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.

Our expertise is utilized by Infection Preventionists, Public Health Experts, First Responders, Dentists, Physicians, Nurses, Veterinarians, Aestheticians, Environmental Services professionals and janitorial product distributors to develop more sustainable cleaning and disinfection practices in North America.

Our commitment to providing chemical disinfectant education is more than business, it is a passion.

Thursday, August 30, 2012

URGENTLY NEEDED – 1 Angry Bird Knapsack


For those of you in my neck of the woods, school starts next week.  For others, this may be your first or second week of having to listen to your tweens complain about their teachers, or how “Robby” broke their heart.  Next week, my son starts pre-school and while he’s been in a home-based daycare since he was 9 months old, next week he moves from 4 kids of varying ages to a class of 16 3 – 4 year olds who if they are anything like my little devil use the back of their hand or their sleeve to wipe their runny nose.

Most people are aware that daycares and schools are breeding grounds for infections, particularly colds, flus and intestinal illnesses.  It’s inevitable that children will “share” their germs in the daycare or school environment for the simple factor of proximity.  Close contact besides helping to spread germs can also help to build up a child’s immunity.   There are of course, a few simple precautions that can help keep kids (and yourself!) healthy as they head back to school. 

1.    Teaching kids to keep their hands clean is the number one way to avoid sick days.  I now sound like my mother “Wash your hands before we eat”, “Wash your hands after playing in the sandbox”, “Wash your hands after you go to the bathroom!” Why do boys think because they can pee standing up they do not need to wash their hands?

2.    Teach kids the importance of not to sharing hats, brushes, towels, washcloths, eye makeup or eye drops with other people.  What better way for pink eye or lice to spread!

3.    Keep their area clean.  Like cleaning their hands, cleaning their desk top before eating can help reduce spread of intestinal illness.  I suppose germs could be a source of protein for those picky eaters, but for their health and yours, its best if avoided.

A study published in August 2011 in American Journal of Infection Control, reported that after students ages 5 to 15 received one lesson in hand hygiene where they learned to sanitize their hands with alcohol hand sanitizer three times during the school day, the number of kids who missed four or more school days due to illness dropped by 66 percent. What’s more, the researchers also reported a 20 percent rise in the number of kids with perfect attendance, compared to the previous school year. Other studies show that kids—and their parents--stay healthier if children wash their hands with soap and warm water for 20 to 30 seconds (the length of time it takes to say the alphabet or sing Happy Birthday) several times a day to scrub away germs.

Let’s consider the common cold. Kindergarteners average 12 colds a year, while older kids develop about seven.  The cold season runs from September to March, making these the highest risk months (no wonder we all look forward to spring!). The virus that causes this upper respiratory tract can live for several hours on contaminated objects, such as door handles, books, pens, or a computer keyboard or mouse.  How do we stop the spread?  Along with frequent hand washing (especially before eating), taking a reusable water bottle to school instead of using the water fountain can reduce kids’ risk for colds and other infections since the parts of the fountain that students touch can become contaminated with germs. If your kids catch a cold, teach them to sneeze or cough into a tissue (or the inside of their elbow, if they don’t have a tissue) instead of their hands, so they don’t spread the virus to everything they touch.  Finally, including disinfection of all commonly touched surfaces such as desks, door handles, faucets, etc once per day will go a long way to preventing transmission.

If you have kids heading back to school, I hope unlike me you have your shopping done.  If not, and you happen to come across an Angry Birds Knapsack, give me a call!

 
Bugging Off!

Nicole

Friday, August 24, 2012

Disinfectant Chemistry Report Card #7 – Silver-Based Disinfectants: Is silver good for more than jewelry?


When asked about Silver, the first thought is often with regards to the precious shiny white metal that is used in making jewelleries.  Silver, in disinfection, refers to colloidal nanoparticles of silver that are stabilized by chelating molecules. This can range from solutions of silver nitrate in water to silver dihydrogen citrate that is a more stabilized form in comparison. Silver containing disinfectants have been used extensively for topical wound applications and other medical surface antisepsis such as catheter surfaces and gauzes for covering burns and wounds. In addition, silver has long been used in water treatments as an additive. In terms of its application for general surface disinfection, in the past decade the use of silver disinfecting agents has increased dramatically.

From a cleaning perspective, almost none of the generally-used silver containing solutions has cleaning abilities better than pure water. For use as an environmental surface disinfectant, cleaning ability needs to be taken into consideration both for removal of soils and bioburden from surfaces to be disinfected, but also with respect to any effect that soils may have on the disinfection capability of the product being used. 

With respect to disinfection efficacy, silver containing disinfectants are bactericidal, virucidal, and fungicidal and some formulations have also been reported to show inactivation against Mycobacteria.  Microbial resistance to silver containing disinfectants have been reported in numerous studies along with detailed descriptions of the mechanisms microbial resistance.

Oral administration of silver is generally considered to induce minimal toxicity; however this can depend on the type of silver containing compound and its concentrations. For example, extended uses of silver containing agents on topical and nasal routes can cause Argyria, which is a blue-grey darkening of the region’s skin.

Silver is considered as an environmental hazard because of its toxicity, persistence and bioaccumulative potential. Ionic silver is known to be one of the most toxic metal residues to aquatic organisms. An example could be silver nitrate, which has high aquatic toxicity at even low concentrations. Silver nanoparticles could enter the sewage plants and seriously challenge the biological purification process during water treatment. Soils and waters contaminated with silver ions are often viewed as low in concentration when compared to other metal ions present; however silver is a rare metal in nature and thus its perceived low concentrations are still higher than its natural safe concentration in nature. Ultimately, silver’s toxicity to living organism is limited by the exposure concentration and bioavailability. The uptake level of silver ions, or silver containing compounds, by the organisms’ cells is highly influenced by the form of silver.

Here’s how we would score silver-based disinfectants on the key decision making criteria:

     Speed of Disinfection – B to C

o     Contact times range from minutes to hours depending on the type of silver-containing solution used

 
     Spectrum of Kill – B to C

o     Silver disinfectants can kill a selection of bacteria, virus, and fungi; however performance in this criteria is tied to type of silver-containing solution

o     Some nanoparticle solutions have shown the ability to provide residual activity on surfaces

 
     Cleaning Effectiveness – D

o     Most formulations do not contain surfactants making their cleaning efficacy no better than water

     Safety Profile – C - D

o     Silver is generally considered to induce minimal toxicity; however this is dependent upon the type of silver containing compound, its concentrations and bioavailability.

o     Ionic Silver is one of the most toxic metal residues to aquatic organisms

 
     Environmental Profile – D

o     Silver is considered as an environmental hazard because of its toxicity, persistence and bioaccumulative potential


     Cost Effectiveness – B to C

o     Cost is dependent on  the formulation of the disinfectant and thus the concentration at which silver ions are used.

 
**For more in-depth scientific information about Alcohol and other disinfectant chemistries, stay tuned to www.infectionpreventionresource.com.

 
Bugging Off

 
Nicole

Thursday, August 16, 2012

Life slime…the stuff nightmares are made of


JEAPARDY QUESTION: “What does plaque on your teeth, the slippery slime on river stones, the gel-like film on the inside of flower vases, the unsightly stains in toilet bowls, the gunk that clogs your drains, otitis media (ear infections) and bacterial endocarditis (infection of the inner surface of the heart) have in common?”

ANSWER: “Nicole, what are BIOFILMS?”

In Lee’s “Are there Monsters in your drain” blog he alluded to the issue of bacterial growth in the drains of sinks being the root cause of outbreaks within healthcare facilities.  The bacteria being “splashed” and contaminating clean surfaces or items could be attributed to biofilm. 

Biofilm as highlighted above is nothing new to the world and can be found almost ANYWHERE!  Literally translated, Biofilm means “life slime” and can basically develop in any environment that has bugs (bacteria, fungi, yeasts, etc), has a flow of water and has a surface on which to stick.  When these bugs adhere to the surface they excrete a slimy, glue-like substance that helps them stick to all kinds of surfaces such as metals, plastics, rocks, implanted medical devices, teeth and tissue.

Depending on where they are found and what organisms they are comprised of, biofilms can be dangerous or beneficial.  Biofilms are responsible for billions of dollars in lost productivity due to equipment damage by causing pipes to plug or corrode, however they can also be used to help treat environmental wastes such as sewage or be used to manufacture medicines.  As a society, we most commonly associate biofilms with their related infections where biofilms can develop on medical device surfaces such as catheters, medical implants or wound dressings.  However, don’t be fooled, biofilms happily colonize on many household surfaces such as toilets, sinks, countertops, cutting boards and coffee pots!  Poor disinfection practices and ineffective cleaning products may increase the incidence of illness associated with pathogenic organisms commonly found around the home.

An outbreak in 1994 that caused hundreds of infections in asthmatics pushed the concern of biofilms to the forefront.  Pseudomonas aeruginosa, in its biofilm state was able to survive the disinfection process during manufacturing of inhalers and when used by unsuspecting asthmatics, was transported directly to the lung tissue where it flourished.  At least 100 people died from the biofilm infection.

Closer to my home, in 2000 an outbreak of E.coli O157:H7 killed 7 people and sickened some 2500 residents, many of them children.  The drinking water system had been contaminated by manure following heavy rains and the water treatment system did not have appropriate levels of residual chlorine to kill the bacteria.  During the “clean up” of the town’s water-mains, flushing and swabbing of 41 kilometers of water-mains was conducted and it was noted that increased levels of Coliform and other bacterial populations were being isolated…..biofilm was being sloughed off the sides of the water mains and continued to contaminate the water.  Perhaps the next time your city undergoes water-main cleaning and / or upgrades during the summer and invariably slows down traffic you won’t grumble as much.  What are a few extra minutes for your commute when the alternative could lead to severe diarrhea or possible death?

Of course the most well known culprits for biofilm generation are whirlpool tubs, hydrotherapy tubs or foot spa baths.  I can cite several well published outbreaks associated with piping found in tubs.  Biofilm can be shed from the pipes into the water and if you have sores or breaks in the skin these may become infected as a result of this exposure.  Perhaps now it makes sense why spas tell you not to shave your legs before a pedicure or other treatment involving a tub?  If that’s not enough, the circulation of water can aerosolize the bacteria making it easy to inhale and as noted in the 1994 outbreak of asthmatics, inhaling biofilm bacteria directly into your lungs is not a good thing!

So now that you’ll never be able to drink tap water, have a pedicure or kiss your significant other in the morning for fear of coming in contact with biofilm, let’s talk about how we deal with it.  Oxidizing chemistries such as chlorine or hydrogen peroxide have been recognized as being effective at both removing and destroying biofilms.  Good old fashioned scrubbing (mechanical removal) can also help to remove most biofilms from surfaces, however, to completely clean off and remove the biofilm slime oxidizing chemicals will be needed.  The good news is that biofilms can be removed or destroyed by chemical and mechanical means with consistent cleaning and disinfection practices. BUT – it only takes a very short time for biofilm to re-establish itself and then you have to start the battle all over again.  As Lee suggested in his sink blog, having established procedures that detail how to clean and disinfect and with what frequency to disinfect areas that are harbingers of biofilm will help stop their growth and development.

I hope the next time you stay in a hotel you ask yourself “When was the last time the lines of the in-room coffee maker were cleaned?”  You may reconsider making yourself that pot of coffee……and people wonder why I’m a StarBucks girl……


Bugging Off!

Nicole

Saturday, August 11, 2012

Common sense…is not so common….

 As far as I’m concerned, if a book doesn’t make you say, “huh”, “ohh” or “mmh” at least a few times during its reading, it was not time well spent (romance novels excluded of course…those are just for mindless guilty reading pleasures!).   But I do know one such book that was peppered with such moments.  If you didn’t know that a group of dead flamingos in the Bronx Zoo heralded the North American landfall of West Nile Virus, or that an emergency dog-sled relay across Alaska to bring diphtheria antitoxin to the stricken community of Nome was the birth of the annual Ididarod race, then you’ve not read Dr. Bonnie Henry’s book, “Soap, Water and Common Sense”.

The title of the book was unabashedly derived from a William Osler quote, “Soap and water and common sense are the best disinfectants”.  From viruses to bacteria to parasites and fungi, Dr. Henry dispels some of the all-too-common myths and misinformation about good bugs and bad bugs, and offers an eye opening account of the history of disease as well as up-to-date and accurate information on everything from the bugs we breathe to the bugs we eat and drink to the bugs in our backyard and beyond.

Although much of the wisdom on display in this book will not come as a surprise to professionals in infection prevention and control, it is both an entertaining and educational read.  Her list of the “top 10 ways to stay healthy” that predictably starts with hand hygiene, surprising ends with “Use condoms”.  That addition gave me pause likely because it is not a preventative measure that is commonly discussed in the manufacture of surface disinfectants (where I spend most of my life) and is not much addressed elsewhere in the book.  Nevertheless, it is an absolutely necessary addition!  In fact, there are little side stories, quips and other surprises throughout the book that keep you moving forward.

In her “Top 10 myths and truths about bugs”, I found many ideas that all of us would be grateful to see disseminated in the wider community.  For example:

“Myth: My immune system is healthy, so I don’t need immunization.  Besides, vaccines are dangerous.
Truth: Vaccines work with your immune system to help you fight infection.  A report of potential link between MMR vaccine and autism has been debunked by scientific evidence.  Vaccines are safe and effective, and our best protection against many infections.”

You only have to follow the news about the increased cases of Whooping Cough (pertussis) in the US to know that vaccines work!  According to the CDC, nearly 18,000 cases have been reported so far in 2012 — more than twice the number seen at this point last year with 9 pertussis-related deaths reported with the majority of deaths occurring among infants younger than 3 months of age.

“Soap and Water & Common Sense – The Definitive Guide to Viruses, Bacteria, Parasites and Disease” is well worth the time to read and while the title may infer that the book may be intended for those in healthcare related fields, the truth is the book is intended for the larger community.  In fact, it lends itself nicely for a book club discussion.  For someone not immersed daily in the prevention of infection, the “huh” moments will be plentiful indeed, and it may even be a life altering (or at least health-improving) experience!

Bugging Off!
Nicole

Wednesday, August 1, 2012

Are There Monsters in Your Drain?

As a child I’m sure we’ve all had nightmares about the monster under our bed, or perhaps hiding in the closet.  However, I don’t personally believe I ever feared the beast lurking in the sink drain.  Unfortunately, this has become a very real concern or nightmare for infection control professionals in healthcare facilities throughout North America and likely around the globe.  Multi-drug resistant strains of various bacteria including Pseudomonas aeruginosa and Klebsiella oxytoca are taking up residence in sink drains and wreaking havoc on the most immuno-compromised patients. Just recently the infection control staff at Mount SinaiHospital (MSH) in Toronto published a study recounting their strategy for addressing an outbreak that was traced back to the prevalence of K. oxytoca in the drains of their ICU handwashing sinks.  This scenario echoes a similar situation encountered by staff at TorontoGeneral Hospital (TGH) years earlier.  In the case of TGH, the bacterial strain was different but the source was the same – the sink drain in the ICU handwashing sinks.  Some of you may be asking – as I did when I first came across the TGH study – how in the world does bacteria dwelling in the deep, dark recesses of a sink drain infect dozens of patients in an ICU?  The simple answer: splashing.  Fact is, a dark and damp sink drain is the ideal location for bacteria to populate and proliferate.  When the tap is running, any splashing that may occur when the water hits the drain could spread germs to both neighbouring hand contact surfaces and directly to the hands of healthcare workers whom are trying to comply with their hand hygiene needs.  So how can we solve this problem?

In both studies, two interventions played a major role.  The first addresses the degree of splashing and is more complicated as it typically involves the renovation or replacement of the sinks in favour of those that are engineered to minimalize splashing.  The second intervention seeks to address the contamination at the source, so as to prevent the potential for transmission to other surfaces even if there is some splashing.  This involves the thorough cleaning and disinfection of the sink drain on a regular basis.  Unfortunately, because the sink drain is not only a perfect breeding ground for bacteria but also the ideal environment for the establishment of biofilm this tends to be a more involved task than everyday cleaning and disinfection.  In these situations particularly close attention needs to be paid to ensuring that the disinfectant remains wet on the surface for the required contact time.  This can prove difficult in a sink drain where a liquid disinfectant solution typically has fleeting contact with the contaminated surface as it races down the drain.  Therefore, preference should be given to rapid acting disinfectants and those that may be available in gelled formats which ensure adhesion to the surface and subsequent contact time compliance.  An equally important consideration is the type of disinfectant chosen for the application.  Preference should be given to oxidizing chemistries (e.g. hydrogen peroxide, chlorine based solutions) as they will chemically work to lift and remove the biofilm from the surface.  Other chemistries such as quaternary ammonium compounds are generally ineffective at penetrating and removing the biofilm.  In addition to selecting the appropriate disinfectant, the utilization of a tool to effectively clean the drains should also be strongly considered.

So does your facility have a procedure in place to ensure that your sink drains won’t be the cause of your next outbreak?

Hasta la vista


Lee – The Germinator