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.

Friday, February 27, 2015

Disinfectant Chemistry Report Card #18 - Hydrogen Peroxide Room Decontamination

Generally, decontamination of hospital rooms has been done manually, using traditional applied disinfectant technologies as we have discussed in previous Disinfectant Chemistry Report Cards.  Concerns associated with conventional cleaning and disinfection methods include: lack of proper cleaning and disinfection protocols, incompatibility between the disinfectant chemistry and cleaning  substrate (e.g. the cloth...), operator error (e.g. was the product diluted correctly), concerns with unrealistic contact time and if surfaces were actually contacted.   In looking for an adjunct to improve the level of cleanliness in a patient room, a new technology has been developed which uses hydrogen peroxide in an automated system to disinfect rooms.

There are two main room decontamination technologies that make use of hydrogen peroxide or hydrogen peroxide-based mixtures; hydrogen peroxide vapour (HPV) or dry-mist (aerosol) hydrogen peroxide.

Though dry-mist and hydrogen peroxide vapour systems use H2O2 to decontaminate rooms, the main difference between them is the droplets of peroxide they generate. HPV uses 30–35% H2O2 to form a gas for distribution resulting in micro-condensation on surfaces, generating a comparatively higher concentration of H2O2 in enclosed areas. Dry-mist systems form particles smaller than 10 μm, which are comprised of ~5% H2O2, occasionally supplemented with peroxyacetic acid, phosphoric acid or silver nitrate.

From an efficacy perspective, published studies have shown H2O2 Room Decontamination devices to be more effective than conventional quaternary ammonium cleaners in decontaminating hospital rooms containing MRSA, C. diff spores and Aspergillus spp. HPV has been shown to be effective in decontaminating hospital rooms containing MRSA, C. diff, VRE, Acinetobacter, Norovirus, Cl. botulinum, non-toxigenic Clostridium spp. and Geobacillus stearothermophilus. Dry-mist has been shown to be effective in decontaminating rooms containing TB, MRSA and Acinetobacter baumannii on open surfaces, and C. diff.  A number of studies have shown that use of HPV in epidemic situations can rapidly reduce rates of infection and two studies have shown that endemic rates of HAI can be reduced 30 to 60 percent.

These systems are automated and they ensure all surfaces are decontaminated; coverage of surfaces is not user-dependent.  While both systems are more effective than conventional cleaning in elimination of bacteria on surfaces they are not a substitute for cleaning. One study gave a mean time of 2 hours and 20 minutes for disinfection using the device after 32 minutes for conventional cleaning techniques. The long cleaning time is likely due to the time required for the vapours to reach all surfaces at a high enough concentration to inactivate pathogens.  However, during cleaning, the room must be kept uninhabited due to the high concentration of hydrogen peroxide released in the air, as it would be toxic to patients and hospital staff, and, in the case of HPC systems, the rooms must be sealed to prevent leakage. From an environmental perspective peroxide-based cleaning systems are more environmentally preferred than other misting or fogging techniques (e.g. bleach, quats, formaldehyde), as they contain no volatile organic compounds and hydrogen peroxide simply degrades into water and oxygen.

Routine use of these decontamination systems would be confined to hospital bed rooms, operating rooms, etc due to the need for complete containment during decontamination. Entire units can be decontaminated, but this requires closure of the unit. These systems present a high initial entry cost for hospitals, as the equipment would need to be purchased (or rented, if possible) in addition to the ongoing cost of liquid canisters.  In addition, special staff training is required for safe operation.


Here’s how we would score Hydrogen Peroxide Room Decontamination on the key decision making criteria for room disinfection:

·         Speed of Disinfection – C
o   Cycle time can range from 90 minutes to 3 hrs depending on room size and system used

·         Spectrum of Kill – A
o   Proven efficacy against all organisms: bacteria, viruses, fungi, mycobacteria and bacterial endospores
o   All surfaces in a room, no matter the room configuration, are disinfected by the process

·         Cleaning Effectiveness – D
o   H2O2 Room Decontamination systems do not eliminate the need for the physical removal of soils to ensure effectiveness and provide an aesthetically  pleasing environment

·         Safety Profile – C
o   Used correctly, the safety concerns can be minimized, however the rooms must be properly aerated to ensure hydrogen peroxide concentrations do not exceed OSHA criteria of 1ppm before re-entry

·         Environmental Profile – A
o   Hydrogen Peroxide degrades into water and oxygen

  • Cost Effectiveness – C
    • Costs of capital expenditure, labour, and consumables need to be considered

**For more in-depth scientific information about Hydrogen Peroxide Room Decontamination Devices, stay tuned to www.infectionpreventionresource.com.

Bugging off!

Nicole

Friday, February 20, 2015

Prions - they affect more than Mad Cows!

As some may know, I come from a farming background.  I grew up on a beef farm and my grandparents owned a large international animal (primarily dairy cows) exporting company.  I am old enough to remember the first appearance of Mad Cow in the UK in the late eighties.  In fact, I did a research project at university on BSE after the first case was identified in Canada in 1992 and yes, I did the project the same year it arrived.....   I know firsthand the devastation such diseases can have on a family's livelihood and a country's economics.

Case in point, in 2003, the announcement of a single case of mad cow disease undermined the entire Canadian cattle industry. The discovery of a single case of BSE on  May 20th, 2003 immediately slammed the door on export markets for Canadian beef and cattle. The result, according to Statistics Canada, was a loss of $2.5 billion in exports, causing a loss of $1 billion in labour earnings, and the loss of 75,000 jobs.  In 2003, Canada was the 3rd largest exporter of beef on a global basis owning 15% of the market.  As of 2013, Canada was 6th at 4.6%.  The industry has never fully recovered.   So it was with much dismay I learned that a case of Mad Cow had been found in Alberta, the first case since 2011. 

Bovine Spongiform Encephalopathy (BSE) or Mad Cow disease as we prefer to call it, is a transmissible spongiform encephalopathy, or TSE, that attacks the central nervous system of cattle. Other types of TSE include scrapie in sheep, chronic wasting disease (CWD) in deer, and Creutzfeldt-Jakob disease (CJD) in human beings. The cause appears to be associated with a protein called a prion, which is naturally present in people and animals.  Diseases caused by prions are known as spongiform diseases, because the brain tissue in infected individuals is filled with holes, giving it a sponge-like appearance. Although prions are found throughout the brain, the symptoms of spongiform diseases vary according to the regions they are most concentrated in. There are currently no effective treatments and no vaccines for spongiform diseases.  All are fatal.

Ever since Stanley Prusiner coined the term prion in 1982 and showed that purified prions can transmit spongiform disease, skeptics have been trying to prove him wrong. The idea that a protein can self-replicate goes against everything we know about transmissible diseases. Even the simplest viruses contain genetic material, DNA or RNA,that codes for proteins necessary for function and transmission.

Prions cannot be destroyed by boiling, alcohol, acid, standard autoclaving methods, or radiation. In fact, infected brains that have been sitting in formaldehyde for decades can still transmit spongiform disease. Cooking your burger 'til it's well done won't destroy the prions!  Unlike bacteria or viruses which are killed or inactivated via disinfection or cooking, when it comes to prions you can't kill what isn't alive! 

From a safety perspective, at least in Canada feeding animals other animal protein bi-products such as offal (aka brains, spinal cords etc) has been banned as a way to limit introduction of TSE infected materials into the food stream.  In 1992, 37,380 cases of BSE were identified in the United Kingdom reaching its peak with almost 800 new cases a week. With changes in feed programs and banning cows >30 months to be used for human consumption the cases of BSE in the UK dropped to 1,144 by 2002.  In Canada it was 10 years between our first and second case and 4 years since our last case.  TSE's are a fact of life and have been dating back to the early 1700's, but they are now sporadic in nature and have never stopped me from enjoying a perfectly BBQ'd T-bone!

Bugging Off!


Nicole

Friday, February 13, 2015

Sometimes it's HOT, sometime it's NOT!

For many of us...it's not hot.  In fact in my part of Ontario our weather forecast reads something like this "A period of very cold wind chills is expected.  A strong cold front has crossed southern Ontario ushering in much colder temperatures and gusty north winds. Wind chill values this afternoon have generally been between minus 20C (-4F) and minus 30C (-22F) across most of southern Ontario.  Tonight will be very cold across all of southern Ontario. Although the winds will diminish somewhat, wind chills of minus 30C (-22F) to minus 35C (-31F) are expected tonight and into Friday morning." 

That is bordering on "I'm going to call in sick" cold!

While not often thought of when choosing disinfectants, the temperature with which you're storing disinfectants should be considered.  The truth is, extreme temperature fluctuations - be it extremely hot or, like today, EXTREMELY cold - can have a negative impact on disinfectants and/or disinfection itself.  Most disinfectants are comprised of significant quantities of water.  What does water do?  It can boil.  It can evaporate.  And without a doubt, it can freeze.  Aside from water, the chemicals within the disinfectant can be seriously impacted.  They can degrade, which will impact both the stability or shelf life of the product, but more importantly it can impact the product's efficacy.  Some can also combust! Both heating and freezing may also impact the stability of a product. Freezing can cause the solution to separate into different phases (think oil and water).  If the solution is not homogenous, you do not have all ingredients mixed together which can lead to lack of efficacy.

Most disinfectant manufacturers will do a Freeze-Thaw test that determines what will happen if the product freezes.  Generally about 5 Freeze-Thaw cycles are completed as the intent of this test is to determine what will happen if there is an accidental freezing during transportation or improper storage for a short period of time.  The test is not intended to cover repeated freezing cycles, such as a product that is left in a car overnight in the cold for an extended period.
In terms of storage under high heat - Again, most disinfectants can handle such a situation for a short period of time, however, products such as bleach or ones with alcohol or solvents can be impacted significantly in terms of stability and efficacy if stored in extreme heat... say the trunk of a car or back of a tractor trailer.

The next time you get a call or email that goes something like this "....They carry wipes in their cars and dispense a few into a zip-lock baggie for each visit leaving the tub in their cars. Sometimes the tub stays in the vehicle all day and overnight. Does freezing (or heat in the summer) have any impact on the effectiveness of the wipes?"  what will your answer be?

I hope you tell the person that storing disinfectants under high heat or extreme cold conditions will impact both the stability (shelf life) and efficacy of a product.  If we're trying to stop the spread of infections we need to ensure our disinfectants work!

Please try to remember not to freeze your disinfectant and if you have some in your car right now... you may just want to run out and rescue it!

Bugging Off!


Nicole

Friday, February 6, 2015

#FF New Year, New Opportunities to Learn

We are one month into the New Year.  I'm betting for some, New Year's resolutions have already been broken or forgotten.  I chose not to get hung up on a New Year's resolution this year, at least in that I did not start immediately on January 1st.  I was smart. I waited until January 19th after I got home from Disney World to give up candy and junk food - I mean who can go to Disney and not eat junk food!

For Talk Clean To Me, my resolution is to continue to bring new content on cleaning and disinfection and the use of chemicals to markets outside of Healthcare, but also to continue to support worthy companies and people who are dedicated to bringing infection prevention education to anyone interested. As noted in past blogs, 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.  Here's the list of upcoming teleclasses until the end of April.


   
For more information on Webber Training, including a full list of the upcoming Infection Prevention and Control Teleclasses, please visit www.webbertraining.com

I hope many of you will take the opportunity to listen to these teleclasses and share them with your colleagues!  

Bugging Off!

Nicole