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.

Wednesday, December 19, 2012

Where did the last 51 weeks go?


WOW!!! It’s hard to believe that this is the last blog for 2012. In looking back through the blogs that were written it is truly amazing to realize just how broad the range of topics was! 

2012 saw the continuation of the Guest Blogger concept with eight (8) different bloggers.  Each is respected in their field and lends their expertise and insight to the Talk Clean to Me Blog on topics pertaining to cleaning and disinfection. We would like thank Mark Heller (Environmental Services Specialist & B2B Consultant), Jason Tetro (The Germ Guy blog), Paul Webber (Webber Training & the global teleclass concept), Darrel Hicks (author of Infection Prevention for Dummies), Jim Gauthier (Infection Prevention & 2012 CHICA Canada President), Rick Wray (Pediatric Patient Safety & Infection Prevention), Dr. Lucas Panteleon (Veterinarian & Animal Infection Prevention), and Professor Ewen Todd (Michigan State University and Guest Blogger on the DEB Hand Hygiene Blog) for their support in 2012! We will continue to introduce you to Guest Bloggers from around the world and also hope to introduce you to some of the blogs we think are worthy of following.

We also introduced a monthly Chemistry Blog in 2012 and will continue to expand our education on chemical actives used for cleaning, sanitizing and disinfection of surfaces, devices and hands in 2013. The focus of the Chemistry Blogs this past year revolved around the actives most found in products uses for surface cleaning and disinfection (Quats, Chlorine, Phenols, Hydrogen Peroxide, Ozone, Alcohols, Silver Dihydrogen Citrate, Organic Acids, Peracetic Acid and Improved Hydrogen Peroxide). Next year, we’ll focus on the chemistries used for hand hygiene and medical device reprocessing and hope our chemical geekiness will in some way lead to frank and educational discussions around the cleaners and disinfectants that we chose and use.

To continue our infection prevention education (a true passion of mine) we will be introducing a “Bug Blog” in 2013. We have from time to time dedicated a blog to a specific bug (i.e., Norovirus, The Cold or Flu etc), based on the time of year or “exciting” events in microbiology (stay tuned for a blog on the new novel Coronavirus!) and for 2013 we want to continue this focus so we not only know about the bug, but better understand how disinfectants “attack” and “kill” the bugs we are concerned with.

Of course, we will be sure to blog about any topic or newly published science that goes with the Talk Clean To Me mandate to educate and provide you the latest resources related to cleaning and disinfection of environmental surfaces, medical devices and hands. It’s true, our commitment to providing chemical disinfectant education is more than business, it is a passion!  

We would like to wish you a Happy Holidays and hope that you continue to follow us in 2013!

 

The Clean Freaks

Nicole and Lee

 

Friday, December 14, 2012

Helpful Hints for a Happy, Healthy Holiday!

With Christmas holidays around the corner and almost daily updates on new outbreaks associated with respiratory or gastro nasties, I thought it prudent for the focus of this week’s blog to be on Holiday Infection Prevention.

We are, without a doubt, well into cold and flu season and while we bandy about the terms “cold” and ”flu”, there are certainly more nasties out there than just the cold and flu. The following list is what Public Health Units from across North America are currently seeing in terms of the bugs implicated in some of the outbreaks so far.


Transmission via Direct Contact (when an infected person sneezes mucus directly into the eyes, nose or mouth of another person), Indirect Contact (Hand-to-eye; hand-to-nose; hand-to-mouth transmission from contaminated surfaces or from direct personal contact i.e. shaking hands) and Airborne (when someone inhales the aerosols produced by an infected person coughing, sneezing or spitting);

Symptoms: Influenza is characterized by sudden onset of high fever (38 C-39 C/100 -103 F), cough (typically dry), headache, muscle and joint pain, severe malaise, sore throat and runny nose.  Illness is self-limiting and most people recover within a week. It can be indistinguishable from the common cold in the early stages but the flu can be identified by the high fever and extreme fatigue.


Transmission via Direct Contact (when an infected person sneezes mucus directly into the eyes, nose or mouth of another person), Indirect Contact (Hand-to-eye; hand-to-nose; hand-to-mouth transmission from contaminated surfaces or from direct personal contact i.e. shaking hands) and Airborne (when someone inhales the aerosols produced by an infected person coughing, sneezing);

Symptoms: RSV manifests with the following symptoms: cough (may be croup like or “seal bark” cough), shortness of breath, bluish skin, difficulty breathing, wheezing, stuffy nose, fever, nasal flaring, and rapid breathing.


Transmission via Direct Contact (when an infected person sneezes mucus directly into the eyes, nose or mouth of another person), Indirect Contact (Hand-to-eye; hand-to-nose; hand-to-mouth transmission from contaminated surfaces or from direct personal contact i.e. shaking hands) and Airborne (when someone inhales the aerosols produced by an infected person coughing, sneezing or spitting);

Symptoms: Rhinovirus is characterized by rhinorrhea, blocked nasal passages, sneezing, coughing, sore throat, croup in infants and malaise. The symptoms experienced depend on the number of virus particles replicated. Infected cells produce a molecule called histamine that results in increased nasal secretions.


Transmission via Direct Contact (when an infected person sneezes mucus directly into the eyes, nose or mouth of another person), Indirect Contact (Hand-to-eye; hand-to-nose; hand-to-mouth transmission from contaminated surfaces or from direct personal contact i.e. shaking hands) and Airborne (when someone inhales the aerosols produced by an infected person coughing, sneezing or spitting);

Symptoms: Parainfluenza causes sore throat, stuffy nose, fever, croup, chest pain, cough, shortness of breath, stuffy nose and wheezing


Transmission is Airborne (when someone inhales the aerosols produced by an infected person coughing, sneezing or spitting) can also spread through Indirect Contact (fecal to oral route);

Symptoms: Most infections result in upper respiratory tract infections.  It can also manifest as croup, conjunctivitis, tonsillitis, or ear infections. Adenovirus can also cause gastroenteritis resulting in diarrhea.


Transmission via Direct Contact (caring for or coming in close contact with infected person) and Indirect Contact (hand-to-mouth from contaminated surfaces; eating or drinking contaminated food);

Symptoms: Norovirus causes nausea and vomiting, diarrhea, stomach pain, body aches, fever and headache

Now that we know who we are trying to fight off, what can we do to stay healthy?  Proper hygiene (cleaning and disinfecting hands and surfaces) and practicing social distancing is the primary means to help stop the spread of the bugs we see during “Cold & Flu Season”.  Approximately 80% of infections are transmitted by hands.  Frequent washing of hands with both soap and water or alcohol hand sanitizers is the single most effective way of limiting the spread of the “Cold & Flu Season” bugs.  Hands should be washed after blowing ones nose (and especially after blowing someone else’s nose!) , after covering your mouth after coughing or sneezing, after using the bathroom and most definitely prior to eating or drinking.   Social distancing means reducing the frequency, proximity, and duration of contact between people (i.e. employees, customers and of course small children) to reduce the chances of spreading the “Cold & Flu Season” bugs from person-to-person.   While this is not always possible we can take the opportunity to turn our heads and cover our mouth and nose with our elbows when we cough and sneeze.  Using our elbows to cover our mouth and nose helps to keep our hands free of germs which could spread disease.

 “Cold & Flu Season” bugs can also be spread by touching objects contaminated with the nasties and then transferring the bug from the hands to the nose, mouth or eyes.  High touch hand contact surfaces such as door knobs, light switches, telephones, keyboards etc should be cleaned and disinfected frequently.  During “Cold & Flu Season” you can help stop the spread by cleaning and disinfecting your work areas before going on breaks, lunch and prior to leaving at the end of the day. 

I hope these tips keep you healthy this holiday season!

Bugging Off!

Nicole


And yes, I am extremely happy with my amazing alliteration abilities!  (Ooops!  I did it again! A)

 

Friday, December 7, 2012

SOS – Spores on Surfaces!

A discussion as to the best way to handle environmental contamination by Clostridium difficile can be at times the equivalent of watching a soap opera. When it comes to who believes what, who knows best, what is stated in current infection prevention guidelines, newly published peer reviewed articles and of course disinfectant manufacturing sales materials highlights the fact that two seemingly similarly educated people can be complete polar opposites!  While I’ve never been involved in a discussion that has come to fisty-cuffs, I do have two pairs of 16oz boxing gloves that I’d gladly provide if it would help come to a consensus!

I think with advancement and by this I mean our ability to manufacture “better” disinfectants, our ability to improve test methods both for disinfectant product efficacy but also for clinical specimen sampling and disease diagnosis we become so enlightened with all the “new” stuff we forget the importance of the basics.  I think we often need to be reminded of the basics.

While there is sufficient published science to support that sodium hypochlorite at the correct dilution and contact time has the ability to kill C.diff spores, it has not been until recent years that Health Canada or the US EPA has approved a method to allow for actual label claims against C.diff.  We can now choose from sodium hypochlorite, hydrogen peroxide and peracetic acid based formulations with registered claims against spores.  Certainly, from an infection prevention perspective this has meant advancement in practices, but in the quest to find products that can KILL we have lost sight of the importance of physical friction.  More simply put, we have lost sight of the importance of how CLEANING, how WIPING can and WILL remove spores from the surface.

Let’s be honest, to kill spores we need to increase the concentration of chemical used.  This increase will result in less than stellar occupational health and safety profiles for the products that are being used and will also have a direct impact on the compatibility with the various surfaces the product will be applied. 

The 2010, SHEA-IDSA Guidelines for Clostridium difficile states “The efficacy of cleaning is critical to the success of decontamination in general, and thus user acceptability of disinfection regimens is key issue”.   When asked about a product’s ability to kill, I have always stated that I do not care what a product kills, if staff will not use the product as designed by the manufacturer, the label claim is meaningless!  Don’t get me wrong, I am in no way saying that we should not use sporicidal agents in dealing with C. diff.  What I am saying is that we need to consider more that what the product kills, but look at how effective the product is at cleaning (thereby removing spores from the surface) and most importantly, how will the staff that will be using these products daily for long periods of time respond?  A well implemented infection control program requires that the products we choose are in fact used!

It was with this that I was quite excited to read a recently published study by Dr. William Rutala and his research team (ICHE,2012;33:1255-1258).  The study compared the importance of physical removal versus sporicidal inactivation of different cleaning and disinfection chemistries.  There was what I thought of as several key take home points – or “Ah-Ha” moments.  First, did you know that most studies have quantitated the level of C. diff spore contamination on surfaces to be  <1Log10?  Why then do Health Canada and the US EPA require manufactures to achieve at least a 6 Log10 reduction against C.diff spores in order to make a claim.  If you didn’t already know, a 6 log10 reduction implies we are chemically sterilizing the surface.  If we do not have that level of contamination on surfaces to begin with why do disinfectants need to achieve such a level of kill?  As mentioned earlier, to obtain sporicidal claims we need to increase the concentration of chemical used.  We are creating disinfectant products that have increased occupational risks.  Perhaps if the test method needed to obtain a sporicidal surface claim was adjusted to provide a more realistic level of kill based on actual surface contamination we would have sporicidal products that we could use on a daily basis without the worry of occupational safety or material compatibility issues.

Secondly, and to me most importantly, CLEANING WORKS!  The study showed that wiping environmental surfaces, even with a non-sporicidal agent can eliminate approximately 3 Log10 of C.difficile spores. Sporicidal agents provided a 3 Log10 to 6 Log10 reduction depending on formulation and/or application with the most commonly used bleach wipe showing just under a 4 Log10 reduction.

I’m not saying that we shouldn’t use sporicidal agents.  I’ve worked with enough facilities in outbreak situation to know they work. However, have we set the bar to high in terms of what is required with respect to obtaining a registered C. difficile claim?  Are we knowingly, exposing our staff to unnecessarily high concentrations of chemicals when as we know the level of contamination on surfaces is significantly lower than the level of kill required to obtain a label claim?  Knowing that cleaning works, would we be wrong to develop protocols that focus on the physical removal of spores for cleaning of isolation rooms and utilize sporicidal agents for terminal cleaning, for outbreaks or for use on wards with higher endemic levels of C. diff?  I know facilities that do just that and do it well.

Food for thought, I hope!


Bugging Off!

Nicole