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Annali Di Igiene : Medicina Preventiva... 2019Healthcare associated infections (HAIs) represent a serious problem for public health, as they increase the morbidity and mortality rates, present a relevant financial... (Review)
Review
BACKGROUND
Healthcare associated infections (HAIs) represent a serious problem for public health, as they increase the morbidity and mortality rates, present a relevant financial burden, and significantly contribute to the antimicrobial resistance.
METHODS
The aim of this review was to investigate the literature about HAIs, with particular reference to hospital environments and the role of cleaning and disinfection procedures. Hospital environments are an essential reservoir for HAIs cross transmission, and the application of appropriate procedures related to hand hygiene and disinfection/sterilization of surfaces and instruments remain key strategies for controlling HAIs.
RESULTS
Different procedures, based on the risk associated with the healthcare procedure, are recommended for hand hygiene: washing with soap and water, antiseptic rubbing with alcohol-based disinfectants, antiseptic and surgical hand washing. Environmental surfaces can be treated with different products, and the mostly used are chlorine-based and polyphenolic disinfectant. The reprocessing of instruments is related to their use according to the Spaulding's classification. In addition, scientific evidence demonstrated the great relevance of the "bundles" (small set of practices performed together) in controlling HAIs.
CONCLUSIONS
Research agenda should include the improvement of well-known effective preventive procedures and the development of new bundles devoted to high-risk procedures and specific microorganisms.
Topics: Cross Infection; Disinfectants; Disinfection; Equipment Contamination; Hand Disinfection; Hospitals; Humans; Public Health
PubMed: 31304524
DOI: 10.7416/ai.2019.2305 -
Enfermedades Infecciosas Y... Dec 2014This article aims to provide a brief review of the main concepts on which the prevention and control of infection are based. Antisepsis comprises a set of techniques... (Review)
Review
This article aims to provide a brief review of the main concepts on which the prevention and control of infection are based. Antisepsis comprises a set of techniques aimed at the total sterilization, or at most, disinfection, removing germs that contaminate an environment. Both procedures must be preceded by an environmental cleanup in the location in which they intend to be applied. The disinfection is carried out using biocides or germicides. Antimicrobial chemicals, that have mechanisms of action and resistances very similar to antibiotics, are generating concern due to the possibility of crossing genetic information that aggravates the problem of bacterial resistance. Most biocides can act as antiseptics, and applied to skin tissue, or disinfectants on inanimate materials. The spectrum of action of germicides depends on the product itself and external controllable factors: temperature, concentration, exposure time, etc. Sterilization techniques are primarily physical, by exposing the material to steam, or sterilizing gas, using autoclaves. Major advances are the use of low temperatures with shorter exposure times, in parallel with technological advances in instrumentation in order to avoid high temperatures and high use rotations due to workload.
Topics: Antisepsis; Disinfectants; Disinfection; Drug Resistance; Equipment Contamination; Humans; Infection Control; Skin; Sterilization
PubMed: 25023372
DOI: 10.1016/j.eimc.2014.04.003 -
The Indian Journal of Tuberculosis Apr 2023Patients with pulmonary tuberculosis (TB) may produce large amount of infectious sputum which needs to be handled carefully both in health care and household settings....
BACKGROUND
Patients with pulmonary tuberculosis (TB) may produce large amount of infectious sputum which needs to be handled carefully both in health care and household settings. As mycobacteria may survive for long duration in sputum; proper collection, disinfection and disposal is necessary to avoid potential disease transmission. We aimed to assess the efficacy of bedside disinfectant treatment of sputum produced by TB patients using easily available disinfectants that can be used both in TB wards and household settings, to sterilize the infected sputum and compared it with sputum without disinfectant treatment.
METHODS
It was a prospective case control study. Sputum of total 95 patients with sputum smear positive pulmonary tuberculosis was collected in sputum containers with lids. Patients on anti-tubercular treatment for more than 2 weeks were excluded. Each patient was given 3 sterile sputum containers to expectorate, Container A containing 5% Phenol solution, Container B containing 4.8% Chloroxylenol and Container C without any disinfectant, acting as a control. Thick sputum was liquified with Mucolytic agent N-acetyl cysteine (NAC). Aliquots of the sputum were sent for culture in Lowenstein-Jensen medium on day 0 (to confirm alive mycobacteria) and on day 1 i.e., after 24 hours (to evaluate effective sterilization). Drug resistance testing was done on all grown mycobacteria.
RESULTS
If the samples on day 0 did not grow mycobacteria (indicating non-viable mycobacteria) or day 1 sample grew contaminants in any of the three containers, they were excluded from the analysis (15/95). In remaining 80 patients, bacilli were alive on day 0 and remained alive even after 24 hours (day 1) in control samples (without disinfectants). The sputum was effectively disinfected resulting in no growth after 24 hours (day 1) in 71/80 (88.75%) containing 5% Phenol and 72/80 (90%) with 4.8% Chloroxylenol. The efficacy of disinfection was 71/73 (97.2%) and 72/73 (98.6%) for drug sensitive mycobacteria respectively. The mycobacteria however remained alive with these disinfectants in all 7 samples of drug-resistant mycobacteria with an efficacy of 0%.
CONCLUSION
We recommend use of simple disinfectants like 5% Phenol or 4.8% Chloroxylenol for safe disposal of sputum of pulmonary tuberculosis patients. It is necessary as sputum collected without disinfection remained infectious after 24 hours. Resistance of all drug resistant mycobacteria to disinfectants was a novel chance finding. This needs further confirmatory studies.
Topics: Humans; Mycobacterium tuberculosis; Case-Control Studies; Disinfection; Sputum; Tuberculosis, Pulmonary; Disinfectants; Phenols
PubMed: 37100568
DOI: 10.1016/j.ijtb.2022.03.027 -
Zoonoses and Public Health Aug 2021Disinfectants for veterinary and livestock use, plus skin antiseptics, are critical elements for the control of infectious agents, including zoonotic and... (Review)
Review
Disinfectants for veterinary and livestock use, plus skin antiseptics, are critical elements for the control of infectious agents, including zoonotic and antimicrobial-resistant micro-organisms, in managed animal species. Such agents impact animal welfare, economic performance and human health. Testing of disinfectants is needed for safety, efficacy and quality control. The present review examines the principal types of test (carrier, suspension, surface and field) that have been developed or attempted, plus the features inherent in the respective tests, particularly with respect to variability. Elements of testing that have to be controlled, or which can be manipulated, are discussed in the context of real-world scenarios and anticipated applications. Current national and international testing regimes are considered, with an emphasis on the UK, continental Europe and North America, and with further detail provided in the Supporting Information. Challenges to disinfectant efficacy include: the nature of the biological targets (bacteria, fungi, yeasts, spores, viruses and prions), the need for economical and safe working concentrations, the physical and chemical nature of contaminated surfaces, constraints on contact times and temperatures, the presence of organic soil and other barrier or neutralising substances (including biofilms), and thoroughness of pre-cleaning and disinfectant application. The principal challenges with veterinary disinfectant testing are the control of test variability, and relating test results to likely performance in variable field conditions. Despite some ambitions to develop standardised field tests for disinfectants, aside from skin antiseptic trials the myriad problems such tests pose with respect to cost, reproducibility and generalisability remain intractable.
Topics: Agriculture; Animal Welfare; Animals; Disinfectants; Disinfection; Humans; Veterinary Medicine
PubMed: 33939312
DOI: 10.1111/zph.12830 -
Journal of Hazardous Materials Aug 2022Chlorine dioxide (ClO) has emerged as a broad-spectrum, safe, and effective disinfectant due to its high oxidation efficiency and reduced formation of organochlorinated... (Review)
Review
Chlorine dioxide (ClO) has emerged as a broad-spectrum, safe, and effective disinfectant due to its high oxidation efficiency and reduced formation of organochlorinated by-products during application. This article provides an updated overview of ClO-based oxidation processes used in water treatment. A systematic review of scientific information and experimental data on ClO-based water purification procedures is presented. Concerning ClO-based oxidation derivative problems, the pros and cons of ClO-based combined processes are assessed and disinfection by-product (DBP) control approaches are proposed. The kinetic and mechanistic data on ClO reactivity towards micropollutants are discussed. ClO selectively reacts with electron-rich moieties (anilines, phenols, olefins, and amines) and eliminates certain inorganic ions and microorganisms with high efficiency. The formation of chlorite and chlorate during the oxidation process is a crucial concern when utilizing ClO. Future applications include the combination of ClO with ferrous ions, activated carbon, ozone, UV, visible light, or persulfate processes. The combined process can reduce by-product generation while still ensuring ClO sterilization and disinfection. Overall, this research could provide useful information and new insights into the application of ClO-based technologies.
Topics: Chlorine; Chlorine Compounds; Disinfectants; Disinfection; Oxides; Water Purification
PubMed: 35739725
DOI: 10.1016/j.jhazmat.2022.129195 -
International Journal of Pharmaceutics Nov 2021Emergent diseases caused by viral and bacterial infections have proven to be a current and future challenge. The occurrence of these diseases is usually accompanied by... (Review)
Review
Emergent diseases caused by viral and bacterial infections have proven to be a current and future challenge. The occurrence of these diseases is usually accompanied by the lack of vaccines and dedicated therapies leaving prevention as the best strategy to adopt. In that context, and apart from confinement and physical distancing measures, an increase in hygiene actions, namely hand and surface cleaning and disinfection can reduce the infection spread originated from our day-to-day routines. However, during crisis situations the high disinfectants demand can very likely lead to having them running out of stock. This impels many individuals and companies to produce their own disinfectants. Here, we explore the main components of a disinfection formulation, both for hand-rub and surface cleaning. Alcohol and non-alcohol based formulations are described, including the possibility to fine tune the properties of the final product in order to increase public acceptance while maintaining product efficacy. The action mechanisms of the main active principles are also described conjugating information from experimental and theoretical data. Overall, the main aspects to develop a disinfectant formulation are addressed, as well as their function, helping formulation developers to better understand the impact of their choices.
Topics: Anti-Bacterial Agents; Antiviral Agents; Disinfectants; Disinfection; Ethanol; Hand Sanitizers; Humans
PubMed: 34592397
DOI: 10.1016/j.ijpharm.2021.121139 -
Infection Control and Hospital... Mar 2018Isopropyl alcohol and ethyl alcohol have been used as low-level disinfectants in healthcare settings for many years. Recent studies have found that ethyl alcohol... (Review)
Review
Isopropyl alcohol and ethyl alcohol have been used as low-level disinfectants in healthcare settings for many years. Recent studies have found that ethyl alcohol inhibits protein synthesis in Escherichia coli by direct effects on ribosomes and RNA polymerase and that 60%-70% solutions have in vitro efficacy against murine norovirus, Ebola virus, and several coronaviruses. Alcohol prep pads or towelettes containing isopropyl or ethyl alcohol and water have been used primarily for disinfection of small noncritical items due to a concern regarding their rapid evaporation rates and associated short contact times. Sterile alcohol solutions are used mostly for disinfection of compounding pharmacies and controlled areas. One new Environmental Protection Agency (EPA)-registered cleaner/disinfectant formulation differs from other alcohol-based disinfectants by virtue of having a 30-second contact time for multiple pathogens and a toxicity rating of category IV. Multiple disinfectants containing ethyl alcohol and/or isopropyl alcohol combined with other active agents such as quaternary ammonium or phenolic compounds are widely used for disinfecting environmental surfaces in healthcare facilities. Infect Control Hosp Epidemiol 2018;39:323-328.
Topics: Alcohols; Cross Infection; Disinfectants; Disinfection; Equipment Contamination; Health Facilities; Humans
PubMed: 29374503
DOI: 10.1017/ice.2017.301 -
Water Research Apr 2019Secondary disinfectants, such as chlorine and chloramine, have been widely applied to minimise microbial risks in drinking water during distribution. Key challenges have... (Review)
Review
Secondary disinfectants, such as chlorine and chloramine, have been widely applied to minimise microbial risks in drinking water during distribution. Key challenges have included the maintenance of stable concentrations of disinfectant residuals and the control of disinfection by-products that may form as a consequence of residual decay processes. Many factors may influence disinfectant residual stability and the consequential formation of by-products. Thus predictions of disinfectant stability and by-product formation are multifactorial problems, complete with numerous complications of parameter co-dependence and feedback amplification of some key parameters. The aim of this review was to derive an understanding of how disinfectant residual stability in drinking water distribution systems is impacted by various influencing factors such as water quality and operational parameters. Factors known to influence disinfectant stability and by-product formation were critically reviewed. A systematic review method was applied to identify 1809 journal articles published in the two decades from January 1998 to December 2017. From the initial screening, 161 papers were selected for detailed assessment. Important factors were identified to include temperature, water age, piping material, corrosion products, pH, hydraulic condition, disinfectant residual type and dosage and microbial activity. Microbial activity is a particularly complex parameter on which to base predictions since many factors are known to influence the degree and nature of such activity. These include temperature, water age, piping material, corrosion products, nutrients, natural organic matter, hydraulic condition and disinfectant residual type and dosage. Disinfectant types and dosages were found to be among the most important factors. Many knowledge gaps and research needs still remain, including the need for a more complete understanding of the factors that influence the production of nitrogenous disinfection by-products.
Topics: Chlorine; Disinfectants; Disinfection; Drinking Water; Water Purification; Water Supply
PubMed: 30743084
DOI: 10.1016/j.watres.2019.01.020 -
Antimicrobial Resistance and Infection... 2019"Ready-to-use" disinfecting wipes (also known as pre-impregnated disinfecting wipe) are broadly used in food industry and domestic situations. Their application in... (Review)
Review
BACKGROUND
"Ready-to-use" disinfecting wipes (also known as pre-impregnated disinfecting wipe) are broadly used in food industry and domestic situations. Their application in hospitals and healthcare centres for decontamination of medical devices and surfaces is steadily increasing because of their convenient implementation in practice and reliable performance. Beside their acceptable compliance and easy application, literature reported the disinfection failure due to the interaction between textile substrate and active ingredients, which can highly increase the risk of an infection outbreak. This review aims to call attention to the wide range of variables affecting the disinfectant-impregnated wipes' (DIWs) disinfection performances in hospitals.
METHODS
A systematic literature search based on the five categories i. wipes, ii. disinfectants, iii. Application methods, iv. interaction between wipes and active ingredients and v. wiping strategy which can possibly influence the disinfection effectiveness of DIWs was conducted by Google scholar. Studies regarding the efficacy evaluation of DIWs in clinical applications were also reviewed from the National Centre for Biotechnology Information database.
RESULTS
Variables that impact on the disinfection performance of disinfectant-impregnated wipes in surface disinfection in hospitals were summarised and critically discussed. In addition to the information, current disinfectant-impregnated wipes' decontamination efficacy test standards were reviewed, and different standards exposed some disadvantage in their testing design.
CONCLUSION
Various parameters contribute to the impact of DIWs disinfection performance in practice. The interaction between disinfectant active ingredients and the wiping materials barricades their broad application in hospitals. More studies of the DIWs' disinfection efficacy in clinical practice are in need. Current standards evaluating the DIWs' efficacy are required to improve for more realistic condition simulation and differentiating between mechanical removal of inoculum from a surface and chemical inactivation of the test microbe.
Topics: Cross Infection; Disinfectants; Disinfection; Environmental Microbiology; Equipment Contamination; Humans
PubMed: 31452873
DOI: 10.1186/s13756-019-0595-2 -
Molecules (Basel, Switzerland) Feb 2022Electrolyzed water (EW) is a new type of cleaning and disinfecting agent obtained by means of electrolysis with a dilute sodium chloride solution. It has low cost and... (Review)
Review
Electrolyzed water (EW) is a new type of cleaning and disinfecting agent obtained by means of electrolysis with a dilute sodium chloride solution. It has low cost and harm to the human body and is also friendly to the environment. The anode produces acidic electrolyzed water (AEW), which is mainly used to inhibit bacterial growth and disinfect. The cathode provides basic electrolyzed water (BEW), which is implemented to promote human health. EW is a powerful multifunctional antibacterial agent with a wide range of applications in the medicine, agriculture, and food industry. Studies in vitro and in vivo show that it has an inhibitory effect on pathogenic bacteria and viruses. Therefore, EW is used to prevent chronic diseases, while it has been found to be effective against various kinds of infectious viruses. Animal experiments and clinical trials clearly showed that it accelerates wound healing, and has positive effects in oral health care, anti-obesity, lowering blood sugar, anti-cancer and anti-infectious viral diseases. This review article summarizes the application of EW in treating bacteria and viruses, the prevention of chronic diseases, and health promotion.
Topics: Animals; Anti-Infective Agents; Disease Management; Disinfectants; Disinfection; Electrolysis; Food Microbiology; Humans; Hydrogen-Ion Concentration; Water; Water Microbiology
PubMed: 35209015
DOI: 10.3390/molecules27041222