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, February 27, 2014

Bugs make for good conversations!


As we have tried to highlight through the Talk Clean To Me blog, the Clean Freaks have a passion for educating anyone and everyone when it comes to infection prevention and the use of cleaning and disinfecting chemicals.  One other way we try to support education on global basis is through an annual sponsorship of Webber Training Inc. The Teleclass Education by Webber Training is an international lecture series on infection prevention and control topics. The objective is to bring the best possible infection prevention and control information; to the widest possible audience; with the fewest barriers to access. 

In keeping with the theme for this quarter "bugs, germs and pathogens" the following is a list of teleclasses that have been offered or will be offered this year. The cost to join in is very minimal and the proceeds of the teleclasses go directly back into provision of education initiatives to infection prevention professionals from under-resourced countries.
Date of Teleclass
Title of Teleclass
Speaker
January 31st
Universal MRSA Screening: Is it worthwhile and for whom?
Dr. Barry Cookson, London School of Hygiene & Tropical Medicine and University College London
April 16th
Prevention of MRSA Bacteremia in European Hospitals: Secrets of Success
Dr. Michael Borg, St. Luke's Hospital, Malta
September 11th
Economic Analysis of VRE: Assessing Attributable Cost and Length of Stay
Dr. Marc Romney, Providence Health Care, Canada
October 8th
Public Reporting and Disclosure of HAI Rates: Positive Impact or Confusion?
Dr. Maryanne McGuckin, McGuckin Methods International, USA
October 16th
Healthcare Laundry: Epidemiology & Microbiology Issues
Dr. Lynne Sehulster, CDC, USA
November 13th
Emerging Respiratory Viruses: are healthcare workers protected?
 Dr. Virginia Roth, The Ottawa Hospital, Canada
December 2nd
Update of Clostridium difficile infections in Europe
Prof. Ed Kuijper, Leiden University Medical Center, Germany
 
For more information on Webber Training including a full list of the upcoming Infection Prevention and Control Teleclasses, please visit www.webbertraining.com

In support of the Webber Training Teleclass program, the PTS Team will provide FREE access to these 6 upcoming teleclasses (a $210 gift!). There are two (2) chances to win.  All you need to do is post a comment telling us why you follow the blog and what your favorite blog so far has been! The first reader to comment back on this blog AND the first reader who comments on the Talk Clean To Me LinkedIn group will each be given access to the teleclasses listed above!

Bugging Off!

Nicole

Friday, February 21, 2014

ESBL + Male Gender = Dirty Environment

As I penned the title to this week's blog, the irony was not lost on me as I live in a household of males: husband, son, cat and even the fish.  Being the chief kitty litter and fish bowl cleaner I know what those to can do and for anyone who has children, I'm sure I do not have to describe the mess an active 5 year old boy can make - particularly since we've entered the LEGO phase of our lives.  As for my husband, he's a lost cause....

Thinking that the male gender makes for a dirty environment and finding the scientific evidence to support your theory are two entirely different things altogether!  But Freeman et al spelt it out in black and white in their recently published study titled "Predictors of hospital surface contamination with Extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae: patient and organism factors".  The study as you've likely surmised is not about how dirty men make their environment, but rather an investigation to determine if the rates of environmental contamination are higher with ESBL K. pneumoniae (ESBL-KP) or ESBL E. coli (ESBL-EC).

Before delving into the study, I do not want to assume that everyone knows what ESBL or extended-spectrum β-lactamase organisms are.  In a nutshell, they are gram-negative bacteria that produce an enzyme, beta-lactamase that can break down commonly used antibiotics, such as penicillin and cephalosporins, making infections with ESBL producing bacteria more difficult to treat.  E.coli and Klebsiella pneumoniae are common producers of ESBL, and they usually cause urinary tract infections (UTIs) and bacteraemia.

Before trying to blame their associated ability to contaminate the environment with the fact that these are antibiotic resistant organisms (AROs) recall my blog Doors , Keys and Sledgehammers which discussed the fact that antibiotic resistance does not equal chemical resistance.  A bug is a bug in terms of disinfectant efficacy...as long as the disinfectant is used correctly and contact times are met - but we'll save that for another blog. 

Nor should you think that your EVS department cannot play a vital in stopping the spread of ESBLs or other AROs as the NIH facility in Bethesda, MD proved that enhanced cleaning can stop an outbreak.  Read the Fancy that - Implementing Tougher Cleaning Standards Halts Outbreak to learn more about that story.

The moral of the story, I mean study, as presented by Freeman and his colleagues is that patients with ESBL-KP or ESBL-EC are more likely to contaminate their hospital room with viable bacteria and they can do so more effectively if colonized or infected with ESBL-KP as compared to ESBL-EC.  As the researcher stated, one possible explanation for the fact that ESBL-KP made for a dirtier environment could be due to the intrinsic biological differences between E. coli and K. pneumoniae.  In keeping with the title of the blog, they found that there was an association between male gender and environmental contamination that trended towards significance possible reflecting gender-based differences in hygiene practices.  As ESBL's are known to cause UTIs perhaps that fact that many men do not clean their hands after using the facilities and we all know women always wash their hands!

Nor did prior cleaning seem to have a significant effect on contamination rates in part perhaps because cleaning was inadequate (and contact time was not met) or due to the fact that recontamination occurred rapidly post cleaning.  In the end, ESBL-KP environmental contamination seems to be higher than ESBL-EC which may help to explain the corresponding differences in transmission rates between the two organisms.

This bodes the question, should we consider increasing the frequency of cleaning and disinfection to at least twice per day?  The CDC recommends increasing cleaning and disinfection to three times per day for Norovirus.  Perhaps we need to consider this with all organisms that have shown the ability to contaminate the environment and lead to colonization or infection?  You run the numbers, which will save the facility more money? Increasing cleaning frequency (manpower and chemical use) and decreasing HAI rates or maintaining status quo and paying for HAIs which in recent figures I have seen cost a facility upwards of $19 Million per year!


Bugging Off!

Nicole

Thursday, February 13, 2014

H1N1, H5N1, H10N8, H7N9, H5N8 - What Influenza strain will we see next?

It may seem odd, at this stage in the Flu season to write yet another blog on Influenza, particularly when reports in Flu activity in North America are starting to decline. Rest assured, this blog is not going to focus on how to prevent transmission of the flu through cleaning and disinfection, what the symptoms of flu are or a reminder that it's not too late to get vaccinated.

Instead I want to focus on the question that inevitably comes up when a new strain of influenza comes knocking on our door. That question is:
"Do you have efficacy against the H(insert number)N(insert number) strain of Influenza?"
 
As most would attest, in accordance to EPA criteria, if you do not see the "bug" you are concerned with on the label then the disinfectant cannot makes claims against it. To some aspects I can agree, however, if we look at the plethora of data investigating disinfectant efficacy we know that from an efficacy perspective there are not any differences in a disinfectant product's ability to kill K. pneumonia, K. pneumonia ESBL, K. pneumonia MDRO or K. pneumonia CRE. From a purely scientific perspective, if a disinfectant can kill K. pneumonia for example, it does not matter whether you are dealing with the ESBL, the MDRO or the CRE strain. Unfortunately, the EPA has been slow to adopt this stance which has lead disinfectant manufacturers into the "claims race" for bragging rights on who has the greatest number of claims on their label. The truth is when it comes to efficacy claims, strength is not always found in numbers.

For Influenza however; for once, I can say the EPA has finally got it right!  In 2009, when the Pandemic H1N1 strain hit and panic over how facilities were to develop cleaning and disinfection protocols when disinfectant products available on the market did not have efficacy testing against the specific H1N1 strain, the EPA determined that since there were over 500 disinfectant products registered for use on hard, non-porous surfaces against influenza A viruses that based on available scientific information, the currently registered influenza A virus products will be effective against the 2009-H1N1 flu strain and other influenza A virus strains on hard, non-porous surfaces. Of course, for safe and effective use of these products, the EPA reminded users to always follow label instructions and to pay special attention to the product’s dilution rate (if applicable) and contact time. Fancy that, if you kill 1 strain you kill them all. 

In health care, where we talk about evidence based practices, why then do we not use the science, the evidence and the experts who generate the science and evidence to develop evidence based practices around efficacy claims? The EPA has shown it can work for Influenza perhaps we should consider using the same rational for antibiotic resistant bacteria? 

In the meantime, the rates of H7N9 cases and deaths continue to increase and a new strain, H10N8 has caused the death of two people with genetic testing showing it appears to be more virulent to mammals. Is this concerning from an infection prevention perspective?  Yes. Are we concerned from an environmental hygiene perspective? NO. If you kill 1 strain you kill them all.


Bugging Off!

Nicole

 

Friday, February 7, 2014

Stuffies - Children's Comfort Toys and Home to Bacterial Burden!


I think we can all go back in time and remember our first "stuffie", that best friend you dragged from place to place.  That creature of comfort who you could not go to sleep without and heaven forbid if your mother absconded with your beloved for a quick trip through the wash! The travesty over thinking your beloved was gone forever when in fact your mother was simply looking out for your best interests in trying to keep it clean (and germ free!)

Last month, an interesting study titled "Biofilm Formation enhances Fomite Survival of S. pneumoniae and S. pyogenes"  was published in the Journal of Infection and Immunity.  S. pneumoniae a gram positive bacterium which is one of the most common agents associated with community-acquired pneumonias, accounting for up to 25% of these infections. It is also a common cause of bacterial meningitis, bacteraemia, and otitis media, as well as an important cause of sinusitis, septic arthritis, osteomyelitis, peritonitis, and endocarditis. S. pneumoniae is part of the normal upper respiratory tract flora, but, as with many natural flora, it can become pathogenic under the right conditions, like if the immune system of the host is suppressed. S. pyogenes which is a common bacterium thought to inhabit respiratory tracts of 5 - 15% of individuals, is also the cause of many important human diseases, ranging from mild superficial skin infections to life-threatening systemic diseases. Examples of mild S. pyogenes infections include pharyngitis ("strep throat") and localized skin infections ("impetigo"). It can also be the cause of dangerous infections such as scarlet fever and toxic shock syndrome.  In the last century, infections by S. pyogenes claimed many lives especially since the organism was the most important cause of puerperal fever (sepsis after childbirth - recall the Dissenter Blog and Ignaz Semmelweiss the Father of Hand Hygiene?).

Thinking that disease causing bacteria cannot live long outside of the human body on inanimate objects - like dishes or toys – the researchers from the University at Buffalo New York looked specifically at two strains of Streptococcus. Instead they found that bacteria associated with strep throat and ear infections could survive outside the body for long periods on toys at a day care center.  The results clearly demonstrate that while planktonic cells that are desiccated rapidly lose viability both on hands and abiotic surfaces such as plastic, biofilm bacteria remain viable over extended periods of time outside the host while still remaining infectious.  Of the surfaces they tested 4 of 5 stuffed toys tested positive for S. pneumonaie, while the cribs were found to harbor S. pyogenes.

The belief is that these bacteria form into biofilms allowing them to survive.   The conclusion being that commonly handled objects that are contaminated with this biofilm bacteria could act as reservoirs of bacteria for hours, weeks or months perpetuating the spread of potentially infectious pathogens to those (children or adults) that come in contact with them.

There are times I could easily live in a bubble, but I choose not to freak out too much and try my best to remember to wash my hands before putting food into my mouth.  Unfortunately, as I tucked my son into bed and got the prerequisite snuggle from his best bud "Patchy-Patch" the thought crossed my mind that I could not remember the last time I threw him in the wash.....I did stop myself from washing my mouth out with soap to counteract the potential plethora of bugs but rest assured Patchy-Patch is headed for the laundry this weekend!



Bugging Off!

Nicole