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, October 31, 2013

CLEANING, HAND HYGIENE & VACCINATION a few of my favorite INTERVENTIONS for Flu Season!

The ugly truth is that Summer is over, Fall is upon us and with that is the start of Flu and Norovirus season.  While the Flu season does not typically peak until January-February, we have entered into what we consider the "FLU SEASON" (read with the Twilight Zone theme song in mind) and truly never know when we may start to see cases or outbreaks of Influenza within hospitals, long term care facilities or schools pop up.

The fact that my son has come down with his first "viral" infection of the Fall and I just finished reading an article by Wong et al published in Pediatrics titled "Influenza-Associated Pediatric Deaths in the United States, 2004−2012" seemed a good enough reason to tackle infection prevention practices for the flu.  But first, let me highlight some of the facts uncovered in the study:

1. Between 2004 & 2013 the CDC logged 830 flu deaths in children younger than 18.

2. 43% of the children who died, did not have underlying conditions that put them at risk for flu complications.

3. A disproportionate number of flu deaths were seen in kids with underlying conditions such as asthma (there are currently 7.1 Million children in the US who have asthma).

4. Previously healthy youngsters appeared to die more quickly than those who had underlying conditions—one-third died within 3 days of symptom onset.  Pneumonia was the most frequent complication.

5. Few of the children who died were vaccinated against flu.

First off, the flu is NOT a gastro or intestinal bug.  Influenza is a highly contagious respiratory disease caused by an Influenza virus.  Unlike the common cold, the flu usually comes on suddenly and most people will often feel some or all of these symptoms:

• Fever or feeling feverish/chills (but not EVERYONE will have a fever)

• Cough

• Sore throat

• Runny or stuffy nose

• Muscle or body aches

• Headaches

• Fatigue (tiredness)

• Some people may have vomiting and diarrhea, though this is more common in children than adults.

People with flu can spread it by coughing, sneezing or TALKING to others up to about 6 feet away!  The droplets "excreted" by someone carrying the flu can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.  People can also get flu by touching a surface or object that has flu virus on it and then touching their own mouth or nose.

This is where my favorite INTERVENTION strategies come in to play:

1. Cleaning:  Environmental surfaces should be cleaned and disinfected frequently with an EPA or Health Canada approved disinfectant.  Access to Pre-moistened wipes that can be easily used without need for PPE is a great way to include not just nursing and environmental services staff as the primary parties for cleaning and disinfection.  Visitors, patients and students (for schools) can also do their part in helping to keep the environment clean and flu free!

2. Hand Hygiene: Wash hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.

3. Vaccination:  The annual Flu shot can help reduce your chance of getting seasonal flu by 80%.  The flu kills, why chance yours or a loved one's life!

According to the WHO, Influenza A H3N2 is the predominant strain in circulation this year.  Check out the WHO Influenza website for the latest flu trends and Influenza activity from around the world.

Stay safe this FLU SEASON!
 

Bugging Off!

Nicole

 

Tuesday, October 22, 2013

Infection Control Week - 7 days of focused prevention!

This week is International Infection Prevention Week (IIPW) around the world. As many of you will know from reading past blogs, Infection Prevention and Control programs have been widely recognized as a corner stone to preventing and controlling the spread of infections both within the community and within healthcare facilities.  IIPW is a week to not only promote infection prevention practices but celebrate with healthcare workers for the work and efforts put forth the other 51 weeks of the year to stop the spread of infection.

There are a number of educational webinars and other educational materials available:




While IIPW is often focused towards healthcare settings, there is nothing to stop those of us who work in non-healthcare areas to celebrate IIPW.  There are numerous fun and educational games or activities that can be tailored to any facility.  A hand washing competition using Glo-Germ (UV reflective goo), regardless of where you work is always entertaining!   Or with the increased usage of ATP meters, activities such as “who has the dirtiest cell phone or keyboard” can also open one’s eyes as to the need for cleaning and disinfection of the surfaces we touch and use frequently throughout the day.

Test your Infection Prevention knowledge with the following questions.
 
If you post your answers on the blog and we'll let you know how well you did!

True or False:   

1. To disinfect for pathogens such as bacteria or viruses, spray or wipe the disinfectant on to the surface to be disinfected and let air dry.
 
2. Cleaning with a disinfecting agent will remove pathogens no matter how you use it.

3. The most common route of bacteria transmission is contaminated surfaces.

Word Scramble:

4. Your best defense against infection is:  AHDN EGNYEHI

5. The name of the virus that causes respiratory infections typically between the months of November and April:  UZILANNFE

Perhaps next year we can have an Infection Prevention joke off?   Do you think I'd win with this?

How do you get a tissue (Kleenex) to dance?  You put a BOOGIE in it!!!



Bugging Off!

Nicole

 

Sunday, October 20, 2013

Disinfectant Chemistry Report Card #17 - Silver and Copper as Antimicrobial Surface Agents

Copper is the oldest metal known to human civilization, and dates back to about 10,000 years. Silver mining also started about 5,000 years ago, where silver was used as a value resource and coinage. Antimicrobial effects of both metals have been utilized long before the concept of microbes became reality. Containers with an external layer of silver or copper were used to keep water fresh and food from spoiling. Silver coins were also dropped into milk containers to prevent milk from spoiling quickly. Direct use of copper and silver as antimicrobials started only in the recent decades. Disinfectant solutions containing colloidal copper or silver ions are used to treat hard surfaces. An external layer of copper is used on certain high-touch surfaces in healthcare settings to aid in prevention of microbial cross-contamination. Certain soft surfaces, such as fabrics, are also impregnated with silver nanoparticles to control and minimize the growth of odor causing bacteria. 

Based on the chemical properties of silver or copper ions in solution, such disinfectants by themselves would have no cleaning power, unless additional surfactants and soaps are added to the formulation. In general, both metal ions are cytotoxic to pathogenic bacteria. Free silver ions disrupt the functional properties of active proteins such as enzymes. This change would cause alteration of the 3D structure of proteins and therefore result in loss of function. Silver is also hypothesized to damage DNA structures. Copper is known to interact with active proteins in microbial cells and therefore interrupt their functions, resulting in microbial death. Copper ions are also thought to interact with membrane lipids which results in rupturing of the microbial cells.

These metal ions can in additionally affect viruses, as viruses also have protein and lipid structures on their external shell. Resistant strains of pathogens have been known to combat against the metal ions by either preventing their entry into the cell, or through mutations that result in change of their protein surfaces.

Silver oxidation does occur slowly. Disinfectant solutions containing colloidal silver care exposed to gradual oxidation, which would eventually cause them to crash out of the solution and precipitate. Once out of solution, they no longer are available to interact with microbial cells. Antimicrobial surfaces covered with copper coatings also undergo oxidation. Such antimicrobial hard surfaces are in fact affected by oxidation and deposition of organic soils on the most surface layer of copper. Organic soils and oxidized ions can act as a barrier layer and prevent the surface microbes from touching and interacting with the silver or copper layers. Therefore, the surfaces have to be cleaned and kept residue free in order to be effective against pathogens. Copper and silver coated surfaces also impose compatibility problems when they are to be disinfected with various cleaner disinfectant agents. Such incompatibilities may arise in forms of corrosion, or immediate formation of an oxidized film layer that either degrades the surface or decreases the efficacy of those against pathogens.

Continuous exposure of humans to solutions with colloidal silver can result in deposition of silver particles inside the skin cells. Over a very long exposure time and over-accumulation, it can cause a condition called Argyria, which is discolouration of skin into a blue-gray colour.

Both copper and silver, especially silver, are extremely harmful to the environment. Silver is known to have high aquatic toxicity as it can bioaccumulate in marine organisms’ tissues. Therefore, proper disposal of disinfectants containing colloidal silver or copper are often problematic, as the intent is to prevent its flow to open waters and oceans.

Here’s how we would score Silver and Copper on the key decision making criteria for antimicrobial surface agents:

Speed of Disinfection – N/A

o Use of Silver and Copper provides continuous reduction and inhibits growth of pathogens on surfaces (e.g. over extended periods of time from 2 - 24hrs)

Spectrum of Kill – C

o Efficacy against bacteria and viruses has been shown but is dependent upon the metal ions being able to directly contact the pathogen

Safety Profile – B - C

o Prolonged to silver can lead to bio-accumulation on skin and lead to health concerns

Environmental Profile – D

o Both copper and silver and known to be extremely harmful to the environment

o Silver in particular has high aquatic toxicity and can bioaccumulate in tissues

Cost Effectiveness – D

o Such products are still in their infancy, facilities need to weigh the cost of use versus benefit to infection reduction

 

**For more in-depth scientific information about Silver, Copper and other Antimicrobial Surface Agents, stay tuned to www.infectionpreventionresource.com.
 
 
Bugging Off!
 
Nicole

 

 

 

Friday, October 11, 2013

A little Salmonella with your Chicken?


I'm almost getting too paranoid to travel. In August I blogged about the Cyclospora outbreak that was affecting 16 states and linked back to lettuce used by several restaurant chains including one that I had eaten at while on a trip to Michigan and Massachusetts. I just got back from San Fran on Sunday and wouldn't you know it, by Monday I was reading about a Salmonella outbreak that is currently circulating around 17 states across the US with California being the hardest hit.   I was under the weather for a few days while on this trip. I did eat some chicken while there, but can't say that food was the true cause.

As of October 7, 2013, a total of 278 persons infected with seven outbreak strains of Salmonella Heidelberg have been reported from 17 states. Of these cases, 42% of ill persons have been hospitalized, but no deaths have been reported. Illness onset dates range from March 1 to September 24, 2013 with a range in age from <1 year to 93 years.  The median is age of 20 years and 51% percent of ill persons are male (can we say beer, chicken wings and Monday Night Football?).

The on-going outbreak investigations conducted by local, state, and federal officials indicate that consumption of Foster Farms brand chicken is the likely source of this outbreak of Salmonella Heidelberg infections. The outbreak strains associated with the outbreak are resistant to several commonly prescribed antibiotics which may be associated with an increased numbers of hospitalizations seen thus far.  While it is not unusual for raw poultry from any producer to have Salmonella bacteria, it is uncommon to have multidrug-resistant Salmonella bacteria.

Salmonella  is a rod-shaped, gram-negative, non-spore-forming bacteria.   In the US, there approximately 42,000 cases of salmonellosis reported each year, but because many milder cases are not diagnosed or reported, the actual number of infections may be twenty-nine or more times greater.  Most persons infected with Salmonella bacteria develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most persons recover without treatment. Salmonella bacteria can survive for weeks outside a living body, and they are not destroyed by freezing.

Salmonella can be transmitted both by direct and indirect contact through a number of ways as listed below, but basically, you're eating poop:

• Infected or contaminated food;

• Poor kitchen hygiene, especially problematic in institutional kitchens and restaurants because this can lead to a significant outbreak;

• Excretions from either sick or infected but apparently clinically healthy people and animals;

• Polluted surface water and standing water (such as in shower hoses or unused water dispensers);

• Unhygienically thawed fowl;

• An association with reptiles (pet tortoises, snakes, iguanas, aquatic turtles, and also amphibians (frogs)

In healthcare facilities, high touch surfaces are often contaminated with nosocomial pathogens, and may serve as vectors for cross-transmission.  While Salmonella is typically associated with eating of contaminated food a study that investigated the degree of pathogen transfer from contaminated surfaces to hands showed that transmission to hands occurred 100% of the time with Salmonella spp., Escherichia coli, and Staphylococcus aureus.  As hand hygiene compliance rates for healthcare workers is around 50 % at best, the risk of transmission from contaminated surfaces cannot be overlooked.

The best way to avoid any type of direct contact with Salmonella is to immediately wash your hands and all contaminated surfaces after every use. Surfaces that are reused in the kitchen such as countertops and food prep areas should be cleaned and sanitized in order to kill off bacteria.  Surfaces within a patient's room infected with Salmonella should be cleaned and disinfected daily and healthcare workers and visitors should be vigilant with hand hygiene.

Let's hope that thawing a turkey in a cooler is considered hygienic!   I'd hate to be the cause of a Salmonella outbreak at the Canadian Thanksgiving Dinner I'm hosting on Saturday....


Bugging Off!

Nicole


Wednesday, October 2, 2013

A New Claim on the Block?

For years, consumers have been striving to rid their homes of odour eating bacteria.  I'm sure that if you were to check under your sink or where ever you keep your cleaning supplies you would find a spray bottle that claims to kill odours on contact.  If you dig deep enough you may also find something that you can use to clean and sanitize your carpets or other fabrics -  you know the one you bought when you were house training your dog?

The concept of soft surface sanitizing has been around for some time and widely used by us in our homes as a mean to rid ourselves of nasty odours.  However the concept of sanitizing soft surfaces within the healthcare market is relatively new and our focus is not to rid ourselves of offending odours but to try and kill pesky pathogens from surfaces than may contribute to transmission of disease.  First off, infection prevention within healthcare focuses on disinfection of environmental surfaces and patient care equipment.  We need to kill significant numbers of the germs that are the cause for hospital infections such as bacteria, viruses and fungi.   EPA registered disinfectants allow us to do just that.  BUT, EPA registered disinfectants are intended for use on hard, non-porous surfaces (beds, tables, toilets, Infusion pumps etc) that do not absorb disinfectants and can be "easily" cleaned and disinfected (at least according to the EPA definition..).  In designing healthcare facilities great care is taken when choosing finishes and equipment to ensure that we can clean and disinfect thereby effectively minimizing the transmission of germs.

Where then in the realm of infection prevention do soft surfaces fit in?  Well, until recently when researchers started investigating if soft surfaces such as privacy curtains contributed to infection transmission everyone's stance was "change when visibly soiled".  I suppose the ugly truth was we ignored one of the most highly touched surfaces in a patient room because we did not know what to do with it!  The science being published today is showing that pathogenic germs can be found on privacy curtains.  There has not been a study that I am aware that conclusively blames privacy curtains for transmitting infections or being the root cause of an outbreak, but I suppose, if touched enough by HCWs and said HCWs did not clean their hands after touching the environment (privacy curtains count!) then.......it could be plausible. 

Enter stage left, the new claim on the Healthcare block - Soft Surface Sanitizing.  It's important for HCWs to understand, sanitizing DOES NOT equal disinfection.  Sanitizing means you reduce the number of Vegetative Bacteria on a surface usually by 99.9%.  Sanitizing claims DO NOT allow for claims against viruses.  Further, to make such a claim (at least according to the EPA), testing needs to be done on ALL of the soft surfaces you wish to use it on.  The type of fabric may impact the ability of a chemical to kill so testing on 100% cotton or 100% polyester only may not cover the plethora of fabrics we see with in a healthcare facility.

It is important that HCWs, especially those in infection prevention or environmental services understand the distinction between disinfection and sanitizing claims.  Certainly such a claim has merit, but if you choose to implement a product with a soft surface sanitizing claim as part of your infection prevention program do not think that it is the silver bullet for stopping the spread of germs.  Sanitizing will reduce the level of germs of the surface.   But, sanitizing soft surfaces such as privacy curtains does not negate the need for proper hand hygiene or continued vigilance in cleaning and disinfection of environmental surfaces and patient care equipment AND the use of a soft surface sanitizer does not negate the need for laundering! 

In the end, it will be interesting to see if researchers can build the science to conclude that such a claim will in fact make a difference from an infection prevention perspective, but don't get caught in the noise and hype of marketing and advertising.  I've seen data to show that wiping or spraying a privacy curtain can reduce bioburden.  In theory, reduced bioburden on curtains may help to reduce the risk for transmission, but hand hygiene will still by far be the most effective means to reduce transmission.  This New Claim on the Block will certainly "legally" allow chemical manufacturers to paint a pretty picture of how their products can be used and in talking with some healthcare facilities that have been cited for using a "disinfectant intended for use on hard, non-porous surface" on a porous or soft surface you will now be able to state that your product is appropriate for use on soft surfaces.  But, be sure to tell that Joint Commissions auditor that soft surface disinfectants do not exist. 

The question I have is if the new claim on the block will be like the boy band New Kids on the Block?  Will it fizzle out after its moment in the starlight or will it truly make a difference and be an important part of a well managed infection prevention program?  For me, the jury is still out, but I suppose that it is in part as intuitively if you spray any disinfectant onto a soft surface ensuring it is damp and allow the appropriate contact time common sense would dictate that you're going to kill at least some of the germs on the surface would it not?


Bugging Off!


Nicole