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The purpose of this study was to investigate the effects of contamination of venous blood with a lipid-containing solution on parameters measured by a modern blood gas analyzer. We collected venous blood from 17 healthcare workers (46 ± 11 years; 53 % women) into three blood gas syringes containing 0 , 5 and 10 % lipid-containing solution. Blood gas analysis was performed within 15 min from sample collection on GEM Premier 5000, while triglycerides and serum indices were assays on Roche COBAS C702. Triglycerides concentration increased from 1.0 ± 0.3 mmol/L in the uncontaminated blood gas syringe, to 39.4 ± 7.8 and 65.3 ± 14.4 mmol/L (both p<0.001) in syringes with 5 and 10 % final lipid contamination. The lipemic and hemolysis indices increased accordingly. Statistically significant variation was noted for all analytes except hematocrit and COHb in the syringe with 5 % lipids, while only COHb did not vary in the syringe with 10 % lipids. Significant increases were observed from 5 % lipid contamination for pO2, SO2 and lactate, while the values of pH, pCO2, sodium, potassium, chloride, ionized calcium, glucose, hematocrit (10 % contamination), hemoglobin and MetHB decreased. All these changes except lactate and CoHb exceeded their relative performance specifications. Artifactual hyperlipidemia caused by contamination with exogenous lipids can have a clinically significant impact on blood gas analysis. Manufacturers of blood gas analyzers must be persuaded to develop new instruments equipped with serum indices. [ABSTRACT FROM AUTHOR]

Background: Enhancing the current breast pump sanitization method may improve maternal satisfaction and increase a mother's likelihood of providing human milk for their hospitalized infants in the Neonatal Intensive Care Unit (NICU). Other than Centers for Disease Control (CDC) data, there is lack of studies on sanitization practices. Currently, the only option in the hospital setting for breast pump equipment cleaning is a steam sanitization plastic bag. Purpose: Using the Q. Basin will increase participant satisfaction compared to the steam sanitization bag. Methods: A multi-phased pilot study was conducted in our quaternary care NICU to test the Q. Basin, a novel design developed to wash, dry, and safely steam sanitize breast pump equipment compared to the standard steam bag. A bacterial study was conducted on breast pump equipment from 10 mothers by swabbing the equipment immediately at hour zero and 24 hours. Twenty NICU mothers concurrently evaluated their satisfaction via a 3-question survey comparing the Q. Basin and the steam sanitization plastic bag method. Results: The results showed a 20% increase in satisfaction with Q. Basin compared to the steam bag method. Implications for Practice and Research: Data analysis from the satisfaction survey concludes that mothers pumping preferred the Q. Basin as a quicker, faster, and more environmentally friendly method for breast pump part sanitization. Additional safety and materials studies are required before using the Q. Basin in the clinical environment. [ABSTRACT FROM AUTHOR]

When developing devices and processes, viable spores and biological indicators can be used to detect the presence of the sterilising agent. In particular, a change in the D values can provide important information. But indicators, which can only be evaluated in a laboratory after 7 days’ incubation, are not recommended for routine operations in the healthcare setting. Chemical indicators are useful for distinguishing between sterilized and unsterilized items of packaging. They are needed for the Bowie & Dick test but are not suitable for demonstrating proof of sterilization. [ABSTRACT FROM AUTHOR]

Introduction: This study investigated the extent of contamination with antineoplastic agents on floor surfaces of the ward and the outpatient chemotherapy center of a Japanese cancer center to evaluate healthcare workers' risk of occupational exposure to antineoplastic agents outside of the designated drug preparation areas. Methods: In this study conducted at Aichi Cancer Center, the amount of fluorouracil detected on various floor surfaces was measured using liquid chromatography—tandem quadrupole mass spectrometry. Areas around the toilets were cleaned with a surfactant two or three times a day, whereas other floor surfaces were cleaned only with dry and wet mops. Results: Fluorouracil was detected on all surveyed floor surfaces, with particularly high amounts detected around the toilet areas in the ward. Additionally, areas with more human traffic tended to have higher fluorouracil contamination. Conclusions: This survey suggested that antineoplastic agent contamination occurring through patient excretions might spread throughout the hospital with human traffic. Therefore, controlling the spread of antineoplastic agent contamination in hospitals should include the review of measures to mitigate contamination around toilets and to implement effective cleaning methods for floor surfaces. [ABSTRACT FROM AUTHOR]

Dermal substitutes have been introduced to improve the outcome of wound healing. Despite proven efficacy in trials, these skin constructs do not have a firm footing in treatment protocols. This survey aimed to gain insight into the international perspective on dermal substitutes. An open, voluntary and anonymous internet‐based international survey was conducted. Eligible to complete the survey were professionals involved in the surgical treatment of patients with wounds. Information was collected on participant demographics, appointed facilitators, barriers, indications and contraindications related to the use of dermal substitutes, as well as participants' perceptions on the current available evidence and treatment protocols. A total of 148 professionals from 30 countries completed the survey. The majority of participants were male (57%), with 60% being plastic surgeons. Eighty‐three percent of the professionals had experience in using dermal substitutes. The primary facilitators were 'increased scar elasticity' and 'reduction of contractures', while primary barriers included 'costs' and 'contamination risk'. Sixty‐two percent of the professionals acknowledged the efficacy of dermal substitutes; however, the majority emphasised the absence of clear indications and treatment protocols. This study emphasises the acknowledged efficacy of dermal substitutes while highlighting the need for clearer indications and treatment protocols. [ABSTRACT FROM AUTHOR]

Background: Soilage of the surgical endoscope occurs frequently during minimally invasive surgery. The resultant impairment of visualization of the surgical field compromises patient safety, prolongs operative times, and frustrates surgeons. The standard practice for cleaning the surgical camera involves a disruption in the conduct of surgery by completely removing the endoscope from the field, manually cleaning its lens, treating it with a surfactant, and reinserting it into the patient; after which the surgeon resumes the procedure. Methods: We developed an automated solution for in vivo endoscope cleaning in minimally invasive surgery- a port that detects the position of the endoscope in its distal lumen, and precisely and automatically delivers a pressurized mist of cleaning solution to the lens of the camera. No additions to the scope and minimal user interaction with the port are required. We tested the efficacy of this troCarWash™ device in a porcine model of laparoscopy. Four board-certified general surgeons were instructed to soil and then clean the laparoscope using the device. Representative pre- and post-clean images were exported from the surgical video and clarity was graded (1) digitally by a canny edge detection algorithm, and (2) subjectively by 3 blinded, unbiased observers using a semi-quantitative scale. Results: We observed statistically significant improvements in clarity by each method and for each surgeon, and we noted significant correlation between digital and subjective scores. Conclusion: Based on these data, we conclude that the troCarWash™ effectively restored impaired visualization in a large animal model of laparoscopy. [ABSTRACT FROM AUTHOR]

Introduction: Disposable duodenoscopes and duodenoscopes with disposable endcaps are being used in clinical practice to reduce or eliminate the risk of transmitting infections. The study aim was to assess perceptions and experiences regarding the use of these duodenoscopes among advanced endoscopy fellows in a nationally representative sample. Methods: A 17-item electronic survey was sent to 74 advanced endoscopy training programs. The survey was completed by 50 participants and their responses were included for analysis. Results: Most participants were from academic training programs (82.7%) and identified as being in their 7th year of post graduate training (92%; PGY-7). Participants performed an average of 414 ERCPs. 29% reported difficulty with cannulation using disposable duodenoscopes versus 15.7% with duodenoscopes with disposable endcaps (vs. standard duodenoscope). 96% of trainees perceived disposable duodenoscopes as not cost effective and 92% stated they would not use this device during independent practice. 100% of trainees stated that they would use duodenoscopes with disposable endcaps during independent practice. For their most challenging cases, 90% of trainees preferred using standard reprocessable duodenoscopes while no trainee indicated they would prefer using a disposable duodenoscope in this scenario. 82% of participants stated that disposable duodenoscopes and disposable endcaps should be used exclusively or preferentially for high-risk patients citing cost, functionality, and concerns regarding environmental impact. Discussion: Advanced endoscopy fellows perceive disposable duodenoscopes as impacting technical maneuverability. Concerns about functionality, cost effectiveness and environmental impact are barriers to adoption. [ABSTRACT FROM AUTHOR]

As neurosurgery has advanced technologically, more and more neurosurgical implants are being employed on an aging patient population with several comorbidities. As a result, there is a steady increase in the frequency of infections linked to neurosurgical implants, which causes serious morbidity and mortality as well as abnormalities of the skull and inadequate brain protection. We discuss infections linked to internal and external ventricular and lumbar cerebrospinal fluid drainages, neurostimulators, craniotomies, and cranioplasty in this article. Biofilms, which are challenging to remove, are involved in all implant‐associated illnesses. It takes a small quantity of microorganisms to create a biofilm on the implant surface. Skin flora bacteria are implicated in the majority of illnesses. Microorganisms that cause disruptions in wound healing make their way to the implant either during or right after surgery. In about two thirds of patients, implant‐associated infections manifest early (within the first month after surgery), whereas the remaining infections present later as a result of low‐grade infections or by direct extension from adjacent infections (per continuitatem) to the implants due to soft tissue damage. Except for ventriculo‐atrial cerebrospinal fluid shunts, neurosurgical implants are rarely infected by the haematogenous route. This research examines established and clinically validated principles that are applicable to a range of surgical specialties using implants to treat biofilm‐associated infections in orthopaedic and trauma cases. Nevertheless, there is little evidence and no evaluation in sizable patient populations to support the success of this extrapolation to neurosurgical patients. An optimal microbiological diagnostic, which includes sonicating removed implants and extending culture incubation times, is necessary for a positive result. Additionally, a strategy combining surgical and antibiotic therapy is needed. Surgical procedures involve a suitable debridement along with implant replacement or exchange, contingent on the biofilm's age and the state of the soft tissue. A protracted biofilm‐active therapy is a component of antimicrobial treatment, usually lasting 4–12 weeks. This idea is appealing because it allows implants to be changed or kept in place for a single surgical procedure in a subset of patients. This not only enhances quality of life but also lowers morbidity because each additional neurosurgical procedure increases the risk of secondary complications like intracerebral bleeding or ischemia. [ABSTRACT FROM AUTHOR]

Introduction: Compounding robots are increasingly being implemented in hospital pharmacies. In our hospital, the recent acquisition of a robot (RIVATM, ARxIUM) for intravenous cancer drug compounding obliged us to replace the previously used infusion devices. The objective of the present study was to assess and qualify the new intravenous sets prior to their use in our hospital and prior to the implementation of the compounding robot. Materials and Methods: The ChemoLockTM (ICU Medical) was compared with the devices used previously for compounding (BD PhaSealTM, Becton-Dickinson) and infusion (Connect-ZTM, Codan Medical). The connection/disconnection of infusion devices to/from 50 mL infusion bags was tested with a dynamometer (Multitest-i, Mecmesin). Leakage contamination was visualized by a methylene blue assay and was quantified in simulated pump infusions with 20 mg/mL quinine sulfate (N = 36/group); after the analytical assay had been validated, quinine was detected by UV-spectrophotometry at 280 and 330 nm. Groups were compared using chi-squared or Mann–Whitney U tests. Results: The connection/disconnection test showed that although all the devices complied with the current standard, there was a statistically significant difference in the mean ± standard deviation compression force (51.5 ± 11.6 for the Connect-ZTM vs. 60.3 ± 11.7 for the ChemoLockTM; p = 0.0005). Leaks were detected in 32 (29.1%) of the 110 tests of the ChemoLockTM. The contamination rates were also significantly different: 13.9% for the BD PhaSealTM versus 75.0% for the ChemoLockTM; p < 0.0001). Discussion/conclusion: Our results showed that the new infusion device complied with current standards. However, the presence of contamination emphasizes the need for operators to use the recommended personal protective equipment. Further studies of contamination with cancer drugs are required. [ABSTRACT FROM AUTHOR]

Background: Flexible endoscopes have a complicated design which includes several small lumen channels intended to facilitate the flow of fluids, tissue, and tools through the length of the device. This complex design leads to reprocessing challenges for high-level disinfection (HLD) to ensure endoscopes are free from contaminants that could lead to hospital-acquired infections. The aim of this project was to identify optimal strategies and obstacles for each stage of flexible endoscope HLD through an integrative review with the goal of achieving reprocessing excellence. Methods: A literature search was conducted using PubMed/Medline and CINAHL databases. A total of 32 articles and six guidelines were included in the review. Results: Ten elements with best-practice recommendations of flexible endoscope HLD have been identified. The HLD elements that received the most literature support include quality assurance/process monitoring and manual cleaning/decontamination. Several barriers to the adequate performance of HLD elements were also identified. Conclusion: This integrative review applied varying levels of rigour to identify and synthesize best practices for the following HLD elements: point-of-use treatment, transport, leak testing, manual cleaning/decontamination, visual inspection, manual or automated HLD, rinsing/drying, storage/hang time, record keeping, and quality assurance/process monitoring. [ABSTRACT FROM AUTHOR]

Objectives: The present systematic review was conducted to give an overview of toothbrush contamination among the general population and the factors affecting toothbrush contamination with an evidence‐based approach. Data/Sources: Medline (Pub Med), CINAHL Plus, Cochrane Library and Dentistry and Oral Health Sciences Source were searched for the results after applying the search strategy from January 2012 to May 2022, following inclusion and exclusion criteria. The data were collected using a self‐made data collection form on study characteristics, population attributes and the main features, including the study's outcomes. The methodological quality of the included studies was independently evaluated based on the Joanna Briggs Institute's (JBI) critical appraisal checklist for cross‐sectional studies and the Risk of Biasness Tool‐1 (Rob‐1) for randomized controlled trials (RCTs). A descriptive analysis of the included studies was done using SWiM guidelines. The impact of charcoal and non‐charcoal brushes on toothbrush disinfection was quantitatively analysed using a forest plot. Study Selection: Of the 687 studies screened by title and abstract, 27 articles were selected for full‐text evaluation using the EndNote reference program (Ver. X9.2). From these, 15 qualified and were included in the systematic review. Among the selected studies, eight were RCTs, six were cross‐sectional studies, and the remaining one was an in vitro experimental study. Conclusions: The toothbrush becomes contaminated even after its first usage, and the contamination level rises with continued use. There are a number of factors that lead to the contamination of brushes, such as increased humidity brought on by a plastic cover or a toilet setting. Charcoal brushes show significant efficacy as compared to regular bristles in reducing toothbrush contamination; however, more RCTs are needed to further assess its efficacy. Nevertheless, rinsing with chlorhexidine mouthwash after daily brushing shows favourable results. [ABSTRACT FROM AUTHOR]

Purpose: Cleaning is crucial for reprocessing reusable surgical instruments (RSIs). In this study, we used the adenosine triphosphate (ATP) bioluminescence method to assess the cleanliness of RSIs according to the cleaning method used. Methods: From April 3 to June 2, 2023, surgical sets, including hemostatic forceps, needle holders, operating scissors, dressing forceps, and suction tubes, that arrived at the decontamination room in the central sterile supply department of one general hospital were selected through convenience sampling. For each of the three cleaning processes, 30 cleaned RSIs were sampled with test swabs for inspection, and the relative light unit value was measured using ATP test equipment. Results: Suction tubes, hemostatic forceps, and needle holders ranked low in cleanliness (χ²=11.69, p=.020), and the contamination rate after mechanical cleaning was significantly lower than that after manual cleaning (χ²=31.34, p<.001). Conclusion: Surgical instruments treated by manual processing and those containing tubes were associated with the low cleanliness. Therefore, it is necessary to check whether surgical instruments, including tubes, are manually washed at an appropriate level, and regular monitoring will be required. [ABSTRACT FROM AUTHOR]

Introduction: Antineoplastic drugs (ADs) are commonly used pharmaceuticals for anticancer treatments. It has previously been shown that the external surface of drug vials frequently is contaminated with ADs. More than a decade ago methods to prevent occupational exposure were introduced by using plastic coverage of the glass vials or packing vials in a secondary plastic container. The aim of the pilot study was to determine contamination levels of ADs on different parts of AD packaging of two different commercially available drug vials on the Swedish market and to investigate the occurrence of cross contamination of ADs. Methods: Packagings of gemcitabine (GEM) and 5-fluorouracil (5-FU) were tested by wipe sampling. Five ADs; GEM, 5-FU, cyclophosphamide (CP), ifosfamide and etoposide were quantified using liquid chromatography mass spectrometry. Results: AD contaminations were detected in 69% and 60% of the GEM and 5-FU packaging samples. Highest levels, up to approximately 5 µ g/sample, were observed on the glass vials. The protective shrink-wrap of 5-FU vials and the plastic container of GEM were contaminated with low levels of 5-FU and GEM, respectively, and furthermore the 5-FU vials with shrink-wrap were cross-contaminated with GEM. Cross-contamination of CP and GEM was detected on 5-FU vials with plastic shrink-wrap removed. Conclusions: External contamination of ADs are still present at primary drug packagings on the Swedish market. Protection of AD vials by plastic shrink-wrap or a secondary plastic container does not remove the external contamination levels completely. The presence of cross contamination of ADs on drug packagings was also observed. [ABSTRACT FROM AUTHOR]

Formula fed infants experience gastrointestinal infections at higher rates than breastfed infants, due in part to bacteria in powdered infant formula (PIF) and bacterial contamination of infant feeding equipment. The United Kingdom National Health Service (UK NHS) has adopted the World Health Organization recommendation that water used to reconstitute PIF is ≥70°C to eliminate bacteria. We used community science methods to co‐design an at home experiment and online questionnaire ('research diary') to explore the safety of PIF preparation compared to UK NHS guidelines. 200 UK‐based parents of infants aged ≤12 months were recruited; 151 provided data on PIF preparation, and 143 were included in the analysis of water temperatures used to reconstitute PIF. Only 14.9% (n = 11) of 74 PIF preparation machines produced a water temperature of ≥70°C compared with 78.3% (n = 54) of 69 kettle users (p < 0.001). The mean temperature of water dispensed by PIF preparation machines was 9°C lower than kettles (Machine M = 65.78°C, Kettle M = 75.29°C). Many parents did not always fully follow NHS safer PIF preparation guidance, and parents did not appear to understand the potential risks of PIF bacterial contamination. Parents should be advised that the water dispensed by PIF preparation machines may be below 70°C, and could result in bacteria remaining in infant formula, potentially leading to gastrointestinal infections. PIF labelling should advise that water used to prepare PIF should be ≥70°C and highight the risks of not using sufficiently hot water, per WHO Europe advice. There is an urgent need for stronger consumer protections regarding PIF preparation devices. Key points: Only 14.9% (n = 11) of 74 PIF preparation machines produced a water temperature of ≥70°C compared with 78.3% (n = 54) of 69 kettle users (p < 0.001).The mean temperature of water dispensed by PIF preparation machines was 9°C lower than kettles (Machine M = 65.78°C, Kettle M = 75.29°C).Most parents routinely washed and sterilised bottles and teats.Many parents did not always fully follow NHS safer PIF preparation guidance, including 21.8% washing their hands half the time or less, and 14.6% regularly pre‐preparing bottles.Most parents did not appear to understand the risks of PIF bacterial contamination. [ABSTRACT FROM AUTHOR]

Introduction: Clot formation, infection, and biofouling are unfortunate but frequent complications associated with the use of blood-contacting medical devices. The challenge of blood-foreign surface interactions is exacerbated during medical device applications involving substantial blood contact area and extended duration of use, such as extracorporeal life support (ECLS). We investigated a novel surface modification, a liquid-impregnated surface (LIS), designed to minimize protein adsorption and thrombus development on medical plastics. Methods: The hemocompatibility and efficacy of LIS was investigated first in a low-shear model with LIS applied to the lumen of blood incubation vials and exposed to human whole blood. Additionally, LIS was evaluated in a 6 h ex vivo circulation model with swine blood using full-scale ECLS circuit tubing and centrifugal pumps with clinically relevant flow rate (1.5 L/min) and shear conditions for extracorporeal carbon dioxide removal. Results: Under low-shear, LIS preserved fibrinogen concentration in blood relative to control polymers (+40 ± 6 mg/dL vs polyvinyl chloride, p <.0001), suggesting protein adsorption was minimized. A fibrinogen adhesion assay demonstrated a dramatic reduction in protein adsorption under low shear (87% decrease vs polyvinyl chloride, p =.01). Thrombus deposition and platelet adhesion visualized by scanning electron microscopy were drastically reduced. During the 6 h ex vivo circulation, platelets in blood exposed to LIS tubing did not become significantly activated or procoagulant, as occurred with control tubing; and again, thrombus deposition was visually reduced. Conclusions: A LIS coating demonstrated potential to reduce thrombus formation on medical devices. Further testing is needed specialized to clinical setting and duration of use for specific medical target applications. [ABSTRACT FROM AUTHOR]

Dentistry involves the use of many instruments that are sharp and deal with blood and saliva that may be contaminated with either HBV, HCV, or HIV. Professional exposure of healthcare workers (as dentists and dental students) to blood or other potentially infected biological material may cause transmission of infection to them. Transmission of infection can occur through several routes; mucosal, cutaneous, or percutaneous. Transmission of pathogens may result in an asymptomatic infection. This situation may last for weeks or months until symptoms appear. Some patients are, thus, not aware of their infectious status and may carry an asymptomatic infection when visiting a dental practice. Aim of study The objective of the current study was to detect the level of knowledge among dental students regarding the human immunodeficiency virus, hepatitis B virus, and hepatitis C virus. The attitude and risk perception of the students about the treatment of patients with these viruses were also assessed. In our study, we determined also the relationship between knowledge, attitude, and risk perception. Methodology Six hundred eighty responded students were included in this study. They were selected from all 5 years of study to form 2 equal groups (340 students in each group), group I (junior students): 1st, 2nd, and 3rd years and group II (senior students): 4th and 5th years. The questionnaires (distributed to the students) included five main parts: the sociodemographic part, the knowledge part, the attitude part, the risk perception part, and the self-evaluation part. Results (1) The correct answer score was higher in group II than in group I (58.54% and 41.46% respectively). (2) The professional attitude score was higher in group II than in group I (60.81% and 39.19% respectively). (3) The positive risk perception was higher in group II than in group I (56.20% and 43.80% respectively). Conclusion The level of knowledge plays an important role in forming attitudes and risk perceptions toward patients with HBV, HCV, and HIV. This is of concern in dentistry and other similar fields like otolaryngology. [ABSTRACT FROM AUTHOR]

Introduction: The handling of antineoplastic drugs should follow strict supervision and safety rules to minimize the occupational exposure risks to professionals involved. The external surface contamination of drug vials is recognized as a health risk. So, our goal was to determine if there is residual contamination on the vials and containers surface of the antineoplastic drugs doxorubicin (DOX) and cyclophosphamide (CP). Methods: A cross-sectional study was conducted. Samples were collected using a uniform sampling procedure on the inner surfaces of the packages/boxes and the outer surfaces of the vials. The analyzes were executed by high-performance liquid chromatography/mass spectrometry (UHPLC-MS/MS). Results: A total of 209 samples were analyzed, 66 of CP and 143 of DOX. CP levels were detected in nine samples (13.63%), three were below the lower limit of quantification (LLQ) and the other six had contamination levels ranging from 1.24 to 28.04 ng/filter. DOX levels were detected in 36 samples (25.17%), two were below the LLQ and the others had levels between 1.32 and 664.84 ng/filter. The majority of samples with residual contamination were in vials (80.0%), however, boxes also showed contamination. Conclusions: The results revealed the presence of residual contamination in the vials and packages of CP and DOX drugs. Although the residues found in each sample are small, special care should be taken in the handling and disposal of the antineoplastic drugs. The use of personal protective equipment is fundamental while handling the vials and packaging of cytotoxic drugs. [ABSTRACT FROM AUTHOR]

Surveillance for environmental contamination of antineoplastic drugs has been recommended by authoritative bodies such as the United States Pharmacopeia and the National Association of Pharmacy Regulatory Authorities. Clear guidance is needed on how to develop sampling strategies that align with surveillance objectives efficiently and effectively. We conducted a series of simulations using previously collected surveillance data from nine cancer treatment centers to evaluate different sampling strategies. We evaluated the impact of sampling 2, 5, 10, or 20 surfaces, at monthly, quarterly, semi-annual, and annual frequencies, while employing either a random or sentinel surface selection strategy to assess contamination by a single antineoplastic drug (AD) or by a panel of three ADs. We applied two different benchmarks: a binary benchmark of above or below the limit of detection and AD-specific hygienic guidance values, based on 90th percentile values as quantitative benchmarks. The use of sentinel surfaces to evaluate a three-drug panel relative to 90th percentile hygienic guidance values (HGVs) resulted in the most efficient and effective surveillance strategy. [ABSTRACT FROM AUTHOR]

Introduction: In a suitable condition, it is important to perform any dental restorative procedure using an operatory field isolated. Then, the aim of this study was to compare the bond strength of composite restorations to dentin affected by any contamination agent through a systematic review. Methods: This systematic review was performed following the PRISMA 2020 guidelines. The literature search was conducted until September 2022 by scanning the following databases: Embase, PubMed, Scielo, Scopus, and Web of Science. Manuscripts evaluated the bond strength of resin‐based materials to permanent human dentin contaminated with blood or saliva were selected for full‐text review. The risk of bias was assessed by the RoBDEMAT tool. Results: A total of 3750 papers resulted from the search from all databases. After the full‐text reading, a total of 62 articles remained for the qualitative analysis. The contamination agents used were blood, saliva, and hemostatic agents. A great variety of protocols were used to contaminate the dentin surface, and the contamination process occurred in several steps of the bonding process, including before and after the etching process, after the primer application and after the adhesive application. Also, several decontamination procedures were tested, including reapplication of the etching material, rinsing with water, chlorhexidine or sodium hypochlorite and reapplication of the adhesive system. Conclusion: Any contamination with blood or saliva impaired the bond strength of resin‐based materials to dentin. Decontamination procedures including water‐spray and reapplication of the bonding system could revert the impairment produced by the saliva or blood contamination. The use of hemostatic agents as a method of blood decontamination is not recommended. Clinical Significance: Clinicians should avoid contamination during a bonding procedure, otherwise, a reduction in the bond quality is expected. [ABSTRACT FROM AUTHOR]

Context.--Tissue contaminants on histology slides represent a serious risk of diagnostic error. Despite their pervasive presence, published peer-reviewed criteria defining contaminants are lacking. The absence of a standardized diagnostic workup algorithm for contaminants contributes to variation in management, including investigation and reporting by pathologists. Objective.--To study the frequency and type of tissue contaminants on microscopic slides using standardized criteria. Using these data, we propose a taxonomy and algorithm for pathologists on ''floater'' management, including identification, workup, and reporting, with an eye on patient safety. Design.--A retrospective study arm of 1574 histologic glass slides as well as a prospective study arm of 50 slide contamination events was performed. Using these data we propose a structured classification taxonomy and guidelines for the workup and resolution of tissue contamination events. Results.--In the retrospective arm of the study, we identified reasonably sized benign tissue contaminants on 52 of 1574 slides (3.3%). We found size to be an important parameter for evaluation, among other visual features including location on the slide, folding, ink, and tissue of origin. The prospective arm of the study suggested that overall, pathologists tend to use similar features when determining management of potentially actionable contaminants. We also report successfully used case-based ancillary testing strategies, including fluorescence in situ hybridization analysis of chromosomes and DNA fingerprinting. Conclusions.--Tissue contamination events are underreported and represent a patient safety risk. Use of a reproducible classification taxonomy and a standardized algorithm for contaminant workup, management, and reporting may aid pathologists in understanding and reducing risk. [ABSTRACT FROM AUTHOR]

HIGHLIGHTS: CLABSIs are a major concern in both the adult and pediatric patient population. Contamination of catheter hubs is a common cause of CLABSI. A novel, transparent line guard protects CVAD hubs from gross contamination. Central line-associated blood stream infections (CLABSIs) are a serious and potentially deadly complication in patients with a central venous access device (CVAD). CVADs play an essential role in modern medicine, serving as lifelines for many patients. To maintain safe and stable venous access, infection prevention bundles are used to help protect patients from complications such as CLABSI. Despite most CLABSIs being preventable, rates have been on the rise, often disproportionately impacting critically ill children. New solutions are needed to strengthen infection prevention bundles and protect CVADs from pathogen entry at catheter hubs and line connections. A novel, Food and Drug Administration–listed device has become available recently to guard CVADs from sources of gross contamination, addressing this apparent gap in infection prevention technology and practice. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this study was to create a cleaning procedure by comparing the performance of six different cleaning methods on the surfaces in pharmacy intravenous admixture service (PIVAS) work area. Method: A stainless steel plate was simulating contaminated by gemcitabine, cyclophosphamide, epirubicin, etoposide, and paclitaxel, which was then dried and cleaned by per current cleaning protocols. The residues were collected and quantified by ultra-performance liquid chromatography–tandem mass spectrometry (UPLC–MS/MS). Based on the most appropriate cleaning protocol, three cleaning variables were optimized: (1) use of dry gauze after cleaning agent application; (2) cleaning paths (inside-out vs. outside-in); (3) cleaning times (once or twice). Best conditions were tested with real samples from a hospital PIVAS. Results: This 10–2 M sodium dodecyl sulfate (SDS) and dry gauze cleaning protocol increases cleaning efficiency as well as saves time. Different from the traditional cleaning manner, we found that cleaning from outside to inside can not only improve the cleaning efficiency but also overcome the uneven distribution of drug residues caused by cleaning action. When simulating contamination at a high dose (4 mg/mL) level, it was found that the decontamination efficacy increased with repeating one more time. Conclusion: The 10–2 M SDS and dry gauze cleaning protocol could obtain the best cleaning effect. The success of cytotoxic drug decontamination is determined not only by the cleaning solution, but also by the cleaning route and frequency. Compared with the traditional cleaning manner, there was a significant reduction in the contamination levels in the PIVAS work area after the cleaning protocol with 10–2 M SDS and dry gauze. [ABSTRACT FROM AUTHOR]

Introduction: Verification of blood collection tubes is essential for clinical laboratories. The aim of this study was to assess performance of candidate tubes from four alternative suppliers for routine diagnostic haematology testing during an impending global shortage of blood collection tubes. Methods: A multicentre verification study was performed in Cape Town, South Africa. Blood from 300 healthy volunteers was collected into K2EDTA and sodium citrate tubes of BD Vacutainer® comparator tubes and one of four candidate tubes (Vacucare, Vacuette®, V‐TUBE™ and Vacutest®). A technical verification was performed, which included tube physical properties and safety. Routine haematology testing was performed for clinical verification. Results: Vacucare tubes did not have a fill‐line indicator, Vacuette® tubes had external blood contamination on the caps post‐venesection and Vacutest® tubes had hard rubber stoppers. K2EDTA tubes of Vacuette®, Vacucare and Vacutest® performed similarly to the comparator. Unacceptable constant bias was seen for PT in Vacucare (95% CI −2.38 to −0.10), Vacutest® (95% CI −1.91 to −0.49) and Vacuette® (95% CI 0.10–1.84) tubes and for aPTT in Vacuette® (95% CI 0.22–2.00) and V‐TUBE™ (95% CI −2.88 to −0.44). Unacceptable %bias was seen for aPTT in Vacucare (95% CI 2.78–4.59) and Vacutest® tubes (95% CI 2.53–3.82; desirable ±2.30), and in V‐TUBE™ for mean cell volume (95% CI 1.15–1.47, desirable ±0.95%) and mean cell haemoglobin concentration (95% CI −1.65 to −0.93, desirable ±0.43%). Conclusion: Blood collection tubes introduce variability to routine haematology results. We recommend that laboratories use one brand of tube. Verification of new candidate tubes should be performed to ensure consistency and reliable reporting of results. [ABSTRACT FROM AUTHOR]

Unplanned births outside of hospitals have becoming an issue in cities. The majority of healthcare professionals are paramedics. When performed alone, this event frequently causes them strain and anxiety. Their primary worries were the safety of mothers and newborns, as well as insufficient obstetrical equipment. As a result, our team developed a portable birth bed equipped with newborn safety devices for this research. One hundred fourteen paramedics of local area participated in this study and were divided into intervention and conventional group. In simulation trials, the study found that this safety intervention outperformed the conventional setup. We determined that our technology aided in the delivery of unusual babies. However, it requires additional research in the actual situation. [ABSTRACT FROM AUTHOR]

AIM: The aim of this study is to evaluate highly touched clinical surfaces using visual inspection methods and adenosine triphosphate by bioluminescence to identify soiling in intensive care units. METHOD: Descriptive, cross-sectional study carried out in three intensive care units located in Belo Horizonte, MG, Brazil. Data collection included 142 assessments of environmental surfaces. For data analysis, the Pareto diagram and descriptive statistics were used through measures of central tendency. RESULTS: The visual inspection identified dirtiness in the infusion pump, alcohol dispenser, and telephone. The surface that showed a high level of contamination by organic matter identified by the adenosine triphosphate bioluminescence test was the telephone, with a median of 1012 RLU/cm2 (±348.8). CONCLUSION: The surface evaluation methods used in the intensive care units made it possible to identify dirt on surfaces highly touched by hands, reinforcing the need for investments in training and audits in the process of cleaning and disinfecting surfaces. [ABSTRACT FROM AUTHOR]

Introduction Toothbrushes get contaminated with use and may be a source of infection and cross-contamination. Disinfection of toothbrushes after use results in reduction in amount of bacteria on toothbrushes. Various agents are used, like chlorhexidine, UV lights, triclosan, baking soda, neem, etc. for the same. Material and Methods A total of 120 individuals belonging to the age group of 8 to 11 years old were recruited. Six groups based on the disinfection solution and type of disinfectant were made: Group 1- bamboo toothbrush and water, group 2- nylon toothbrush and water, group 3- bamboo toothbrush and triclosan mouthwash, group 4- nylon toothbrush and triclosan mouthwash, group 5- bamboo toothbrush and baking soda and group 6- nylon toothbrush and baking soda. After brushing, the children/ parent were asked to disinfect the toothbrush for five minutes after every use for eight days. Bristle samples were collected on days 1 and 8 for the evaluation of CFU/ml of total bacterial count. Results A total of 118 participants completed the study. The mean bacterial counts in CFU/ml on day 1 were 7.17 ± 0.59, 7.12 ± 0.61, 6.73 ± 0.52, 6.94±0.67, 6.86±0.57 and 7.03±0.56 for group 1 to 6, respectively. The mean bacterial counts in CFU/ml on day 8 were 7.14 ± 0.57, 7.04 ± 0.58, 1.48 ± 0.36, 1.91 ± 0.35, 2.07±0.43 and 2.07±0.32 for group 1 to group 6, respectively. Conclusion Triclosan containing mouthwash and baking soda were both similar in terms of the disinfection of bamboo toothbrushes with plant based bristles and nylon toothbrushes. [ABSTRACT FROM AUTHOR]

Successful treatment of peri-implantitis requires decontamination of implant surfaces exposed to biofilms and byproducts of tissue inflammation. In this regard, dental lasers may provide a clinical benefit. While the inherent characteristics of specific laser wavelengths may damage titanium implant surfaces, in vitro and animal studies have shown that damage to the target surface can be avoided with the selection of appropriate laser parameters. In this in situ human study, five hopeless implants were irradiated, each by one of the following lasers: Nd:YAG (1,064 nm), Er,Cr:YSGG (2,780 nm), Er:YAG (2,940 nm), CO2 (9,300 nm), and CO2 (10,600 nm) at their recommended settings. All implants were then removed and examined under scanning electron microscopy for the presence of residual bacteria and to assess the extent of damage to the implant surface. An additional implant (implant no. six) was irradiated and evaluated by the Limulus Amebocyte Lysate test for the presence of residual lipopolysaccharide endotoxin. The results showed that while there were localized areas of heat-related damage to an implant surface following laser irradiation, residual bacteria were rarely noted. Additionally, the Limulus Amebocyte Lysate test indicated a nearly complete removal of endotoxin. With the use of appropriate settings, all current dental lasers can be utilized for implant surface decontamination in a human. [ABSTRACT FROM AUTHOR]

Purpose: After some initial setbacks in the 1970s, ceramic implants seem to be a promising alternative to titanium implants. Since the surface of an implant system represents the interface to surrounding biologic structures, the study focuses on cleanliness and surface topography. Clinical documentation of the corresponding systems completes the picture and allows a better evaluation of zirconia implant systems. Materials and Methods: Five different ceramic implant systems were selected randomly and purchased via blind-shopping: Z5s (Z-Systems), ZiBone (COHO), W implant (TAVDental), ceramic. implant (vitaclinical), and BioWin!/Standard Zirkon Implantat (Champions-Implants/ZV3 system). Three samples of each implant system underwent scanning electron microscopy (SEM) imaging and elemental analysis (EDS). Where appropriate, subsequent Time-of-Flight Secondary Ion Mass Spectrometry (ToF-SIMS) was performed to identify the chemical nature of impurities. Surface topography was evaluated, and a search for clinical trials in the PubMed database, on the websites and by written request to each dental implant manufacturer, was performed. Results: Surfaces of Champions implants (ZV3) and Z-Systems implants were relatively clean, whereas the other investigated surfaces of vitaclinical, TAV Dental, and ZiBone implants all displayed organic contaminations on their surfaces. Four of the investigated ceramic implants showed a moderately rough implant surface. Only the vitaclinical ceramic. implant had minimal surface roughness. Three ceramic designs--vitaclinical, ZV3, and Z-Systems--had clinical trials documented with up to 3 years of follow-up and results varying between 82.5% and 100% survival. TAV Dental W and ZiBone implant systems lacked properly conducted clinical recording of results. Conclusion: The results of this study showed that it is technically possible to produce zirconia implants that are largely residue-free. On the other hand, the variety of significant residues found in this analysis raises concerns, as contamination may lead to undesirable biologic effects. The lack of clinical studies in peer-reviewed journals does not seem to be relevant for the approval of marketing, nor does the lack of surface cleanliness. In the authors' opinion, a critical analysis of these aspects should be included in a more stringent future analysis prior to the marketing of oral implant systems. [ABSTRACT FROM AUTHOR]

The augmentation mammoplasty with prosthesis implantation is the most frequent aesthetic surgical intervention. One of the most frequent complications associated to this surgery is the bacteriological contamination of the implants. In order to avoid it, different protocols like the 14-points have been proposed. One of the measures included is the avoidance of the aerial exposure of the prosthesis before implantation. However, the risk of contamination without direct contact has not been well-established. Our aim has been to evaluate the risk of aerial contamination breast prostheses during the surgical procedure. During the course of the surgery of augmentation mammoplasty with prosthesis implantation, we rubbed a hyssop over the prosthesis before the full unwrapping; these samples were used as the control group. Afterwards, the prostheses were irrigated with either saline serum or povidone-iodine and exposed to air in the operating room. New samples were taken with a hyssop after 2 and 5 min. All these samples were cultured in the microbiology lab. In total, 36 prostheses, microtexturized and smooth ones, were analyzed. All microbiological cultures were negative at 0′, 2′, and 5′, regardless of the implant texture and the irrigation fluid used. There is no microbial contamination of the breast implants during the course of the surgical intervention preimplantation due to aerial exposure, and there might be therefore other different sources of prosthesis contamination. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the effect of blood contamination on marginal adaptation of cold ceramic (CC) and mineral trioxide aggregate (MTA) Angelus using scanning electron microscopy (SEM). Methods: This in vitro experimental study was conducted on 24 extracted single-rooted human teeth. After cleaning and shaping, the root canals were filled with lateral compaction technique. The apical 3 mm of the roots was cut, and cavities with 3 mm depth were created at the apex. The teeth were randomly assigned to two group (n = 12) for the application of CC and MTA Angelus as retrograde filling materials. CC and MTA Angelus were prepared by mixing the powder with blood, and applied in the cavities. After 24 h, their marginal adaptation to the canal walls was assessed by SEM. Data were statistically analyzed by t-test (alpha = 0.05). Results: The mean marginal gap was 8.98 μm in the CC, and 16.26 μm in the MTA Angelus group; this difference was statistically significant (P < 0.001). Conclusions: The present in vitro study revealed that following complete blood contamination of powder, CC showed significantly superior marginal adaptation than MTA Angelus as shown by SEM assessment. [ABSTRACT FROM AUTHOR]

Background: Between January and September 2022, 10 patients who were admitted to the Intensive Care Unit (ICU) for a period of more than 72 hours were found to have carbapenemase-producing Enterobacteriaceae (CPE) in their screening/clinical specimens. No epidemiological association was found among them, and none had received healthcare outside Canada in the preceding 12 months. The study investigated whether sink drains could be a source of CPE transmission. Methods: A retrospective study was conducted on all patients admitted to the ICU during the surveillance period who tested positive for CPE, alongside a pilot study involving environmental screening cultures collected from hand hygiene (HH) and washroom sink drains in ICU rooms after the patients had been discharged. Information was gathered on CPE risk factors, such as recent travel history or hospitalization outside of Canada, endoscopic retrograde cholangiopancreatography procedures, or hemodialysis within the last 12 months. Results: During the surveillance period, 15 non-duplicate CPE isolates were obtained from 14 patients in the ICU. Out of the 14, 10 patients were identified after ICU stays of greater than 72 hours. Klebsiella pneumoniae carbapenemase (KPC) was the most identified carbapenemase, found in five (50%) of isolates, followed by three (30%) New Delhi metallo-β-lactamase, and two (20%) Oxacillinase-48 like carbapenemase. In addition, a total of 33 sink drains underwent testing: 24 were HH sinks, while nine were inpatient washrooms. Among the 24 HH sink drains, nine (37.5%) tested positive for CPE, eight of these sink drains (88.9%) had KPC genes, two (22%) had NDM genes, and one (11%) had VIM genes. Among the HH sink drains contaminated by CPE, three (33.3%) out of these nine shared the same species/gene combination (KPC-Citrobacter freundii) as the CPE-positive patient recently discharged from the room. Conclusion: These findings suggest a potential link between KPC-producing Citrobacter freundii detected in the HH sink drain and a CPE-positive patient. However, the direction of transmission remains unclear. Further research is necessary to analyze the molecular genotyping and validate any potential relatedness among them, in addition, collaborative efforts from the infection prevention and control, microbiology, environmental, and facilities teams are essential to eliminate CPE from HH sink drains. [ABSTRACT FROM AUTHOR]

Cerebrospinal fluid (CSF) diversion procedure in the form of ventriculoperitoneal shunt (VPS) has been performed for over a century and is a well-established method for treating hydrocephalus. With the passage of time and the availability of better technology, several other CSF diversion modalities developed with variable risks and benefits. Lumboperitoneal shunt (LPS) is a close and safe contestant for the VP shunt procedure and is regarded as an alternative treatment modality for hydrocephalus. The present scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A literature search for the study was performed on PubMed, COCHRANE, SCOPUS and ScienceDirect (from inception to 7 July 2022). Those studies that were published in the English language with a report on comparison between VPS and LPS for the management of hydrocephalus were included in the review process. Those studies that do not have comparative outcomes, case reports, letters, reviews, preclinical studies, conference reports and non-human studies were excluded from the study. Search results showed 134 records; after removing the duplicates and excluding 12 studies with reasons, five studies were included in the present review. Several complications were described in patients who underwent either VP Shunt or LP Shunt surgery. Although communicating hydrocephalus forms one of the most significant subgroups of patients in neurosurgical practice and VP and LP shunt procedures are also widely performed, the literature review shows limited comparative efficacy. In addition, the reported studies have a broad spectrum of indications, disease conditions and complications with a heterogeneous patient population. To further develop the high level of evidence, there is a need for well-designed prospective protocols to help us develop uniform and practical guidelines. In the present review, we looked into the common complications, including shunt malfunction, shunt infection, subdural haematoma, shunt obstruction and shunt migration between two groups. [ABSTRACT FROM AUTHOR]

Background Differential time to positivity (DTP), defined as pathogen growth at least 2 hours earlier from catheter versus paired peripheral blood cultures, is sometimes used to diagnose central line–associated bloodstream infections (CLABSIs). Previous studies assessing DTP, however, have been small, provided conflicting results, and did not assess heterogeneity across important subgroups. Methods We systematically reviewed the diagnostic characteristics of DTP for CLABSI using MEDLINE, Embase, WoS, CINAHL, LILACS, AMED, and the Cochrane database. Studies were included if they reported sensitivities, specificities, predictive values, likelihood ratios, or 2 × 2 tables of DTP for diagnosing CLABSI. Extracted data were analyzed by using forest plots, bivariate model meta-analysis, and QUADAS-2 quality assessment. Results We identified 274 records, of which 23 met the criteria for meta-analysis. Among 2526 suspected CLABSIs, DTP demonstrated a summary sensitivity of 81.3% (95% confidence interval [CI]: 72.8%–87.7%), specificity of 91.8% (95% CI: 84.5%–95.8%), positive likelihood ratio of 9.89 (95% CI: 5.14–19.00), and negative likelihood ratio of 0.20 (95% CI:.14–.30). Covariate analysis based on catheter duration, study design, and patient immune status demonstrated no significant differences. However, DTP performed worse for Staphylococcus aureus (low sensitivity but high specificity) and Candida (high sensitivity but low specificity) compared to other organisms. Conclusions DTP performs well in ruling CLABSIs in or out. Obtaining paired catheter and peripheral blood cultures for DTP when the infectious source is unclear may prevent unnecessary line removal and diagnostic tests. However, this must be balanced against higher contamination rates from catheter cultures. [ABSTRACT FROM AUTHOR]

HIGHLIGHTS: Over-the-needle (OTN) PIVC devices are at inherent risk of insertion related skin contamination. Through-the-needle (TTN) catheter deployment resulted in no measurable contamination in this study. OTN catheters were 1.67 times more likely to be contaminated than TTN in this study. Aim: To compare a traditional over-the-needle peripheral intravenous catheter device to a through-the-needle (TTN) peripheral intravenous catheter device for early bacterial contamination during insertion. Methods: Five TTN test devices (OspreyIV 20 g SkyDance Vascular, Inc) and 5 OTN comparative devices (Insyte Autoguard 20 g Becton Dickinson) were aseptically inserted through targeted zones inoculated with 1 mL aliquot suspension of approximately 1 × 10 CFU of Staphylococcus aureus among 3 healthy sheep. Immediately after insertion, each study catheter was surgically removed from the surrounding tissue and cultured for the presence of Staphylococcus aureus inoculum that may have been transferred to the catheter during insertion. Results: Final culture results of the 5 test articles found no bacterial colonies. Final culture results of the 5 comparative articles revealed 2 of 5 were contaminated with bacterial colonies. The absolute risk reduction is 40%, or a 40% rate of contamination drops to a 0% rate of contamination when the TTN catheter deployment was used. The risk ratio achieved was 1.67, indicating catheters placed using the OTN deployment were 1.67 times more like to be contaminated than the TTN deployed catheters. Conclusion: In this present ovine study, the data revealed that use of a novel TTN approach resulted in less contamination than the more traditional OTN approach. Traditional OTN devices, developed over 70 years ago, are at inherent risk of insertion-related contact contamination. The results of this research, as well as previously published studies, point toward considering physical catheter protection strategies such as TTN devices as a potential alternative to OTN devices. [ABSTRACT FROM AUTHOR]

Background: The hospital environment serves as a niche for pathogenic microorganisms, so efforts are constantly being made to identify the potential mode of microbial pathogen transmission causing clinical infections. Objective: The aim of this study was to microbiologically examine the stethoscopes used by clinicians at the University of Benin Teaching Hospital (UBTH) in Benin, Nigeria. Methods: A total of 106 clinicians' stethoscopes were cleaned using cotton-tipped swabs dampened with normal saline. This included both earpieces along with the diaphragm (three samples per stethoscope). The samples were then sent to the Medical Microbiology Laboratory of UBTH and processed immediately as per the standard guidelines. The emergent colonies were subsequently identified, and antimicrobial susceptibility tests were performed. Results: A total of 114 (35.8%) bacterial isolates were recovered, including Staphylococcus aureus (S. aureus) (33.3%), coagulase-negative staphylococci (CoNS) (33.3%), Bacillus spp. (22.8%), Acinetobacter spp. (5.3%), Escherichia coli (E. coli) (1.8%) and Klebsiella spp. (3.5%). Diaphragms had the highest yield of methicillin-resistant S. aureus (MRSA) (46.2%) and CoNS (17.9%). Age (P = 0.0387) and cadre of clinician (P = 0.0043) were risk factors for contamination, whereas clinicians who never cleaned their stethoscopes (P = 0.0044) or cleaned only the earpieces (P = 0.0001) had more contaminated stethoscopes. Conclusion: The contamination rate of stethoscopes used by clinicians in Benin City was 56.6%. There is a need to establish proper stethoscope cleaning practices for all cadres of personnel in clinical practice to minimise health risks to patients and healthcare workers (HCW). [ABSTRACT FROM AUTHOR]

This study aimed to investigate the survival and persistence of enveloped phi 6 bacteriophages on several fomites at farmers markets and simulate cross-contamination at farmers markets. Fomites from farmers markets were inoculated with phi 6 bacteriophages (a surrogate for coronaviruses such as SARS-CoV-2) and plaque forming units (PFUs) were assessed over 30 days at 23 ± 2 °C. Phi 6 persisted up to 16 days on wicker, 13 days on plastic, 4 days on cardboard and molded pulp fiber, and 2 days on tablecloths. The transfer rate of phi 6 from fomites to hands and produce was assessed at high and low phi 6 concentrations at 23 ± 2 °C. With a high concentration level (107 PFU/ml), the mean transfer rate from fomites to produce ranged from 21% to 30%, and fomites to hands ranged from 21% to 29%, while with a low phi 6 load (10³ PFU/ml), the transfer rate from fomites to produce ranged from 10% to 30%, and no phi 6 was detected from fomites to hands. The results highlight the high risk of cross-contamination from fomites. From a practitioner and public health standpoint, the results of our study show the need to address the use of containers made from cardboard, molded pulp fiber, and wicker, and to ensure that these containers are not reused over time. In addition, managers of farmers markets should encourage the use of nonporous and easy-to-clean and sanitize reusable containers and other food contact surfaces. [ABSTRACT FROM AUTHOR]

The great majority of workplace respirator efficacy studies have measured total inward leakage (TIL) for particulate contaminants. One of the first such studies, designated the Harris study, was conducted in the early 1970s in US underground coal mines. As in other particle-based studies, inside-the-facepiece dust sampling was continuously conducted across the inhalation and exhalation phases of the breathing cycle, although unlike in other studies, respirable dust cyclones were used in air sampling. Because exhaled air was partially depleted of dust particles due to deposition in the respiratory tract, the measured time-averaged dust concentration inside the facepiece underestimated the time-averaged dust concentration inspired into the facepiece. In turn, the reported TIL values underestimated the true TIL values experienced, which is to say, overestimated respirator efficacy. This paper describes a method to correct the Harris study's reported TIL values for respiratory tract deposition while accounting for particle size-selective sampling by the cyclone devices. Given the estimated coal mine particle size distribution outside the respirator, it is shown that the reported TIL values should be increased by the multiplicative factor 1.69. This paper also discusses the assigned protection factor (APF) of five for the quartermask respirator class and shows that 4/5 quartermasks in the Harris study did not meet the criterion for complying with this APF value when using the corrected TIL values. [ABSTRACT FROM AUTHOR]

Summary: Here, we present a case of mass ventilator failure due to contaminated medical air. Multiple ventilators failed routine tests, including almost all of the ventilators in our intensive care unit. A faulty air compressor had led to water contamination of our centre's supply of medical air. Water entered the pipeline supply of air and, hence the ventilators and anaesthetic machines. The disruption of the machines' proportional mixer valve resulted in unreliable delivery of fresh gas flow. This malfunction was discovered during routine pre‐use checks, and backup ventilators were available to replace the faulty ventilators. A shortage of equipment was averted due to a serendipitous availability of ventilator stockpiles prepared for the COVID‐19 pandemic. Ventilator shortages are commonly described in mass casualty and pandemic scenarios. While there are multiple strategies described in literature to augment and maximise equipment available for mechanical ventilation, stockpiling equipment remains an expensive but necessary component of disaster contingency planning. [ABSTRACT FROM AUTHOR]