JOURNAL OF HOSPITAL INFECTION

Disinfection effect of ozonated water on SARS-CoV-2 in the presence of salivary proteins
Yasugi M, Gunji K, Inagaki KI, Kuroda M and Ii C
Ozonated water is expected to be an effective disinfectant for SARS-CoV-2 present on environmental fomites; however, ozone is consumed by organic substances, resulting in attenuation of its effect. SARS-CoV-2 present in saliva can contaminate environmental surfaces; therefore, it is essential to understand the effect of organic substances in saliva on the disinfectant properties of ozonated water.
Cost-effectiveness of faecal microbiota transplantation compared with vancomycin monotherapy for early Clostridioides difficile infection: economic evaluation alongside a randomised controlled trial
Birch CR, Paaske SE, Jensen MB, Baunwall SMD, Ehlers LH and Hvas CL
For Clostridioides difficile infection (CDI), faecal microbiota transplantation (FMT) is currently recommended for patients with three or more CDI episodes. A recent randomised controlled trial (RCT) show that FMT may be considered early, defined as intervention during the first or second CDI episode. Compared with standard care for first or second CDI, patients randomised to FMT had €1,645 lower hospital costs over 26 weeks owing to fewer admissions and hospital contacts and less medication use.
Impact of a Polyhexanide-based Antiseptic Skin Solution on Candida auris Colonization and Invasive Fungemia
Charisi K, Galanis I, Zarras C, Totikidis G, Kouroupis D, Massa E, Michailidou C, Goumperi S, Kosmidou E, Alektoridou C, Vlachakis D, Mouloudi E, Pateinakis P, Pyrpasopoulou A and Antachopoulos C
The Development of Disinfectant Tolerance in Klebsiella pneumoniae
Noel DJ, Keevil CW and Wilks SA
Disinfectants are a critical infection control measure that are relied upon globally in a range of settings including healthcare, food production, and domestic environments. However, bacteria have been shown to survive disinfectant treatments when harboured in dry surface biofilms or when disinfectants are used ineffectively. This provides an opportunity for organisms to develop low-level tolerance to various disinfectants. The capability of bacteria to develop adaptations to non-antibiotic antimicrobial agents is often overlooked. This study investigates the ability of Klebsiella pneumoniae NDM-1 strain NCTC 13443 to adapt to a range of common chemical disinfectants (benzalkonium chloride, didecyldimethylammonium chloride, polyhexamethylene biguanide, chlorocresol and bronopol) via serial passage exposure method. After long-term adaptation K. pneumoniae developed tolerance to all tested disinfectants, exhibiting a minimum inhibitory concentration increase of between 30-413% compared to the untreated parent samples. Characterisation of disinfectant cross-tolerance showed that while cross-tolerance can occur, most adapted samples became more susceptible to the second disinfectant treatment, likely because of the fitness cost of adaptation. Observed cross-tolerance/increased susceptibility was not always reciprocated between disinfectant-tolerant samples, indicating that the order of disinfectant exposure is important during tolerance development. This has significant implications for disinfectant cleaning routines, and is likely due to variations in the underpinning tolerance mechanisms, even when the disinfectants display similar mechanisms of action. This study reports the capability and readiness of clinically relevant K. pneumoniae to adapt to common disinfectants that are relied upon every day across the world, delivering much-needed insights into an often-overlooked aspect of antimicrobial resistance.
Analysis of a persistent outbreak with vancomycin resistant Enterococcus faecium (VREfm) revealed the need for an adapted diagnostic algorithm
Nijhuis RHT, Weersink AJL, Stegeman-Heining F, Smilde AE and Melles DC
Our setting was challenged with an outbreak of different vancomycin resistant Enterococcus faecium (VREfm) including vanA and/or vanB containing isolates. Remarkably, it was observed that screening by use of a vanA and vanB real-time PCR on overnight enriched specimens from time to time tested positive for VanB with very low Ct-values, whereas VREfm-specific enrichment cultures remained negative. Here, we describe the analysis of the diagnostic results leading to adaptation of the diagnostic algorithm.
The Barts Surgical Infection Risk tool (B-SIR): external validation and comparison with existing tools to predict surgical site infection after cardiac surgery
Magboo R, Cooper J, Shipolini A, Krasopoulous G, Kirmani BH, Akowuah E, Byers H and Sanders J
We previously developed and internally validated the Barts Surgical Infection Risk (B-SIR). We sought to explore the external validity of the B-SIR tool and compare with the Australian Clinical Risk Index (ACRI) and Brompton and Harefield Infection Score (BHIS).
In vitro and in use efficacy of a rapid, targeted UVC decontamination system
Yui S, Karia K, Muzslay M, Wilson P and Ali S
Ultraviolet C (UVC) decontamination systems are used in healthcare to supplement manual cleaning. Systems typically target whole rooms with fixed, vertical bulbs. A novel system with emitters on articulating arms was designed for rapid, targeted decontamination.
Cold atmospheric plasma as an alternative decontaminant to control healthcare-associated infections and antimicrobial resistance. Significant potential that can be realised globally
Humphreys H and Daniels S
Assessing the role of environment in Pseudomonas aeruginosa healthcare-associated bloodstream infections: a one-year prospective survey
Virieux-Petit M, Ferreira J, Masnou A, Bormes C, Paquis MP, Toubiana M, Bonzon L, Godreuil S and Romano-Bertrand S
To prospectively investigate the role of hospital environment in Pseudomonas aeruginosa (Pa) nosocomial bloodstream infections (BSIs) during one year in a tertiary-care hospital.
ANTIMICROBIAL EFFICACY OF AN EXPERIMENTAL UV-C ROBOT IN CONTROLLED CONDITIONS AND IN REAL HOSPITAL SCENARIO
Casini B, Scarpaci M, Chiovelli F, Leonetti S, Costa AL, Baroni M, Petrillo M and Cavallo F
Among no-touch automatized disinfection devices, UV-C radiation proved to be one of the most effective against a broad-spectrum of microorganisms causing healthcare-associated infections.
EFFECTIVENESS OF ZERO SURGICAL INFECTION PROJECT (ZSIP) IN SPANISH HOSPITALS 2017-2021. A PROSPECTIVE COHORT STUDY
Navarro-Gracia JF, Gómez-Romero FJ, Lozano-García FJ, Ortí-Lucas R, Delgado-De Los Reyes JA, Fernández-Prada M, Herruzo-Cabrera R, and
The Zero Surgical Infection Project (ZSIP) in Spain is a nation-wide program to prevent surgical site infections (SSI), sponsored by the Ministry of Health. The program includes the application of 5 key preventive measures (PM) grouped in a bundle: Perioperative antibiotic prophylaxis (PAP), skin antisepsis (SA), hair removal (HR), normothermia (NT) and normoglycemia (NG).
Povidone-iodine and Silver-nitrate are Equally Effective in Eradicating Staphylococcal Biofilm Grown on a Titanium Surface: An in vitro Analysis
Semeshchenko D, Veiga MF, Visus M, Farinati A, Huespe I, , Buttaro MA, Slullitel PA and
There is no consensus on the irrigation solution and concentration that should be used when performing a debridement, antibiotics, and implant retention (DAIR)-surgery.
Extended-Spectrum β-Lactamase-Producing Bacteria from Hospital Wastewater Pipes: Isolation, Characterisation, and Biofilm Control using Common Disinfectants
Wu J, Thompson TP, O'Connell NH, McCracken K, Powell J, Gilmore BF, Dunne CP and Kelly SA
Hospital wastewater systems have been identified as reservoirs for antibiotic-resistant bacteria, with biofilms harbouring extended-spectrum β-lactamase (ESBL)-producing microorganisms posing significant infection risk. This study focuses on the antimicrobial susceptibility and biofilm control of ESBL-producing bacteria from wastewater pipes from a tertiary care teaching hospital in Ireland, which had experienced endemic infection outbreaks caused by ESBL-producing bacteria. Following isolation of ESBL-producers on selective agar antibiotic susceptibility profiles were determined for a number of antibiotics assessed for their ability to form biofilms. Biofilm eradication studies using the commercially available disinfectants bleach, Optizan, Virkon, and Clinell were performed on selected isolates. ESBL-producing bacteria (n=39 isolates) showed a high degree of resistance to β-lactams. Biofilm-forming ability ranged from non-adherent to strongly adherent and appeared to be source dependent, suggesting the characteristics of the pipe environment played an important role in biofilm formation. All disinfectants showed effective biofilm eradication under suggested working conditions. Effectiveness was significantly reduced following reductions in concentration and contact time, with only Clinell showing significant biofilm reduction against all isolates at all concentrations and contact times tested. Of the chlorine-based formulations, Optizan frequently outperformed bleach at lower concentrations and treatment times. Biofilm eradication was strain dependent, with varying disinfectant response profiles observed from biofilms from different Stenotrophomonas maltophilia isolates. This study highlights the high degree of ESBL-producing bacteria recovery from patient-facing hospital wastewater apparatus. Their ability to form resident biofilms and act as potential reservoirs of infection emphasises the need for rigorous and effective infection control practices.
Response to Dr Dancer
Kiernan MA, Garvey M, Norville P, Otter JA and Weber DJ
Ventilation or Aerosol Extraction: Comparing the Efficacy of Directional Air Purifiers, HEPA Evacuators, and Negative Pressure Environments
Hung TY, Yu SH, Chen YC, Su YC, Chen HL, Wu BH, Hu SC and Lin T
This study evaluates aerosol exposure during various respiratory activities (breathing, tachypnea, coughing, and oxygen therapy) in environments with directional air purifiers (DAP), HEPA evacuators, and standard negative pressure (SNP) rooms to explore potential alternatives for addressing isolation room shortages.
Defending the Surface Microbiome
Dancer SJ
Screening for latent tuberculosis infection among healthcare workers at recruitment in a country with a low incidence of tuberculosis: a retrospective study
Gomes CV, Rusca S, Dumoulin A, Bridevaux PO, Arlettaz L, Emonet S and Catho G
Environmental colistin resistance at a medium complexity hospital in Southern Brazil
de Lima Bastos RL, de Brum GF, Dos Santos BM, Moreira RS, Bär KA, Bicca MR and Vizzotto BS
Transmission pathways and personal protective equipment requirement for mpox clade Ib lineage: nothing new on this front
Decousser JW, Keita-Perse O, Aho Glele LS, Baron R, Carre Y, Cassier P, Chaize P, Coppry M, Dananche C, Florentin A, Fournier S, Racaud J, Rogues AM, Souyri V, Tamames C, Lavigne T, Parneix P, Romano-Bertrand S and
Mycobacteroides abscessus Outbreak and Mitigation in a Cardiothoracic Transplant Population: The Problem with Tap Water
Rathod SN, Weber RT, Salim AA, Tanna SD, Stosor V, Malczynski M, O'Boye A, Hoke K, Landon J, McCarthy S, Qi C, Angarone MP, Ison MG, Williams JL, Zembower TR and Bolon MK
Hospital outbreaks caused by Mycobacteroides abscessus complex are a major cause for concern in vulnerable patients such as the cardiothoracic transplant population.
Clinical and microbiological effectiveness of pulsed-xenon ultraviolet light disinfection in a neonatal intensive care unit in Japan
Komamizu S, Yamamoto Y, Morikane K, Kuwabara Y, Kondo M, Tatebayashi K, Koyama T and Terazawa D
Meticillin-resistant Staphylococcus aureus (MRSA) is a common causative agent of serious healthcare-related infections in neonatal intensive care units (NICUs). In adult ICUs, pulsed-xenon ultraviolet (PX-UV) disinfection of environmental surfaces, along with alcohol-based hand hygiene and terminal cleaning, has been demonstrated to reduce the MRSA acquisition rate. However, the impact of PX-UV use in NICUs on reducing MRSA transmission remains unexplored.