GMS Hygiene and Infection Control最新文献

Background: Prevention of nosocomial infections continues to be crucial to ensure patient safety and improve healthcare outcomes. In this regard, surface contamination plays an important role in the undetected transmission of nosocomial pathogens as a continuous, sporadic event or in the context of outbreaks. However, the impact of reducing bacterial contamination through copper-coated surfaces remains controversial.

Methods: A pilot study was set up in a blinded, randomized controlled design to elucidate the antimicrobial activity of door handles coated with a copper-nickel alloy. Twelve doors in a specialized department of tumor and revision surgery of a German orthopedic hospital were randomly selected to install visually indistinguishable stainless-steel door handles, either without coating (control group, n=6) or with an alloy coating consisting of 30% copper and 70% nickel (study group, n=6). Patients, all involved personnel and investigators were blinded with regard to the assignment of door handles. Door handles were sampled for viable microorganisms at 24 h after disinfection by (i) consecutive use of wet and dry swabs and (ii) contact agar slides. Bacterial growth was detected and bacteria were identified using MALDI-TOF mass spectrometry. In addition, contamination kinetics of door handles were determined by ATP measurement at time points 0 h, 1 h, 2 h, 4 h, 8 h, 12 h and 24 h after disinfection. Each technique was used on three subsequent days.

Results: Using swab method, the mean total number of colony forming units (cfu) of control and copper-nickel alloy surfaces was 2.14 cfu/cm² and 0.67 cfu/cm², respectively, yielding a difference of 68.7% (p=0.27). Bacterial counts from contact agar slide samples resulted in 0.86 cfu/cm² on control and 0.6 cfu/cm² on coated door handles which equals a difference of 30.2% (p=0.31). ATP bioluminescence measured over three subsequent days from coated door handles showed a decreased bioburden by 70.8%, 23.1%, 55.5%, 79.7%, 45.9%, 56.0%, and 68.3% of relative light units compared to control door handles at time points 0 h (before disinfection), 0 h (after disinfection), 1 h, 2 h, 4 h, 8 h, and 12 h, respectively. Statistically significant differences (p<0.05) were obtained for time points 4 h and 12 h.

Conclusion: Our data indicate a trend of reduced bacterial and overall bioburden on copper-nickel-coated door handles. Further, larger randomized controlled trials are warranted to investigate the influence of copper-coated surfaces on the prevention of hospital-acquired infections.

Curcumin, which is a polyphenol from the rhizomes of Curcuma longa, has been found to possess anti-inflammatory, antioxidant, and antimicrobial activities. This systematic review examines the effectiveness of curcumin in treating oral inflammation, e.g., periodontal diseases, gingivitis, oral lichen planus (OLP), and radiation-induced oral mucositis (ROM). The studies in this review assess different curcumin formulations, including gels, hydrogels, nano-curcumin, and mouthwashes, as adjunctive agents in oral inflammatory diseases. The studies indicate that curcumin significantly decreases clinical markers of inflammation, improves healing, and reduces patient discomfort, warranting its use as an adjunctive therapeutic agent.

An ecological community of commensals, symbiotic and pathogenic organisms share our body space. Alterations in the ecologically balanced population of microflora result in dysbiosis and are critical determinants of systemic health and diseases, especially in the context of immunosuppression. The oral microbiome and chronic inflammation may have a role in carcinogenesis.

Background: The risk of transmission of hepatitis B virus (HBV) to healthcare workers (HCW) is well known. However, evidence for supporting guidelines with respect to exclusion of infected HCW from exposure prone procedures (EPP) remains poorly characterized.

Method: A systematic review of studies published providing serological data for transmission of HBV infected HCW to patients was performed. Following preferred reporting items for systematic reviews and meta-analyses (PRISMA) we searched MEDLINE, Scopus and Cochrane databases to identify publications prior to September 2024.

Results: The literature search yielded 311 studies and 39 from nine countries met the inclusion criteria. A total 53 of HCW were considered as source cases of transmission and 25,000 individuals tested for at least one HBV marker. 66 transmissions by HCW to patients were confirmed through DNA analysis; in 100 patients HBV transmissions were considered probable and in 480 patients at least possible. Of the 36 studies in which HBeAg in HCW was determined, the antigen was positive in 29 studies (80.6%), and negative only in seven studies (19.4%), comprising a total of only 31 and 17 HCW, respectively. The HBV viral load of the transmitting HCW was conducted in only 8 studies including 18 HCW, of those four were HBeAg-positive and 14 HBeAg-negative. Although the viral load in HBeAg-negative sources generally was 10 times lower than in HBeAg-positives, considerable variability was seen in HBeAg-negatives with overlapping values up to 1.5×10⁹ copies/mL. A HBV DNA value of 4×10⁴ copies/mL represents the lower threshold for transmissibility for 18 source cases in all studies, however, for the other 35 no measurements were available. Due to the low evidence on defining an HBV DNA viral load below which HBV transmission from HCW to patients appears unlikely, the safety thresholds for excluding infected HCW from performing EPP in most recent national guidelines (UK, Germany, the Netherlands and the US) still differ by factors of as much as 5 (200 IU/mL to 1,000 IU/mL).

Conclusions: The published literature on HBV transmission from HCW to patients is sparse and offers only limited guidance on national prevention guidelines.

Background: The COVID-19 pandemic has highlighted the risk of airborne transmission of viruses, especially in public indoor spaces or healthcare settings. Effective indoor air purification systems are necessary to limit the spread of these pathogens, and the deployment of portable air cleaners (PACs) has increased rapidly since then. Germicidal ultraviolet (UV) radiation technologies have recently supplemented conventional air filtration technologies. Thus, the purpose of this study was to evaluate the air decontamination efficacy of a PAC using a 275-nm UVC-LED unit and fibrous-media air filters.

Method: Two different filters were used in the study: a High-Efficiency Particulate Air (HEPA) filter and an Efficient Particulate Air (EPA) filter. The PAC was operated in an experimental aerosol chamber with an airflow rate of 200 m³/hour for 10 or 20 minutes. Subsequently, the concentration of infectious viruses and particles in the air was measured. Decontamination efficacy was compared between UVC-LED radiation, filtration, and a combination thereof against Feline Coronavirus (FCoV) and influenza A virus (H3N2) aerosols.

Results: Infectious virus reductions were comparable between the UVC and filter measurements. A decrease of 94% in FCoV concentration was observed after 10 minutes of device runtime, increasing to 99.8% after 20 minutes compared to control measurements. H3N2 showed greater susceptibility, with a reduction of 99.7% achieved after 10 minutes. Interestingly, a synergistic effect was observed with significantly lower virus concentrations when both technologies were combined.

Conclusion: These findings highlight the potential of PACs equipped with emerging UVC-LED technologies as effective tools for indoor air decontamination. The deployment of PACs equipped with UVC radiation and filtration could be a promising alternative or supplement to ventilation systems, especially in healthcare settings and other public spaces.

Introduction: The chemical composition and microbial contaminants of commercially bottled water are managed according to public health regulations, but there are gaps in these criteria for fungal agents. For this reason, commercial bottled water brands filled in 19-L polycarbonate bottles from various water sources in western Anatolia and sold in Izmir and neighboring provinces were randomly selected and analyzed.

Materials and methods: Fungal screening was carried out in water samples using the membrane filtration technique. The number of fungi was counted in colony-forming units (cfu)/100 ml. All fungi isolated from packaged water samples were initially phenotypically analyzed for initial preliminary identification. Amplification of the well-conserved internal transcribed spacer (ITS) region was performed by polymerase chain reaction (PCR) using internal transcribed spacer (ITS)1/ITS4 primers for genotypic identification of the isolates. Using the basic local alignment search tool (BLAST), sequencing results were compared with the National Center for Biotechnology Information (NCBI) database, and species assignments were made for 31 samples. 25 moulds and 6 yeasts were identified, and molecular identification was supported by the actin gene region. The mycotoxin formation potential of the isolated Penicillium, Aspergillus, Alternaria and Cladosporium spp. was also screened using the ammonium vapor test, LC-MS and HPLC. The amount of citrinin, the metabolite produced by the Penicillium citrinum B4 strain, was determined by liquid chromatography-mass spectrometry.

Results: The most dominant strains detected in the analysis of water samples were Cladosporium, Penicillium and Alternaria. With 411.586 µg/l, the amount of citrinin was well above the upper limit for beverages.

Conclusion: The values obtained here emphasize that fungal contaminants and mycotoxins in bottled water should be included in the water analysis criteria. To the best of our knowledge, this is the first detailed research in this field in Turkey.

Introduction: A blinded survey in 81 dental practices, 84 medical practices, and 35 hospitals revealed that for conducting disinfecting surface cleaning and surface disinfection, instead of reusable clothes moistened on-site with disinfectant solution, either wipe dispenser systems for self-preparation or ready-to-use (RTU) wipes are being used. Therefore, the aim of this study was to examine, i.e., the impact of incorrect loading of the wipe roll with disinfectant solution (DS) when using wipe dispenser systems, and the consistency of the DS delivery amount when using RTU wipes.

Method: In two different wipe dispenser systems, the saturation of the wipe roll after loading with DS was visually inspected and photographically documented by adding 0.1% fluorescein sodium to the disinfectant solution. The coverage of the wipes used on a melamine resin surface (75x133 cm) was visually checked after a defined wiping mode following analogous staining.For two RTU products, a flow pack and a stand-up bag pwith the opening at the top, the saturation of the wipes and the delivery amount of the DS during use were gravimetrically determined.

Results: In the wipe dispenser system with alcohol-based DS, the amount of disinfectant solution released decreased when the solution was loaded horizontally or vertically, instead of circularly as recommended by the manufacturer. After circular loading with the manufacturer-recommended wetting time of 30 minutes, the wipe rolls were evenly saturated, and the delivery amount onto the surface during wiping disinfection was sufficiently constant. In the wipe dispenser system with an oxygen-releasing DS, after horizontal instead of circular loading the residual volume in the dispenser after removal of the last cloth was 320 ml instead 350 ml. The delivery amount onto the surface during wiping disinfection was therefore also lower (4.2+0.574 g instead of 5.0+0.606 g, p<0.0001). For the flow pack, uniform saturation was achieved when the package was stored upside down with the sealed opening facing downward the night before the first use. In the vertical pack, the delivery amount of the first wipe was significantly lower than that of the subsequent wipes.

Conclusion: For the tested flow pack, it should be noted in the user manual that the flow pack should be stored upside down, i.e., with the opening facing downward, for more than 12 hours before the first use, to achieve uniform wetting of all wipes.For the stand-up bag, it is important to follow the manufacturer's instruction that the first wipe be discarded.Since the DS delivery amount differed between the flow pack and vertical pack, it would be beneficial if, as in both cases, the manufacturer generally specified the reach for wiping disinfection for each RTU product.

Background and objectives: Colonization of pregnant women by Streptococcus (S.) agalactiae can lead to intrauterine infections after childbirth and potentially life-threatening infections in newborns. The current effectiveness of available antimicrobials is decreasing, posing a serious threat. Hence, there is an urgent requirement to develop novel categories of antimicrobial agents that can efficiently and swiftly eradicate these infections. To developed new strategies in the management and reduction of infections arising from S. agalactiae, our objective was to evaluate the antibacterial efficacy of tungsten nanoparticles (WO₃) on the expression of tetracycline and erythromycin-resistance genes in S. agalactiae isolated from pregnant women.

Materials and methods: A total of 46 Group-B streptococcus (GBS) isolates from rectovaginal swabs, blood, and urine cultures were obtained from pregnant women (13-35 weeks gestation) attending Central and Gynecological Hospitals in Tehran, Iran. The identification of GBS isolates was conducted using a variety of routine bacteriological techniques and targeted assays for the molecular characterization of the GBS isolates. The antimicrobial susceptibility test was carried out according to the Kirby-Bauer method. PCR was employed to screen for the presence of tetracycline and erythromycin resistance-associated genes. Tungsten oxide (WO₃) nanomaterials were successfully synthesized and characterized using FE-SEM (field emission scanning electron microscopy), and DLS (dynamic light scattering) techniques. The microdilution assay was used to assess the antimicrobial efficacy of WO₃ nanostructures. Furthermore, real-time PCR was employed to investigate the effectiveness of WO₃ nanostructures in the regulation of the expression of the tetM and ermB resistance genes.

Results: The findings of the antibiotic susceptibility assays demonstrated a considerable proportion of S. agalactiae strains with high resistance to tetracycline (87%), erythromycin (71.4%), and clindamycin (63%). Conversely, the resistance rates for chloramphenicol and levofloxacin were 8.7% and 6.5%, respectively. The results of antibiotic susceptibility assays revealed high-resistance S. agalactiae strains to tetracycline (87%), erythromycin (71.4%), and clindamycin (63%), while resistance rates chloramphenicol, levofloxacin, penicillin and ampicillin were 33.3%, 14.8%, 11.1%, and 7.4%, respectively. In addition to the mentioned antibiotics, it is worth noting that all strains exhibited sensitivity to other antibiotics such as ceftriaxone, linezolid, and vancomycin. Of the 24 (88.8%) erythromycin-resistant/intermediate isolates, the ermB gene was found in 16 (66.6%), and the mefA gene in 1 (4.2%) isolates. Furthermore, the tetM and tetO genes were recovered by

Introduction: The aging process is accompanied by a variety of challenges that significantly impact the quality of life and overall well-being of older adults. This study explores several key factors that negatively affect seniors, including loneliness, frailty syndrome, falls, polypharmacy, urinary incontinence, chronic pain, and malnutrition.

Method: The PubMed and Google Scholar databases were searched to find scientific articles in which the terms "elderly", and "quality of life" appear in the title, abstract, or keywords.

Results: Loneliness emerges as a critical issue, contributing to mental health problems such as depression and cognitive decline. Falls, a leading cause of injury among older adults, often result in long-term physical and psychological consequences. Polypharmacy, while intended to manage multiple chronic conditions, increases the risk of adverse drug reactions and medication non-adherence. Frailty syndrome reduces a patient's susceptibility to stressors. Urinary incontinence, often stigmatized, affects physical comfort and social interactions, reducing the dignity of those affected. Chronic pain disrupts daily functioning and exacerbates feelings of helplessness, while malnutrition undermines physical health, leading to frailty and increased susceptibility to illnesses. All of these factors have their impact on quality of life in older adults.

Conclusions: The study identifies key factors negatively affecting the quality of life in older adults, including physical, psychological, and social challenges that require comprehensive and targeted interventions.

Objective: To assess the efficacy and safety of methylprednisolone combined with rivaroxaban versus rivaroxaban monotherapy in mild cases of COVID-19.

Methods: This quasi-experimental study was conducted at three hospitals in Ho Chi Minh City, Vietnam, from September 2021 to March 2022. Patients received either rivaroxaban 10 mg/day (Regimen 1) or methylprednisolone 16 mg/day plus rivaroxaban 10 mg/day (Regimen 2) for 7 days. Outcomes included progression to severe disease, adverse events, and changes in clinical and laboratory parameters. Statistical analysis employed Fisher's exact test and Generalized Estimating Equations (GEE).

Results: Among 108 patients, no progression to severe disease or deaths occurred. Regimen 2 significantly improved laboratory markers, including white blood cell counts (+0.290; p<0.001), platelet counts (+0.102; p=0.032), aspartate aminotransferase (+0.335; p=0.013), alanine aminotransferase (+0.397; p=0.006) and CD4 cells (+0.458; p<0.001), and reduced activated partial thromboplastin time (-0.083; p=0.003) compared to Regimen 1. No significant differences in clinical symptoms were observed. Adverse events were rare, with one non-serious event reported in Regimen 1.

Conclusion: Combination therapy with methylprednisolone and rivaroxaban enhanced immune and coagulation parameters without increasing adverse events. These findings suggest potential benefits of early intervention in mild COVID-19, warranting further research.