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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.

Cleaning indicators are widely used to evaluate the efficacy of cleaning processes in automated washer-disinfectors (AWDs) in healthcare settings. In this study, we systematically analyzed the performance of commercial indicators across multiple simulated cleaning protocols to guide the correct selection of suitable cleaning indicators in Central Sterile Supply Departments (CSSD). Eleven commercially available cleaning indicators were tested in five cleaning simulations, P0 to P4, where P1 represented the standard cleaning process in CSSD, while P2-P4 incorporated induced-error cleaning processes to mimic real-world errors. All indicators were uniformly positioned at the top level of the cleaning rack to ensure comparable exposure. Key parameters, including indicator response dynamics (e.g., wash-off sequence) and final residue results, were documented throughout the cleaning cycles. The final wash-off results given by the indicators under P0, in which no detergent was injected, were much worse than those of the other four processes. Under different simulations, the final results of the indicators and their wash-off sequences changed substantially. In conclusion, an effective indicator must be selected experimentally. The last indicator to be washed off during the normal cleaning process that can simultaneously clearly show the presence of dirt residue under induced error conditions is the optimal indicator for monitoring cleaning processes.

Background. The control of biological hazard risk in health care and dental clinic environments represents a critical point in relation to the Covid-19 infection outbreak and international public health emergency. The purpose of the present review was to evaluate the scientific literature on the no-touch disinfection procedures in dental clinics aiming to limit transmission via airborne particles or fomites using no-touch procedures for environmental decontamination of dental clinics. Methods. An electronic database literature search was performed to retrieve research papers about Covid-19 and no-touch disinfection topics including full-length articles, editorials, commentaries, and outbreak studies. A total of 86 papers were retrieved by the electronic research. Results. No clinical article about the decontamination of a dental clinic during the Covid-19 pandemic was detected. About the topic of hospital decontamination, we found different no-touch disinfection procedures used in hospital against highly resistant organisms, but no data were found in the search for such procedures with respect to SARS-CoV-2: (1) aerosolized hydrogen peroxide, (2) H2O2 vapor, (3) ultraviolet C light, (4) pulsed xenon, and (5) gaseous ozone. One paper was retrieved concerning SARS-CoV-2; 32 documents focused on SARS and MERS. The cleaning and disinfection protocol of health care and dental clinic environment surfaces are essential elements of infection prevention programs, especially during the SARS-CoV-2 pandemic. Conclusion. The decontamination technique that best suits the needs of the dental clinic is peroxide and hypochlorous which can be sprayed via a device at high turbine speed with the ability of producing small aerosol particles, recommendable also for their low cost.

To explore the effects of quality traceability systems on sharing medical community disinfection centers. We selected 3028 cases of medical community instrument packages that were manually handled by a single medical community’s disinfection center as the control group and 3302 cases of medical community instrument packages processed at the same center using an automated system as the experimental group. The quality of medical community instrument management, efficiency, adverse event incidence rate, and user satisfaction were compared to evaluate the advantages of device management using the system. The time consumed for statistical usage queries, cost queries, accounting, scrap statistics, and package status inspection reports for the medical community instrument packages in the experimental group were significantly lower than those in the control group, and the incidence rate of adverse events in the experimental group was lower than that in the control group as well ( P  < 0.05). In addition, the average satisfaction score was higher than the control group. The use of the quality traceability system in the disinfection center improved the quality of medical community instrument management, increased efficiency, reduced the incidence of adverse events, and improved staff satisfaction with the process.

There are increased risks of contracting COVID-19 in hospitals and long-term care facilities, particularly for vulnerable groups. In these environments aerosolised coronavirus released through breathing increases the chance of spreading the disease. To reduce aerosol transmissions, the use of low dose far-UVC lighting to disinfect in-room air has been proposed. Unlike typical UVC, which has been used to kill microorganisms for decades but is carcinogenic and cataractogenic, recent evidence has shown that far-UVC is safe to use around humans. A high-fidelity, fully-coupled radiation transport and fluid dynamics model has been developed to quantify disinfection rates within a typical ventilated room. The model shows that disinfection rates are increased by a further 50-85% when using far-UVC within currently recommended exposure levels compared to the room’s  ventilation alone. With these magnitudes of reduction, far-UVC lighting could be employed to mitigate SARS-CoV-2 transmission before the onset of future waves, or the start of winter when risks of infection are higher. This is particularly significant in poorly-ventilated spaces where other means of reduction are not practical, in addition social distancing can be reduced without increasing the risk.

Modern day dermatologists conduct different esthetic and surgical procedures, with risk of infective complications. Hence, infection control practices need to be established in dermatological practice to minimize the risk of exogenous infections. These practices include hand washing, cleaning, sterilization, disinfection, operation theater sterilization and specifications. Proper hand washing after examination of each patient and prior to any surgery with a formulation containing alcohol alone or as a combination with other agents reduces the chances of transferring infections to and from patients. Sterilization and disinfection constitute the most important aspect of infection control. Disinfectants and disinfecting procedures vary according to the environment and equipment. Proper knowledge of different processes/agents for sterilization and disinfection is essential. Disinfectants for use in hospitals should always be freshly prepared and should be of adequate strength. Sterilization is carried out most commonly using steam sterilizers or ethylene dioxide sterilizers. The waste generated during practice is a potential source of nosocomial infections and should be treated as per the proper protocol and guidelines. Trained staff to carry out these practices is essential.

In this work, we developed a device capable to generate a non-thermal plasma discharge inside a sealed bag. The aim of this study was to assess the effectiveness of the oxygen, nitrogen and argon plasma sterilization on Pseudomonas aeruginosa, Staphylococcus aureus and Bacillus subtilis spores according to the NF EN 556 Norm. Moreover the bag integrity which is a critical key to maintain the sterile state of items after the end of the process was verified by Fourier Transform Infrared (FTIR) and X-ray Photoelectron Spectrometry (XPS) analyses. After plasma treatments, the bacterial counting showed a 6 log reduction of P. aeruginosa and S. aureus in 45 min and 120 min respectively whatever the gas used and a 4 log reduction of B. subtilis spores in 120 min with only oxygen plasma. These results were confirmed by Scanning Electron Microscopy (SEM) observations showing altered bacteria or spores and numerous debris. Taking into account the studied microorganisms, the oxygen plasma treatment showed the highest efficiency. FTIR and XPS analyses showed that this treatment induced no significant modification of the bags. To conclude this non-thermal plasma sterilization technique could be an opportunity to sterilize heat and chemical-sensitive medical devices and to preserve their sterile state after the end of the process.

Health-care-associated infections are a major threat to patient safety worldwide. Transmission is mainly via the hands of health-care workers, but compliance with recommendations is usually low and effective improvement strategies are needed. We assessed the effect of WHO's strategy for improvement of hand hygiene in five countries. We did a quasi-experimental study between December, 2006, and December, 2008, at six pilot sites (55 departments in 43 hospitals) in Costa Rica, Italy, Mali, Pakistan, and Saudi Arabia. A step-wise approach in four 3–6 month phases was used to implement WHO's strategy and we assessed the hand-hygiene compliance of health-care workers and their knowledge, by questionnaire, of microbial transmission and hand-hygiene principles. We expressed compliance as the proportion of predefined opportunities met by hand-hygiene actions (ie, handwashing or hand rubbing). We assessed long-term sustainability of core strategy activities in April, 2010. We noted 21 884 hand-hygiene opportunities during 1423 sessions before the intervention and 23 746 opportunities during 1784 sessions after. Overall compliance increased from 51·0% before the intervention (95% CI 45·1–56·9) to 67·2% after (61·8–72·2). Compliance was independently associated with gross national income per head, with a greater effect of the intervention in low-income and middle-income countries (odds ratio [OR] 4·67, 95% CI 3·16–6·89; p<0·0001) than in high-income countries (2·19, 2·03–2·37; p<0·0001). Implementation had a major effect on compliance of health-care workers across all sites after adjustment for main confounders (OR 2·15, 1·99–2·32). Health-care-workers' knowledge improved at all sites with an increase in the average score from 18·7 (95% CI 17·8–19·7) to 24·7 (23·7–25·6) after educational sessions. 2 years after the intervention, all sites reported ongoing hand-hygiene activities with sustained or further improvement, including national scale-up. Implementation of WHO's hand-hygiene strategy is feasible and sustainable across a range of settings in different countries and leads to significant compliance and knowledge improvement in health-care workers, supporting recommendation for use worldwide. WHO, University of Geneva Hospitals, the Swiss National Science Foundation, Swiss Society of Public Health Administration and Hospital Pharmacists.