Comparison of the Filter Efficiency of Medical Nonwoven Fabrics against Three Different Microbe Aerosols.

　Exact evaluation of the performance of surgical masks and biohazard protective clothing materials against pathogens is important because it can provide helpful information that healthcare workers can use to select suitable materials to reduce infection risk. Currently, to evaluate the protective performance of nonwoven fabrics used in surgical masks against viral aerosols, a non-standardized test method using phi-X174 phage aerosols is widely performed because actual respiratory viruses pose an infection risk during testing and the phage is a safe virus to humans. This method of using a phage is simply modified from a standard method for evaluation of filter performance against bacterial aerosols using Staphylococcus aureus, which is larger than virus particles. However, it is necessary to perform such evaluations based on the size of the actual pathogen particles. Thus, we developed a new method that can be performed safely using inactivated viral particles and can quantitate the influenza virus in aerosols by antigen-capture ELISA (Shimasaki et al., 2016a) . In this study, we used three different microbial aerosols of phi-X174 phage, influenza virus, and S. aureus and tested the filter efficiency by capturing microbial aerosols for two medical nonwoven fabrics. We compared the filter efficiency against each airborne microbe to analyze the dependency of filter efficiency on the microbial particle size. Our results showed that against the three types of spherical microbe particles, the filter efficiencies against influenza virus particles were the lowest and those against phi-X174 phages were the highest for both types of nonwoven fabrics. The experimental results mostly corresponded with theoretical calculations. We conclude that the filter efficiency test using the phi-X174 phage aerosol may overestimate the protective performance of nonwoven fabrics with filter structure compared to that against real pathogens such as the influenza virus.

Advanced Analysis to Distinguish between Physical Decrease and Inactivation of Viable Phages in Aerosol by Quantitating Phage-Specific Particles.

　Recent studies have investigated the efficacy of air-cleaning products against pathogens in the air. A standard method to evaluate the reduction in airborne viruses caused by an air cleaner has been established using a safe bacteriophage instead of pathogenic viruses; the reduction in airborne viruses is determined by counting the number of viable airborne phages by culture, after operating the air cleaner. The reduction in the number of viable airborne phages could be because of "physical decrease" or "inactivation". Therefore, to understand the mechanism of reduction correctly, an analysis is required to distinguish between physical decrease and inactivation. The purpose of this study was to design an analysis to distinguish between the physical decrease and inactivation of viable phi-X174 phages in aerosols. We established a suitable polymerase chain reaction (PCR) system by selecting an appropriate primer-probe set for PCR and validating the sensitivity, linearity, and specificity of the primer-probe set to robustly quantify phi-X174-specific airborne particles. Using this quantitative PCR system and culture assay, we performed a behavior analysis of the phage aerosol in a small chamber (1 m3) at different levels of humidity, as humidity is known to affect the number of viable airborne phages. The results revealed that the reduction in the number of viable airborne phages was caused not only by physical decrease but also by inactivation under particular levels of humidity. Our study could provide an advanced analysis to differentiate between the physical decrease and inactivation of viable airborne phages.

A Highly Sensitive Assay Using Synthetic Blood Containing Test Microbes for Evaluation of the Penetration Resistance of Protective Clothing Material under Applied Pressure.

To prevent nosocomial infections caused by even either Ebola virus or methicillin-resistant Staphylococcus aureus (MRSA), healthcare workers must wear the appropriate protective clothing which can inhibit contact transmission of these pathogens. Therefore, it is necessary to evaluate the performance of protective clothing for penetration resistance against infectious agents. In Japan, some standard methods were established to evaluate the penetration resistance of protective clothing fabric materials under applied pressure. However, these methods only roughly classified the penetration resistance of fabrics, and the detection sensitivity of the methods and the penetration amount with respect to the relationship between blood and the pathogen have not been studied in detail. Moreover, no standard method using bacteria for evaluation is known. Here, to evaluate penetration resistance of protective clothing materials under applied pressure, the detection sensitivity and the leak amount were investigated by using synthetic blood containing bacteriophage phi-X174 or S. aureus. And the volume of leaked synthetic blood and the amount of test microbe penetration were simultaneously quantified. Our results showed that the penetration detection sensitivity achieved using a test microbial culture was higher than that achieved using synthetic blood at invisible leak level pressures. This finding suggested that there is a potential risk of pathogen penetration even when visual leak of contaminated blood through the protective clothing was not observed. Moreover, at visible leak level pressures, it was found that the amount of test microbe penetration varied at least ten-fold among protective clothing materials classified into the same class of penetration resistance. Analysis of the penetration amount revealed a significant correlation between the volume of penetrated synthetic blood and the amount of test microbe penetration, indicating that the leaked volume of synthetic blood could be considered as a latent indicator for infection risk, that the amount of exposure to contaminated blood corresponds to the risk of infection. Our study helped us ascertain, with high sensitivity, the differences among fabric materials with respect to their protective performance, which may facilitate effective selection of protective clothing depending on the risk assessment.

Development of a new technique using glass beads for dry dispersion of airborne fungal spores.

To evaluate the removal of airborne microbes by air cleaners, a technique for generating airborne fungal spores in the dry state in a test chamber (dry dispersion) become necessary. The Society of Indoor Environment Japan (SIEJ) published SIEJ Standard Method No. 20110001 (SIEJ standard),in which an aerial ultrasonic oscillator was used as the device for dry dispersion. However, a more versatile apparatus is also necessary from a practical point of view. Therefore, we developed a new device using glass beads for the dispersion. Glass beads and a fungal sheet containing spores of Wallemia sebi were set in a midget impinger, which was connected to a compressor and a compact test chamber (1 m(3)). Air was blown into the impinger from the compressor. The spores on the fungal sheet were released by impingement of the glass beads when the beads were induced to float by the air blown into the impinger, and the spores were introduced to the chamber by the airflow. This newly developed technique can be used in a compact chamber system and could be applicable as an improved method for generating airborne fungal spores in the dry state in the SIEJ standard.

[Distribution of Clostridium tetani in topsoil from Sagamihara, central Japan].

Despite reports of Clostridium tetani being isolated from soil in Kanazawa, Okinawa, and Tokyo, Japan, little has been studied about C. tetani distribution in other regions. We studied C. tetani in topsoil samples collected from private gardens, public road shoulders, a university campus, mountains, and fields in Sagamihara. C. tetani occurred in 8 of 35 soil samples (22.9%) and tetanus toxin in 7 of the 8 C. tetani-positive samples (87.5%). Contamination was clearly higher in soils from mountains near Tsukui-gun (Kanagawa Prefecture), Minamitsuru-gun, and Uenohara and Koshu cities (Yamanashi Prefecture) than in other regions. These findings suggest that tetanus toxin-producing strains of C. tetani tend to inhabit the topsoil of western Sagaminaha region, as a geographical feature.

[Inactivation of Cryptosporidium parvum oocysts in copper tubing].

We studied whether the infectivity of Cryptosporidium parvum oocysts for suckling mice could be inactivated by copper tubing or by other types of tubing used to construct water distribution systems, including stainless steel, rigid polyvinyl chloride (PVC), PVC-lined steel, polyethylene (PE), cross-linked PE, and polybutene (PB), using glass tubing as the control. Oocysts were incubated in each tubings for 24 hours. The extent of inactivation of infectious oocysts by copper tubing was -1.303 log, which significantly inactivated of infectivity. In contrast, other types of tubing had no significant effect on some oocyst infectivity, although PB did show a maximum inactivation of -0.313 log. 25% of oocysts showed degeneration morphologically after passing through copper tubing, while 0.3% to 1.8% showed degeneration after passing through other tubing. Significant inactivation of infectious oocysts was not caused by water in which copper tubing had been let stand for 24 hours, although it had a cupric ion (Cu2+) concentration of 2.4 mg/L. The direct contact of oocysts with copper surface resulted in a decrease in the recovery percentage of oocysts and generation of hydrogen peroxide (0.5 mg/L) after 24 h of incubation. The percentage of degenerating oocysts was 29%. Such cryptosporidicidal effects of the copper surface on oocysts were completely inhibited by overlaying the surface with a Millipore filter before adding oocysts and incubating oocysts in the presence of catalase, an antioxidant enzyme. These findings suggest that copper tubing inactivates infectious C. parvum oocysts cytotoxically which may be due to oxygen radicals generated by the interaction between Cu2+ and hydrogen peroxide on the tubing surface.

[Antimicrobial ceramic for killing Legionella pneumophila in hot spring waters].

Killing of Legionella pneumophila by an antimicrobial ceramic was evaluated during culture in nine kinds of hot spring water at 40 degrees C. After 24 hours, the efficacy against L. pneumophila varied, depended on water quality. The strongest antibacterial effect was seen in chloride hot spring water from Wakayama and in deionized water. In four hot spring water samples (sulfur and hydrogen carbonate springs from Fukushima, simple thermals from Mie, and radioactive spring from Tottori), the decrease was < -2 log cfu after 48 hours. These results suggest that the antimicrobial ceramic is able to eradicate Legionella from hot spring waters.

[Physicochemical factors influencing distribution of Legionella species in Japanese hot springs].

We examined the relationship between the distribution of Legionella bacteria and various physicochemical characteristics of hot springs in Japan. Legionella bacteria were isolated from 52 (49.5%) out of 105 water samples, particularly from outdoor hot springs (67.3%). The bacterial count in the water samples positive for Legionella (86.5%) ranged from 10(1) to < 10(3) cfu/100 mL. L. pneumophila serogroup (SG) 4 (27.8%) was predominant in the water samples, followed by SG 5 (12.2%). The pulsefield gel electrophoresis (PFGE) patterns of chromosomal DNA for L. pneumophila SG 4 isolated from different parts of a hot spring resort were identical. Isolation of Legionella species from hot spring waters did not occur at pH 1.8-3.3, SO4(2-): > 780 mg/L, and H2SiO3: > 146 mg/L. The hot water-recirculating systems were applied to 18 out of 20 (90%) hot spring facilities which were found positive for Legionella. These results indicate that Legionella species are widespread in hot springs throughout Japan, except for waters with a low pH and non-recirculating waters, and that a single strain of L. pneumophila SG 4 is predominant in a particular hot spring resort.

[Disinfection of water of remove Legionella species: evaluation of an antimicrobial ceramic].

To evaluate the efficacy of an antimicrobial ceramic for killing Legionella strains in vitro, bacteria were exposed to the ceramic soaked in PBS at 25 degrees C or 42 degrees C. The number of L. pneumophila began to decrease significantly after 4 h of exposure at 25 degrees C and reached < 10 log cfu/ml after 12 h. A similar significant decrease was also observed after exposure at 42 degrees C. Furthermore, it was found that the antimicrobial ceramic showed bactericidal activity against six strains of Legionella isolated from various water sources, including L. pneumophila (serotype 1-4), L. micdadei, and L. dumoffii, after 24 h of exposure. The antimicrobial activity against L. pneumophila of the supernatant obtained by soaking the ceramic in PBS for 24 h was also assessed. Bactericidal activity of this supernatant was also noted. Analysis of the supernatant by ICP-MS resulted in the detection of eight metals (Mg, Al, Ca, Mn, Zn, Sr, Ag, and Ba) at a maximum concentration of 2.5 mg/l. When reconstituted PBS was made with all eight metals at the same concentrations as in the supernatant, the reconstituted PBS containing Ag alone and all metals showed significantly bactericidal activity against L. pneumophila, but PBS with only one metal component except Ag or a combination of Ag with Zn and/or Ca did not. These findings suggest that the antimicrobial ceramic possesses strong bactericidal activity against Legionella species and that eight metals released from the ceramic have a synergistic bactericidal effect against Legionella. When the antimicrobial ceramic was placed in hot spring water or cooling tower water instead of PBS, the number of L. pneumophila in the water decreased to < 10 log cfu/ml after 24 h of exposure and the bactericidal activity persisted for 5 weeks. These results indicate that the antimicrobial ceramic can be used to eradicate Legionella species contaminating various water sources.

Apoptosis of intestinal crypt epithelium after Cryptosporidium parvum infection.

Using a neonatal mouse model of Cryptosporidium parvum infection, we investigated whether apoptosis of epithelial cells was induced in the small intestine. At the time when the number of C. parvum oocysts in the ileum was maximal, columnar goblet cells and absorptive cells showed a decrease in the ileal epithelium that was accompanied by a significant reduction in the height of the villi. A few apoptotic epithelial cells were also observed in the vicinity of the basal crypts where C. parvum was proliferating. Morphological changes of the villous structure and apoptotic epithelial cells associated with proliferation of the parasite were scarcely detected in the duodenum, cecum, and colon of the infected mice. These findings suggest that the loss of absorptive cells and goblet cells, and the apoptosis of intestinal epithelial cells, are common events in the ileum after C. parvum infection, and that epithelial apoptosis may have a significant role in the pathogenesis of cryptosporidiosis.