Contamination of equipment and surfaces in the operating room anesthesia workspace: a cross-sectional study

ABSTRACT BACKGROUND: Contamination of the breathing circuit and medication preparation surface of an anesthesia machine can increase the risk of cross-infection. OBJECTIVE: To evaluate the contamination of the anesthetic medication preparation surface, respiratory circuits, and devices used in general anesthesia with assisted mechanical ventilation. DESIGN AND SETTING: Cross-sectional, quantitative study conducted at the surgical center of a philanthropic hospital, of medium complexity located in the municipality of Três Lagoas, in the eastern region of the State of Mato Grosso do Sul. METHODS: Eighty-two microbiological samples were collected from the breathing circuits. After repeating the samples in different culture media, 328 analyses were performed. RESULTS: A higher occurrence of E. coli, Enterobacter spp., Pseudomonas spp., Staphylococcus aureus, and Streptococcus pneumoniae (P < 0.001) were observed. Variations were observed depending on the culture medium and sample collection site. CONCLUSION: The study findings underscore the inadequate disinfection of the inspiratory and expiratory branches, highlighting the importance of stringent cleaning and disinfection of high-touch surfaces.

Evaluation of the active concentration of two disinfectants based on glutaraldehyde and benzalkonium chloride and antimicrobial activity in vitro against Salmonella Heidelberg and Salmonella Typhimurium

Biosecurity, cleaning and disinfection of swine and poultry facilities are fundamental for the reduction of pathogenic microorganisms of importance for public and animal health. The objective of this work was to compare the levels of active ingredient described on the label and the real levels detected in high-performance liquid chromatography (HPLC) of two disinfectants., then evaluate the antimicrobial activity since, following the Germicidal Sanitizing Action and Disinfectant Detergent (Official Method AOAC 960.09) in four different dilutions with the presence of 3% organic matter during 15 min of contact, against Salmonella Heidelberg and Salmonella Typhimurium (ST). The product "A" presents active levels of agreement according to the label. The content of quantified assets for product "B" was lower than that recorded on the label. The disinfectant "A" was effective in microbiological evaluation while the disinfectant "B" had microbiocidal activity compromised by the deficit of assets.

Environmental monitoring in NAT laboratory / 中国输血杂志

【Objective】 To analyze the environmental monitoring results of NAT laboratory from 2016 to 2019 and evaluate the influence of environmental quality on blood screening. 【Methods】 Monthly/Quarterly environmental monitoring was carried out in NAT laboratory regularly by means of air deposition and surface wiping. The monitoring results were statistically analyzed and comprehensively evaluated in combination with the pool/multiplexNATreactiverate and discriminatory/resolutionrate. 【Results】 A total of 48 batches of environmental monitoring tests were conducted from 2016 to 2019, 11 (25 reactive sites) were unqualified, including 15 reactive sites (60%) as the hallway doorknob or access control, which were the public areas shared with serology laboratory, and these sites were not reactive for 6 consecutive months after intensive cleaning and disinfection. In Nov.2017, the air deposition in biosafety cabinet and surface wiping of Cobas s 201 were reactive, and the restwere the doorknobs. Pearson correlation analysis showed that there was no correlation between the positive rate of environmental monitoring and the detection amount, the pool/ multiplex NAT reactive rate and discriminatory/resolution rate. 【Conclusion】 The accidental environmental pollution in the laboratory is not related to the detection amount and positive rate, indicating that the cleaning and anti-pollution measures are timely and effective to ensure the accuracy and reliability of the screen results. NAT laboratory should gradually establish and improve the environmental monitoring system according to the layout and environment so that the environmental quality meets the testing conditions.

Contaminación ambiental por microorganismos multirresistentes y el efecto de la limpieza y desinfección en una unidad de cuidados intensivos / Environmental contamination by multi-resistant microorganisms and the effect of cleaning and disinfection in an intensive care unit / Contaminação ambiental por micro-organismos multirresistentes e o efeito de limpeza e desinfecção em unidade de terapia intensiva

Conocer el rol del medio ambiente es fundamental para evitar las infecciones intra-hospitalarias. Con ese objetivo, se planteó evaluar la prevalencia de contaminación ambiental por microorganismos multirresistentes (MMR) antes y después de la limpieza terminal de habitaciones de pacientes colonizados y establecer si la aparatología de uso común actuaba como reservorio de estos en la unidad de cuidados intensivos (UTI). Se obtuvieron muestras ambientales de las habitaciones, 48 h posteriores a la detección de colonización y luego de las limpiezas. Los resultados mostraron que luego de ambos procedimientos de limpieza se logró reducir de 28,2% a 2,6% la contaminación por Acinetobacter spp. multirresistente (AMR). También, se tomaron muestras de aparatología de uso común encontrándose entre 1,8 y 5,4% de contaminación por MMR. La limpieza y desinfección reducen significativamente la contaminación ambiental. Sin embargo, la colonización de equipos por MMR y el incumplimiento de precauciones universales representan una posibilidad de transmisión cruzada.

It is essential to understand the role of the environment in order to avoid intrahospital infections. To achieve this objective, this research proposes to assess the prevalence of the environmental contamination caused by multi-resistant microorganisms (MRM) before and after terminal disinfection in rooms with colonized patients, but also to establish whether the commonly used device acts as a reservoir of those micro-organisms in an intensive care unit (ICU). Environmental samples were obtained from the rooms, 48 hours after detecting colonization and also after the first and second final cleaning. The results showed that after both procedures, there was a reduction from 28.2% to 2.6% of contamination caused by multi-resistant Acinetobacter spp. (AMR). Samples from appliances and supplies were taken as well, in which case, between 1.8 and 5.4% of contamination levels induced by MMR were found. Cleaning and disinfecting significantly reduce environmental contamination. However, both MMR bacterial colonization and the lack of universal precautions enforcement represent a possibility of cross-transmission.

É essencial conhecer o papel do meio ambiente para evitar as infecções intra-hospitalares. Com esse objetivo, planejou-se avaliar a prevalência de contaminação ambiental por microorganismos multirresistentes (MMR) antes e depois da limpeza final dos quartos de pacientes colonizados e estabelecer se os aparelhos de uso comum atuavam como um reservatório deles na unidade de terapia intensiva (UTI). Obtiveram-se amostras ambientais dos quartos 48 horas após a detecção da colonização e logo após as limpezas finais. Os resultados mostraram que depois dos dois procedimentos de limpeza se obteve uma redução de 28,2% para 2,6% da contaminação por Acinetobacter spp. multirresistente (AMR). Foram obtidas também amostras de aparelhos de uso comum onde se encontraram entre 1,8% e 5,4% de contaminação por MMR. A limpeza e a desinfecção reduzem significativamente a contaminação ambiental. Contudo, a colonização de equipamentos por MMR e o não cumprimento de providências universais representam uma possibilidade de transmissão cruzada.

Importancia del proceso de limpieza y desinfección de superficies críticas en un servicio dental: impacto de un programa de intervención / Importance of cleaning and disinfection of critical surfaces in dental health services: impact of an intervention program

Resumen Introducción La atención odontológica se ha transformado en un desafío para los programas de prevención y control de infecciones asociadas a la atención de salud (IAAS), dado que el ambiente, entre otros factores, juega un rol importante en la cadena de transmisión. Método Se realizó un programa de intervención en el Servicio de Dental del Hospital Militar de Santiago, entre los años 2014-2015, que contempló tres etapas: etapa diagnóstica, de intervención y de evaluación. Objetivo Mejorar la seguridad de las superficies críticas involucradas en la atención dental. Resultados Durante la etapa diagnóstica se constató que el proceso de limpieza y desinfección era deficiente. La superficie crítica más contaminada fue la unidad porta-instrumental, luego el área limpia y la manilla de la lámpara. Las superficies que redujeron significativamente su contaminación, posterior a la intervención, fueron el área limpia y la unidad porta-instrumental. Conclusiones La capacitación en relación a los procesos de limpieza y desinfección de superficies y del equipamiento dental es una de las estrategias costo-eficientes en la prevención de las IAAS, sencilla y fácil de aplicar.

Introduction Dental care has become a challenge for healthcare associated infection prevention programs, since the environment, within other factors, plays an important role in the transmission chain. Materials and Methods An intervention program was designed for the Dental Unit of Hospital Militar de Santiago, between years 2014 and 2015. The program contemplated 3 stages: diagnostic, intervention and evaluation stage. Objective To improve the safety of critical surfaces involved in dental healthcare. Results During the diagnostic stage, the cleaning and disinfection process was found to be deficient. The most contaminated critical surface was the instrument holder unit, then the clean area and lamp handle. The surfaces that significantly reduced their contamination, after the intervention, were the clean area and the instrument carrier unit. Conclusion Training in the processes of cleaning and disinfecting surfaces and dental equipment is one of the cost-effective strategies in preventing healthcare-associated infections (HCAI), with simple and easy-to-apply methods.

Design improvement and application of transfer trolley for collection and distribution in central sterile supply department / 医疗卫生装备

Objective To modify the existed transfer trolley for collection and distribution so as to enhance cleaning and disinfection.Methods The existed transfer trolley was added with an intake pipe,a spray nozzle,a drilled divider,a drainage pipe and etc for perfusion rinse,and equipped with auxiliary mechanisms such as a protective support and preserver.Omnidirectional cleaning and disinfection of the trolley were executed by the intake pipe,nozzle and high-pressure irrigation machine.Results The trolley prevented the disinfection solution from spitting,ensured the safety of the staff and environment,and had the qualified rate of disinfection being 100％.Conclusion The modified transfer trolley gains advantages in environmental protection,energy saving and practicability,and thus is worthy promoting clinically.

Study of Major Risk Factors Analysis and Prevention Measures of Infection in Endoscopic Cleaning and Disinfection / 现代生物医学进展

Objective:To summarize the major risk factors of infection in the process of cleaning and disinfection of endoscopy center in our hospital,and formulate the corresponding prevention measures to reduce the incidence of endoscopic infection so as to ensure medical safety of patients.Methods:The specialist check the cleaning disinfection process,statistics of each link in the risk factors of infection.600 endoscopes were taken at random after disinfection,endoscopic inner cavity and the outer surface samples are collected,the cleaning and disinfection of the test results for evaluating quality indicators.Results:Testing 600 samples of qualified 584,and the percent of pass is 97.3％,gastroscopy,colonoscopy,duodenum mirror,bronchoscope,endoscopic ultrasonography qualified rate was 98.6％,96.8％,95.6％,96.0％,97.2％,respectively.28 strains of pathogenic bacteria were detected in 16 cases of unqualified samples,including 13 strains of helicobacter pylori,7 strains of escherichia coli,4 strains of pseudomonas aeruginosa,2 strains of pseudomonas aeruginosa,1 strains of staphylococcus aureus,1 strains of Klebsiella pneumoniae;16 cases to detect unqualified reason analysis,scrub incomplete accounted for 37.5％,Not according to the instructions required to use multi-enzyme and disinfectant accounted for 18.75％,special infected patients did not do special treatment of endoscopy accounted for 12.5％,endoscopic insufficient drying and the staffhand hygiene is not up to standard accounted for 12.5％,respectively.Conclusion:Endoscopic cleaning and disinfection aspects of infection caused by many factors,infection control education should be strengthened for all personal in the endoscopy center,regular professional training of cleaning and sanitation personal,cleaning and disinfection process should be standardized management,establish traceability registration system,control the quality of the endoscope cleaning and disinfection from each link.It is the main measure to prevent digestive endoscopy center in infection.

Effects of fluorescence labeling method plus feedback and training on hos-pital environmental cleaning effectiveness / 中国感染控制杂志

Objective To understand the cleaning status of hospital environment,and evaluate the effect of fluo-rescence labeling method plus feedback and training on hospital environmental cleaning effectiveness.Methods A total of 27 departments in a hospital were investigated,1 cleaning staff and 2 inpatients were selected from each de-partment,cleaning staff’s knowledge about cleaning and disinfection of environmental object surfaces,as well as cleaning status of inpatients’wards were surveyed,cleaning efficacy of hospital environmental object surfaces were detected with fluorescence labeling method,the surveyed results were performed timely feedback to clinical depart-ments,training on cleaning and disinfection knowledge was conducted,the effective cleaning rate of environmental object surface before and after the training was compared.Results A total of 27 cleaning staff were surveyed,the correct response rate for cleaning frequency was 96.30% ,awareness rate for section concept was 96.30% ,accuracy rate of cleaning order was 92.59% ,accuracy rate of post-cleaning immersion time of sanitary wares in disinfectant was 85.19% ,accuracy rates of replacing,drying,and repeated immersing wiping cloths were 81.48% ,48.15% ,and 25.93% respectively,rates of correct disinfectant formulating method and mop drying time were both 0. Among 54 investigated patients,bed units and ground of wards of 28 patients were cleaned both 1-2 times/day;bed units of 8 patients had never been wiped,18 patients in 9 departments cannot be conducted statistics due to completely in-consistent responses with the other patients of the same departments. The effective cleaning rates of environmental object surfaces before and after the training were 34.62% and 64.96% respectively,difference was significant(χ2=21.81,P<0.01).Conclusion Fluorescence labeling method plus feedback and training can improve cleaning efficacy of hospital environmental object surfaces.

Application of ATP fluorescence detection method in healthcare-associated infection management / 中国感染控制杂志

Objective To explore the effect of ATP fluorescence detection on on-site monitoring and supervision of healthcare-associated infection management .Methods ATP bioluminescence analyzer was used to detect the con-tamination status of hands of health care workers(HCWs),the object surfaces,and the cleaning tools in all quarters of 2015,the detection results were timely given feedback,and improvement measures were put forward.Results A total of 1 294 specimens were detected,the overall qualified rate was 62.75%.The qualified rates of hands of HC-Ws,object surfaces,and cleaning tools increased from 54.35%,50.30%,and 60.26% in the first quarter to 76.42%,64.80%,and 79.52% in the fourth quarter respectively,tendency chi-square test showed that difference was statistically significant (all P <0.05).The median of relative light unit (RLU)of hands of HCWs,object sur-faces,and cleaning tools were 20.00,85.00,and 35.00,respectively.Conclusion ATP fluorescence detection for on-site monitoring and supervision for cleaning and disinfection effect can promote the continuous quality improve-ment of hand hygiene and environmental cleanliness.

Gastroscopes after Cleaning and Disinfection:An Analysis / 中华医院感染学杂志

OBJECTIVE To understand the effect of the cleaning and disinfection of gastroscopes to prevent hospital infection.METHODS The biological monitoring of the gastroscopes from Jan 2007 to Dec 2007 was performed in a retrospective way.RESULTS Before implementation of the Technology Specifications of Cleaning and Disinfection of Endoscopes,the pass rate of the bacterial culture was 71.4%.After tmplementation strictly accordance with the norms after the implementation the qualified rate was 100.0%.CONCLUSIONS Equipped with the necessary cleaning and disinfection equipment,the standard procedures can prevent hospital infection.

Strengthen Management for Rinse and Disinfection of Endoscope / 中华医院感染学杂志

OBJECTIVE To analyze the factors influencing endoscope disinfection,in order to take the effective measure,improve endoscope disinfection work and prevent nosocomial infection.METHODS According to Instructions for Technical Procedures of Endoscope Cleaning and Disinfection published by Ministry of Health,42 samples of disinfected endoscopes from 18 000 were randomly selected.RESULTS The work for rinse and disinfection of endoscope in our hospital came to be standardized procedure gradually.We already achieved qualified by 100 percent according to Instructions.CONCLUSIONS The standardized management for rinse and disinfection of endoscope is the assurance for preventing nosocomial infection.

Cleaning and Disinfection Management of Endoscopes in Hospitals of Wuxi: A Survey of Present Status / 中华医院感染学杂志

OBJECTIVE To know the present status of endoscopes′ cleaning and disinfection in hospitals in Wuxi,(to find) the problem of existence in endoscopes disinfection management,and puts forward the suggestion.(METHODS) According to Technical Operation Standard for Endoscopes Cleaning and Disinfection(2004)′s(requirement),a survey and sampling of disinfected endoscopes were carried out. RESULTS Every hospital all had the rules and regulations of endoscopes management,personnel training rate was 50.00%,personnel protection fitting rate was 64.71%,the rate of the room special for disinfection was 35.29%,cleaning and disinfection(installation) reaching the designated position rate was 41.18%,the standard rate of cleaning and disinfection order was(11.76%,) the fitting rate of endoscopes to preserve inside condition was 23.53%,the eligible rate of(endoscopes) disinfectants in the use was 100.00%,the disinfecting eligible rate of body surface such as attraction bottle,cleaning slot,enzyme slot and washing slot was 100.00%,and the eligible rate of disinfected endoscopes in use and in preserve were 50.00% and 36.36%,respectively.CONCLUSIONS Our hospital is developing endoscope standard including the use of disinfectants as well as the object surface disinfectiong,but all exist the problems in personnel training,personnel protection,speciaized disinfection room,basic cleaning and disinfection(installation),the process of cleaning and disinfection,preservation and disinfection effect of endoscopes,and the work(remains) further standardize.