Welcome to Professional and Technical Services (PTS) – experts in chemical disinfection for infection prevention. Our goal is to educate and provide you the latest resources related to cleaning and disinfection of environmental surfaces, medical devices and hands. As specialists in disinfectant chemistries, microbiology, environmental cleaning and disinfection, facility assessments and policy and procedure creation we are dedicated to helping any person or facility who uses chemical disinfectants.

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Monday, October 16, 2017

The joys of birth and the nightmares of SSIs


The theme across Canada for International Infection Prevention Week is “It’s a Team Thing”.  It’s a perfect theme and without a doubt 100% accurate.  Lapses in infection prevention in most cases are not attributed to a single thing, but a number of factors.  As mentioned last week, to celebrate IIPW I will be posting a daily blog sharing stories of friends and colleagues I work with at Virox whose lives either directly or indirectly have been touched by an HAI.  It’s easy to play the blame game and point fingers, but I am hoping that by sharing these stories, we can instead think of how as a team we can work together to try and prevent HAIs from happening and reinforce the importance of infection prevention in saving lives.

When I sent the email out to our company asking if anyone had been impacted by an HAI in some way, I was hoping no one had a story to share.  That unfortunately, wasn’t the case.  The truth was many of us had.  What was most alarming is that several shared stories that were almost identical.  The stories I am sharing today are one of those.

The birth of a child should be the most amazing day or your life.  After waiting for 9 months, you get to meet the child that you have felt growing in your belly or seen growing in your wife’s belly.  Let’s be honest, giving birth to a child is not all sunshine and roses. It’s messy.  It’s painful and yes, it can be deadly.

Today, I share the stories of the birth of my VP of Manufacturing's first child and the birth of my CEO's third child.  Both stories follow the same path, an SSI after a C-section.  In Zubair's story, his wife, Mehwish, spent two weeks in the hospital following the birth of their daughter, Zara.  Mehwish was put on antibiotics, needed blood transfusions, and as one can expect, it took a while for her to recover, but she eventually went back to full health.  Zara was born March 15, 2016 and today is a health, beautiful little girl.  

My CEO, Randy, had the same thing happen to his wife Catherine.  With 2 children at home, they thought they knew the game plan.  Instead Catherine ended up with a staph infection, spent 2 weeks in quarantine and ICU where she had multiple cocktails of antibiotics.  In fact at one point, his wife’s health had deteriorated so badly they actually had a priest come to her room.  Even after the SSI cleared, she had 3 to 4 years of poor health due to the impact of the ordeal on her immune system.  As Randy tells the story, Malory who is now 20 would sit on his desk while he worked after he had sent his 2 older children who were 7 and 5 at the time to school wearing pyjamas (Little Mermaid and Batman) which he thought was perfectly acceptable clothing…

SSIs are the most common and costly of all hospital-associated infections.  In fact in the US, they account for 20% of all hospital-associated infections, meaning they occur in an estimated 2% – 5% of patients or 160,000 to 300,000 people each year.  The most common pathogens to cause SSIs include bacteria such as StaphylococcusStreptococcus, and Pseudomonas.  So how do SSIs occur?  Unfortunately, it’s really not that difficult. They can infect a surgical wound through various forms of contact, such as contaminated surgical instruments, the hands of a Healthcare worker or caregiver, through germs in the air, or through germs that are already on or in your body that get spread to the wound.

Luckily for my colleagues, while the start to what should have been one of the most joyous occasions of their lives got off to a rocky start, the story ended with a happily ever after for 2 very proud papas and 2 very beautiful girls.  I hope we can use their stories to learn from our mistakes, learn that the cause of an HAI cannot be pinned on a single person or event, but that we all need to pull our weight to try and help stop them from happening to others – others who may be less fortunate.

Bugging Off!

Nicole

Friday, October 13, 2017

Are you part of the 25% group?




Next week is International Infection Prevention Week.  It’s always a fun time of the year with opportunities to provide education, particularly through games.  In fact I came across an on-line quiz that will tell you “What Germ you are” – if of course you were a pesky pathogen.  I’m happy to say I would be MRSA.  As part of celebrating IIPW, next week I will be doing daily blogs sharing stories of how friends and colleagues I work with have been impacted by HAIs.  There are some stories with happy endings and, well, as you can guess, some not so happy endings. 

Knowing what I will be writing about next week, this week I wanted to share a survey I came across that was conducted by Canada Life looking at presenteeism.  I would hazard a guess that most of us can attest to the fact that we to have gone to work despite being ill and knowing we’ll not be functioning fully.  According to the Canada Life survey, 1 in 4 workers would need to be in the hospital before they would call in sick.  Sound familiar to anyone?  When trying to tease out why people pick presenteeism over caring for themselves the following were the primary reasons:
·        People did not want to appear “weak” for not coming in over a “short-     term illness”
·        People were nervous of being seen as “lazy”
·        People were nervous about being considered as “not dedicated”
·        People were made to feel “guilty for taking time off even if ill” by   coworkers and company leaders

While the survey was conducted in the UK, this trend is not limited to the UK.  Results from the NSF Workplace Flu Survey showed that 98% of American workers judge their colleagues for coming into work sick……BUT it’s the minority that actually feel negative about it!  In fact 67% thought those that do come in when sick are hard workers and only 57% of those surveyed said they would encourage a fellow employee to go home “if they thought they were too sick to be at work”.

I know for a fact that presenteeism is not just related to the corporate world.  In my “Who’s the last man/women (girl) standing” blog I discussed a study published in JAMA Pediatrics that looked at presenteeism in healthcare workers finding the top reasons for working while sick included; concern over who would fill in for them, concern that their patients could not get by without them and a widespread belief that if they stayed home because of a cold or flu they would be perceived as being weak or unprofessional. 

What does this say about us?  I’ll admit, I’ve been known to come in with a cold, but that’s because I firmly believe if I can spread it to one person I instantly start to feel better.  If I’m running a fever, I stay home.  I also send people home, admittedly less about concerns for their health, but for the fact that I don’t want to get sick (or get the rest of the team sick)!  I will even admit, upon occasion, I wonder why someone can’t just “suck it up”…. 

So what group are you in?

Bugging Off!

Nicole 

Friday, October 6, 2017

Heater-Cooler Hurts Hearts

Unless you’re completely without feeling, I would hazard a guess that when you hear of something bad happening to a child be it abuse or neglect, injury or disease or even death your heart hurts a little.  Many of us cannot fathom having a deathly ill child.  I’ve been lucky, but I have a close friend whose son at the age of 19 months was diagnosed with a very rare cancer.  The treatment was long, hard, and heartbreaking, and made worse by the fact that my friend was also a childhood cancer survivor so knew exactly what his son was going through.  I’m happy to say that Liam beat the odds and while he remains cancer free, he will continue to be closely monitored.

While not a brand new issue, heater-cooler units that are used during heart surgeries to regulate the temperature of patients on bypass continue to plague Infection Preventionists, since they are difficult to disinfect, but much needed machines that have been the root cause of several outbreaks.  The most recent I’ve read about impacted 12 patients at a children’s hospital who underwent cardiac surgery this summer.  The outbreak was blamed on a single heater-cooler unit used in a single operating room.

Patients exhibited signs of surgical site infections including swelling, wound drainage, redness and fever caused by Mycobacterium abscessus.  This bacterium is an environmental bacteria that is routinely found in water, soil and dust and while perhaps not the most common bacteria to cause SSIs, it has been known to contaminate medications and other products including medical devices.  Transmission of this bacterium generally occurs by injections of substances contaminated with the bacterium or through invasive medical procedures such as open heart surgery that use medical devices, equipment or material that is contaminated with the bacteria.

In order to ensure more patients were not infected the hospital has replaced the heater-cooler device and completed a thorough cleaning and disinfection of the operating room to remove any chance of future environmental contamination.  As for the 12 patients infected, while they have all been hospitalized, the good news is that some are very close to going home!

This story parallels the story of duodenoscopes.  As we improve our ability to develop more and more technically savvy instruments that can aid in the treatment of patients we increase our risk of developing instruments that are more difficult or nearly impossible to reprocess in a way that we can ensure they are safe to use on the next patient.  I’m not saying that we should halt innovation.  What I am saying is that we should, when bringing these devices into our facilities, consider conducting validation studies to ensure that we can safely reprocess in a manner that is reproducible each and every time.  My motto is if we would not use the device on a loved one, we should not use it on a patient!


Bugging Off!

Nicole


Friday, September 29, 2017

What’s in your fridge?

I admit, I troll for articles on cleaning, disinfection, outbreaks and whatever else tickles my fancy as a way to find potential blog topics. Picking a topic for the blog is not just about finding an article or using a question that has been posed.  The hardest part, at least for me, is finding a connection to the story.  Some weeks I know exactly how I’ll start the blog or how I may personalize the story, while other weeks I have a topic that just doesn’t “speak to me”. This week’s topic speaks to me and will likely speak to you too!

How many of you share the office fridge to store your lunch or leftovers after going out to lunch?  Do any of you have that one (or two) colleagues who believe there is a magical fairy or elf that comes in and cleans up the mess in the fridge – you know the stuff that horror stories are made of?  How many times have you opened the door of the fridge only to have your nose recoil in disgust because it smells like something curled up and died in there?   Tell the truth – how many of you have had that happen at home?  It happened to me about a week ago after being away on a business trip for a few days.  It took me a couple of days, but I found the culprit.  It was a piece of steak that even when enclosed in Tupperware managed to smell like….well I don’t want to think about it anymore.  Let’s just say a skunk would have smelled far more pleasant.

According to a recent survey, “Office fridges are an interesting social experiment on people’s warring definitions of cleanliness, hygiene, and manners.”  The survey asked 1000 adults when the last time their office fridge was cleaned.  The average was 93 days! Of the 1000 people surveyed almost half of them lacked even basic food hygiene knowledge!  If you’re unsure what your food hygiene knowledge is, check out the FDA Refrigeration and Food Safety website.  Cold temperatures will help slow the growth of many potential pathogens, but it does not stop them all!  The website also includes the length of time you should leave cooked or uncooked food in the fridge.  Did you know an open package of hot dogs should be tossed after a week?  Who is able to eat an entire package of hot dogs in a week unless you have a small army to feed!

If you’re unsure how to clean the office fridge, here’s a few tips:

  • First, draw straws.  The short straw gets to clean the fridge or you could just have the person who made the biggest mistake that week clean the fridge.
  • Grab some reusable latex cleaning gloves or disposable vinyl gloves.  Don’t be afraid to double glove!
  • Find a N95 respirator to put a mental & physical “barrier” between you and the gross stuff
  • Make sure you have HEAVY DUTY Garbage Bags.  Don’t chintz on the cheap bags, if they rip or tear you’ll have to touch everything twice!
  • Be sure to have a disinfectant that will kill even the nastiest of bugs
  • Stock up on Paper Towels
  • Have Coffee (beans or grounds) out and ready to sniff after cleaning up to get the remnants of any nasty odors out of your nose!
The long and the short is, be an adult.  Unless you work in an office with a magical fairy or elf, clean up after yourself and for the love of Pete, do NOT leave your food in the fridge!  If you don’t eat it, take it home or throw it out!


Bugging Off!


Nicole

Thursday, September 21, 2017

Alcohol – good for drinking, not soaking

I’ve been known to imbibe now and again.  I like to have fun.  Those that know me well may have been involved in one or two of my escapades and a few of you may have heard some stories.  I am happy to say I have never been arrested and never been hospitalized.  Being grounded while a teenager…..well that’s another story!

Why the discussion of alcohol?  Alcohol is one of those “magical” chemicals – you can drink it, you can cook with it, you can wash your hands with it, you can clean with it, you can kill with it and you can use it for fuel (it’s also lights nicely with a match!).  In the chemical world, there are a number of different types of alcohols that can be used as a solvent (helps to dissolve things) mixed in with other chemistries (e.g. Quats) that can be used as a disinfectant.  On its own (aka 70% IPA), we use it as a disinfectant for skin prep and in microbiology, use it as a fixative agent.  Here in lies the catch.

Alcohol is a fixative.  It’s well known to be one, but generally speaking most do not realize what that means or how its ability to adhere organic matter to a surface can impede cleaning and disinfection.  In fact, a study published in AJIC recently looked at just that.  The researchers found that treating contaminated surgical instruments with alcohol and allowing them to dry, increased difficulty in cleaning and could lead to sterilization inefficiency.  The rationale of using alcohol in this way is of course for its killing properties to reduce pathogen load prior to cleaning and disinfection or sterilization.  The researchers found that yes, the bacterial load was reduced when instruments were wiped or sprayed, but this practice significantly increased the attachment of soil to the instruments which made cleaning these same instruments significantly harder. The long and the short was that the benefit associated with the decreased microbial load was overshadowed by the increased difficulty in cleaning and should be discouraged.

While the study looked at surgical instruments, we need to contemplate that alcohol used for surface disinfection will do the same thing.  In surface products, alcohol (IPA, ethanol etc) is often added to boost the efficacy of quats and other disinfectant actives to either enhance efficacy (such as achieve a TB claim) or help to reduce the contact time.  Similar to the effect of sticking soils to instruments, the same will happen when using alcohols on surfaces, highlighting the importance of removing soils prior to wiping with an alcohol containing surface disinfectant.

In the end, it’s about finding the balance of what you are looking for in your facility and knowing the advantages and disadvantages of the disinfectant you are looking at.  If you know what you’re dealing with, you can implement practices to try and minimize the negative side effects of the product.  When it comes to surgical equipment, as cleaning is so vital to ensuring that disinfection or sterilization can occur, I hope you’ll stop the practice of using alcohol to wipe down the instruments prior to cleaning.  When it comes to surface products,  I hope you also do your research, particularly if you work in a high soil environment!


Bugging Off!

Nicole



Friday, September 15, 2017

Poopy Love from Puppies

As I’ve mentioned before, I grew up on a farm.  We raised beef cows, capons (neutered male chickens) and grew cash crops (wheat, corn, soya beans, etc).  As any good animal loving country girl can probably attest, you can make a pet out of virtually any animal.  Some of my favorites were Joy our Jersey who, while a cow, we rode like a horse; there was also Cookie the Capon, Miss Piggy, Herman and Hersey (also cows), Rainbow my thoroughbred horse, Pursey my albino rabbit, Mr. Boots my Dutch belted rabbit, Sparky a very vocal guinea pig and of course we always had a dog or two and lots and lots of cats.  I played in our barns, I’ve mucked my fair share of stalls and yes, I’ve been known to get into manure fights while mucking stalls. I’m pretty sure at some point in my life I’ve eaten poop – unknowingly of course, but I’m sure it’s had to have happened.

While acknowledging in a public forum that I’ve eaten poop, what I can say is that when coming in from the barn I always washed my hands. I washed my hands after playing with our pets, before eating, and I NEVER let any of our animals lick my face or kiss them in any close vicinity to their tongues.  How many of you can say the same?  Not to shame you if you have, but GROSS!!!!  Do you know where those mouths and those tongues have been?

We often talk about Swine or Avian Influenza and Salmonella as common zoonotic diseases.  Certainly, we need only go back a few weeks to my “Fall Fair Fun” blog to read about transmission of pathogens from animals to humans.  Only a few weeks ago there was yet another Salmonella outbreak associated with pet turtles (I talked about that in my “Pet Turtles Pose Health Problems” blog back in 2015).   I think we’ve come to understand that farm animals (and pet turtles) can spread disease but what about adorable, cute, cuddly and wet tongued puppies? 

Well….those darn adorable puppies can also be the cause of outbreaks. In fact, the CDC is currently investigating a multi-state Campylobacter outbreak in people that have been linked to puppies purchased from a chain of pet stores.  At least 39 people across 7 states have been identified and the cause has been linked to puppies sold by a chain of pet stores based in Ohio.  Of the 39 people, 12 are employees while the remaining 27 have been directly linked to either purchasing a puppy from the store or visited the store.  The CDC does not yet know the exact cause of the outbreak and it may be difficult to ever pinpoint the exact cause.

Campylobacter itself is a bacterium that can infect dogs, cats and humans.  There are a number of different strains of Campylobacter that can be found in many of our food production animals so it is most frequently linked to eating raw or undercooked meat. Typical symptoms include diarrhea, abdominal pains and fever that can last for about a week.  Person to person transmission is rare, but transmission from exposure to dog feces is possible.  Washing your hands after handling poop and after touching your dog is recommended – I would hazard a guess that’s not realistic for many dog lovers!  While the CDC does not call it out, letting your dog lick you or kissing on the mouth should also be avoided….dogs do clean themselves down there you know!


Bugging Off!

Nicole


P.S.  Next week it will be a toss-up between a study about how alcohol fixes soil to medical devices or a study on bleach causing COPD.  If you have a preference tweet and let me know!

Friday, September 8, 2017

I’m leaving on a jet plane…

Tell the truth…you all started humming John Denver’s famous song “Leaving on a Jet Plane”.  In case didn’t know, the reason he wrote the song was that he loved to travel, but he hated leaving people (friends, family, loved ones) behind while out on the road.  I too hate leaving my loved ones behind when out on the road.  For most, September signifies back to school and back to routine after an enjoyable summer.  For some of us, it also means back to the travel grind of attending tradeshows and events.  While my fall does not look as bad as my winter and spring travel, I can say that I’m still on track to keep my travel status and in fact will come in at fewer flights than last year.  As I write this blog I have already looked at the weather in Vegas where I am off to on Monday for the ISSA Interclean Tradeshow and started to “virtually” pack my bag.

As many of you are probably well aware, while travelling can be fun and in this case educational, it can also come with myriad of problems such as delayed flights, lost luggage and the very real threat of picking up something infectious.  If you’re lucky, it may be just the common cold; and while it’s irritating, you’ll generally recover without much to show for it (unless it’s a man cold of course).  If your luck is not so good you may pick up norovirus and take a bit longer to feel back to normal, but happy that you’ve lost any weight you gained over the summer.  If you’re really unlucky, well you might pick up the next superbug or emerging viral pathogen. It’s the give and take we have to partake in when it comes to travel.  We have the luxury of globetrotting to far away destinations, but so do bugs!


I think we can all agree there have been several studies and articles about how “germy” planes are and what the “germiest” surface is…. The obvious solution is to ensure the plane arrives with enough time to properly turn it around which includes cleaning and disinfecting all of the surfaces the people on the last flight touched.  The reality of course is that to avoid delaying the next flight, corners get cut to get the next set of passengers on board.  I was extremely interested to see a study out of Arizona State University that looked at ways of decreasing the chance of contamination or spread of germs.  They found that if you split up how the plane was boarded you could decrease the risk!


The researchers realized that if you could reduce the clustering and crowding of people in the isles during the boarding process you could significantly reduce the risk of infecting travelers.  Using a model looking at transmission of Ebola, they found that under the current boarding process there was a 67% chance of reaching 20 or more cases of air travel-related cases of Ebola per month.  However, if they modified how people boarded to reduce crowding, they found the risk of infecting 20 people per month dropped to 40%.  They also found that smaller planes (e.g. 150 seats or less) also reduced the risk of transmission.  I wouldn’t call that rocket science.  With fewer people on a plane there would be less crowding and therefore, the risk of spreading disease would (should) be lower.


Basically, next week I’m doomed.  A hot spot like Vegas means a large plane and lots of people.  The upside is that my status allows me to be one of the first to board the plane and one of the first to get off the plane.  As long as everyone keeps their hands to themselves I should be good!  Of course, it doesn’t hurt that I always have a supply of disinfectant wipes!



Bugging Off!

Nicole