli was significantly higher in the less turbid solution (P = 0.027), while turbidity did not affect the reduction of Staphylococcus aureus (P > 0.05). E. coli was more resistant to QAC treatment than S. aureus. Based on the data obtained we can conclude that QACs could be an alternative in washing processes of fruits and vegetables.

Do WiFi-based hand hygiene dispenser systems increase hand hygiene compliance?

PubMed

Scheithauer, Simone; Bickenbach, Johannes; Heisel, Hans; Fehling, Patrick; Marx, Gernot; Lemmen, Sebastian

2018-05-17

Innovative methods to ensure better compliance in hand hygiene are urgently needed. The aim of this study was to determine if WiFi-based hand hygiene dispenser-driven self-assessment systems (Wireless Fidelity, WiFi-dispenser) can support the work of infection control teams. Our results suggest that the continuous monitoring of dispenser usage can be a valuable addition to infection prevention and control programs, when used in a bundle in combination with conventional hand hygiene training. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

DISINFECTION

EPA Science Inventory

The primary goal of the disinfection process in drinking water treatment is the inactivation of microbial pathogens. These pathogens comprise a diverse group of organisms which serve as the etiological agents of waterborne disease. Included in this group are bacterial, viral and ...

Moist Heat Disinfection and Revisiting the A0 Concept.

PubMed

McCormick, Patrick J; Schoene, Michael J; Dehmler, Matthew A; McDonnell, Gerald

2016-04-02

Moist heat is employed in the medical device, pharmaceutical, and food processing industries to render products and goods safe for use and human consumption. Applications include its use to pasteurize a broad range of foods and beverages, the control of microbial contamination of blood products, and treatment of bone tissue transplants and vaccines. In the pharmaceutical industry, water heated to 65°C to 80°C is used to sanitize high-purity water systems. In healthcare, it has been employed for decades to disinfect patient care items ranging from bedpans to anesthesia equipment. There is a good understanding of the conditions necessary to achieve disinfection of microorganisms at temperatures ranging from 65°C to 100°C. Based on this information, the efficacy of moist heat processes at a range of exposure times and temperatures can be quantified based on mathematical models such as the A0 calculation. While the A0 concept is recognized within the European healthcare community, it has yet to be widely adopted within the United States. This article provides information regarding the A0 concept, a brief overview of the classification of thermal disinfection for use with healthcare applications within the United States, and recent data on reinvestigating the thermal disinfection of a selected panel of microorganisms and a mixed culture biofilm.

COMPONENT-BASED AND WHOLE-MIXTURE TECHNIQUES FOR ADDRESSING THE TOXICITY OF DRINKING WATER DISINFECTION BYPRODUCT MIXTURES

EPA Science Inventory

ABSTRACT

Chemical disinfection of water is of direct public health benefit as it results in decreased waterborne illness. The chemicals used to disinfect water react with naturally occurring organic matter and bromide in the source water, resulting in the formation of a m...

Sanitizers and Disinfectants Guide. Revised

ERIC Educational Resources Information Center

Healthy Schools Network, Inc., 2012

2012-01-01

Sanitizers and disinfectants can play an important role in protecting public health. They are designed to kill "pests," including infectious germs and other microorganisms such as bacteria, viruses, and fungi. Unfortunately, sanitizers and disinfectants also contain chemicals that are "pesticides." Exposure to persistent toxic…

DISINFECTION BYPRODUCTS: THE NEXT GENERATION

EPA Science Inventory

Disinfection of drinking water is rightly hailed as a major public health triumph of the 20th Century. Before widespread disinfection of drinking water in the U.S. and Europe, millions of people died from infectious waterborne diseases, such as typhoid and cholera. The microbia...

Influence of investment, disinfection, and storage on the microhardness of ocular resins.

PubMed

Goiato, Marcelo Coelho; dos Santos, Daniela Micheline; Gennari-Filho, Humberto; Zavanelli, Adriana Cristina; Dekon, Stefan Fiuza de Carvalho; Mancuso, Daniela Nardi

2009-01-01

The longevity of an ocular prosthesis is directly related to the resistance to erosion of its material. The purpose of this study was to evaluate the effects of chemical disinfection and the method of investment on the microhardness of ocular prosthesis acrylic resin. Thirty-two test specimen investments were obtained in two silicones. A segment was cut in each test specimen, and each specimen was fixed in an acrylic disk. The specimens were then polished and submitted to the first microhardness test before immersion in distilled water and incubation for 2 months. During this 2-month period, the specimens were immersed in a water bath at 37 degrees C and were disinfected daily; half were disinfected with neutral soap and the other half were disinfected with 4% chlorhexidine gluconate. After the storage phase and disinfection, a second microhardness test was performed. The surface microhardness values for the acrylic resins were submitted to ANOVA, followed by the Tukey test. The disinfection and the period of storage did not statistically influence the surface microhardness of the acrylic resin, independent of the method of investment of the specimens (Zetalabor or Vipi Sil). The investment of specimens with Zetalabor silicone presented a greater surface hardness, independent of the type of disinfection and the period of storage. Based on these results, we suggest that the microhardness of the resin evaluated was not influenced by the method of disinfection or the time of storage used and was affected only by the investment material.

Nano-TiO2-based photocatalytic disinfection of environmental surfaces contaminated by meticillin-resistant Staphylococcus aureus.

PubMed

Petti, S; Messano, G A

2016-05-01

Traditional cleaning and disinfection methods are inefficient for complete decontamination of hospital surfaces from meticillin-resistant Staphylococcus aureus (MRSA). Additional methods, such as nano-TiO2-based photocatalytic disinfection (PCD), could be helpful. To evaluate anti-MRSA activity of PCD on polyvinyl chloride (PVC) surfaces in natural-like conditions. Two identical PVC surfaces were used, and nano-TiO2 was incorporated into one of them. The surfaces were contaminated with MRSA isolated from hospitalized patients using a mist sprayer to simulate the mode of environmental contamination caused by a carrier. MRSA cell density was assessed before contamination until 180min after contamination using Rodac plates. The differences between test and control surfaces in terms of MRSA density and log MRSA density reduction were assessed using parametric and non-parametric statistical tests. Five strains were tested, and each strain was tested five times. The highest median MRSA densities [46.3 and 43.1 colony-forming units (cfu)/cm(2) for control and test surfaces, respectively] were detected 45min after contamination. Median MRSA densities 180min after contamination were 10.1 and 0.7cfu/cm(2) for control and test surfaces, respectively (P<0.01). Log MRSA density reduction attributable to PCD was 1.16logcfu/cm(2), corresponding to 93% reduction of the baseline MRSA contamination. The disinfectant activity remained stable throughout the 25 testing occasions, despite between-test cleaning and disinfection. The anti-MRSA activity of PCD was compatible with the benchmark for surface hygiene in hospitals (<1cfu/cm(2)), but required 3h of exposure to photocatalysis. Thus, PCD could be considered for non-clinical surfaces. However, for clinical surfaces, PCD should be regarded as supplemental to conventional decontamination procedures, rather than an alternative. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Hospital disinfection: efficacy and safety issues.