Objective To observe the genetic stability of enterovirus A71 (EV-A71) and its resistance to wet environments, dry environments and different temperatures, and to compare with those of poliovirus type 1 (PV-1) Sabin strain. Methods EV-A71 samples were collected from the 1st, 10th and 20th generation cultures. The TCID50 were determined. The genetic stability was determinated by whole genome sequencing. The resistance of EV-A71 and PV-1 Sabin strain to different environmental factors were observed by using the quantitative suspension test and the carrier-based quantitative test. Results The titers of the 1st, 10th and 20th generation cultures of EV-A71 remained stable and the sequencing results of showed no significant difference(P>0.05). The resistance of enterovirus A71 and PV-1 Sabin strain to environmental factors had no significant difference(P>0.05). Conclusion Enterovirus A71 has good stability in gene sequence and viral titer and its resistance to environmental factors is comparable to that of PV-1 Sabin strain.
Objective To investigate the physicochemical properties, disinfection efficacy against indicator microorganisms, and corrosion effects on common metals of three sodium percarbonate-based disinfectants. Methods The active oxygen content, pH value and metal corrosiveness of the three sodium percarbonate disinfectants were measured. Their bactericidal efficacy was evaluated using the quantitative suspension test. Results The active oxygen content of disinfectant A, B and C were 13.2%, 12.1% and 8.93%, respectively. A and B met the standard requirements, while C fell below the standard. At active oxygen content of 1.0%, the pH values of A, B, and C were 10.23, 10.10, and 10.52. All three disinfectants showed no significant corrosiveness to stainless steel, aluminum, or copper, but exhibited slight corrosiveness to carbon steel. The killing log value (KL) against Escherichia coli of disinfectant B≥5.00 with 0.05% active oxygen content incubating for 30 min, against Pseudomonas aeruginosa needed 0.1% active oxygen content for 30 min, and against Staphylococcus aureus needed 0.6% active oxygen content for 15 min. Disinfectant A and C needed 45 min to reach KL≥5.00. For Candida albicans, all three disinfectants with 2.0% active oxygen content achieved KL≥4.00 after 15 min. B completely eliminated Candida albicans within 15 min, while samples A and C required 30 min for complete eradication. In the test against Bacillus subtilis var. niger, all three disinfectants at 3.0% active oxygen content failed to reach KL≤5.00) after 120 min. Conclusion All three sodium percarbonate disinfectants can effectively killing bacterial propagules and fungi, but showed limited efficacy against spores and exhibited slight corrosiveness to carbon steel.
Objective To dynamically detect the concentration of airborne particles in the operating areas of each level of clean operating rooms and to investigate the purification time required for the airborne particles to reach a stable state during the operation. Methods A total of forty-two clean operating rooms in seven tertiary hospitals were selected for simulated surgical testing, and the concentration of airborne particles in the operating areas was repeatedly measured during the process.The Generalized Linear Model (GLM) was used to analyze the differences in airborne particle concentration at various time points, controlling for confounding factors such as temperature, humidity, and fresh air volume. Results The concentrations of suspended particles in ≥ 0.5 and ≥5.0 μm at T1 (0-1 min) and T2 (3-4 min)in the clean operating rooms at all levels were significantly larger than those in the subsequent time periods. However concentrations of ≥0.5 and ≥5.0 μm suspended particles in Class I clean operating room entered the stable stage after the time points of T4 (9-10 min) and T3 (6-7 min), respectively, the concentrations of suspended particles in Class II clean operating room entered the stable stage after T5 (12-13 min) and T4 (9-10 min), and the concentrations of suspended particles in Class III clean operating room entered the stable stage after T6 (15-16 min) and T5 (12-13 min), respectively. The purification rate of ≥5.0 μm suspended particles in each operating room was higher than that of ≥0.5 μm suspended particles. Conclusion A large number of suspended particles are generated at the beginning of the operation, and the suspended particles enter dynamic equilibrium after all the required instrument packages are opened and the inventory is completed for 10 min.
Objective To study the effect and influencing factors of LED ultraviolet light on the disinfection of low-temperature surfaces of different materials, and to provide reference data for the application of LED ultraviolet disinfection technology in low-temperature environment. Methods Under the condition of -18℃, different types of infection carriers were irradiated with LED ultraviolet light, with Staphylococcus aureus as the indicator microorganism, cloth sheets, corrugated paper sheets, stainless steel sheets, glass sheets, filter paper sheets, plastic sheets, etc. as the infection carriers, and the disinfection effect was evaluated based on the quantitative bacteriacidal test of the carriers, and the effects of different organic interferences and other factors on the disinfection effect were detected. Results Under the conditions of this study, the disinfection efficacy of LED ultraviolet light on low-temperature object surfaces of different materials, ranked from strongest to weakest, was as follows: glass slides > stainless steel sheets > fabric pieces > filter paper > plastic sheets > corrugated paper. The impact of different organic interfering substances on the disinfection efficacy of LED ultraviolet light, ranked from the greatest to the least, was as follows: TSB > 3.0% BSA > 0.3% BSA > no interfering substances. Prolonging irradiation time could effectively enhance the disinfection pass rate of filter paper and plastic sheets. Conclusion The disinfection effect of LED ultraviolet light on the surface of low-temperature objects is affected by various factors such as surface material, contamination level, and irradiation duration, etc.
Objective To investigate the disinfection efficacy of vaporized hydrogen peroxide (VHP) in four scenarios involving A2 biosafety cabinets (BSCs). Methods Using G. stearothermophilus spores as biological indicators (1×106 cfu/carrier), VHP was applied to A2 BSCs under four scenarios: (1) decontamination of the BSC workbench, (2) decontamination of the BSC intake/exhaust high-efficiency particulate air (HEPA) filters and workbench, (3) pre-maintenance or HEPA filter replacement decontamination, (4) decontamination prior to BSC decommissioning. Complete inactivation of indicator microorganisms at all test sites was defined as successful disinfection. Results Under 20-25℃, 50%-65% relative humidity, disinfection methods of complete inactivation of indicator microorganisms were as follow. (1) Workbench: fan off, glass door closed, 10 g H2O2 evaporated at 0.5 g/min for 20 min, followed by a 60 min hold time. (2) HEPA filters and workbench: Fan on, glass door open, 60 g H2O2 evaporated at 2 g/min for 30 min, followed by a 30 min hold time. (3) Pre-maintenance or HEPA replacement: 270 g H2O2 evaporated at 2.5 g/min for 60 min (fan on, door open), followed by a 120 min hold phase at 1 g/min (fan off, door closed). (4) Pre-decommissioning: Fan off, door closed, with an external fan circulating air into the BSC chamber; 270 g H2O2 evaporated at 3 g/min for 60 min, followed by a 180 min hold phase at 0.5 g/min. Conclusion VHP effectively eliminates G. stearothermophilus spores in A2 BSCs across diverse operational scenarios.
Objective To investigate the inactivation efficacy of electron beam irradiation at different doses against Staphylococcus aureus, Escherichia coli, Geobacillus stearothermophilus spores, and poliovirus type I (PV-1) vaccine strain. Methods Stainless steel carriers loaded with the four indicator microorganisms were irradiated with electron beams at doses of 5, 15, 20, 25, 30 and 40 kGy (dose rate: 1 kGy/min; irradiation time: 5, 15, 20, 25, 30 and 40 min). Log reduction values (LRV) were calculated to evaluate microbial inactivation. Results After 25 kGy irradiation, LRVs for all four microorganisms reached ≥3.00. However, radiation resistance varied significantly: S. aureus and G. stearothermophilus required 20 and 25 kGy, respectively， and E. coli and PV-1 only required 15 kGy. Conclusion Electron beam irradiation can serve as an effective method for biosafety disinfection, though different microorganisms require different doses.
Objective To understand the current situation of hand hygiene compliance of staff in second-class and above medical institutions in Shanghai, and to provide a basis for hand hygiene intervention strategies. Methods Using a retrospective survey method, the data on staff hand hygiene compliance reported by 75 medical institutions in Shanghai from Jan. 2017 to Dec. 2022 were statistically analyzed. Results From 2017 to 2022, the total compliance rate of hand hygiene in 75 medical institutions in Shanghai was 89.25%; Nurses had the highest compliance rate among staff, at 92.19%, while interns/trainees have the lowest compliance rate for hand hygiene, at 80.62%; The hand hygiene compliance rates of key departments and general departments in 2017—2019 and 2020—2022 were 89.72% and 85.58%,95.88% and 90.21% respectively, Before aseptic operation，before contacts with patients and after contacts with patients' surrounding environmental objects of ICU in 59 medical institutions showed an upward trend(P<0.05), relatively weak hand hygiene awareness after contact with patient and after contacts with patients bodily fluids (Z=0.56，P=0.575； Z=1.69，P=0.091). Conclusion The compliance of staff in Shanghai's second-class and above medical institutions with hand hygiene has been increasing year by year. Interns/trainees and ICU staff have relatively weak hand hygiene awareness after coming into contact with patient and after contacts with patients bodily fluids, and should be the focus of attention for hand hygiene.
Objective To assess the disinfection quality of medical water in sentinel hospitals in Xinjiang. Methods Quarterly monitoring of medical water was conducted in 11 sentinel hospitals from Jan 2016 to Mar 2023. Results A total of 935 medical water samples were collected, with an overall qualification rate of 77.5%. The qualification rate showed an upward trend from 2016 to 2023 (P<0.05). Significant differences were observed among different water types (P<0.05). Dental unit water and surgical handwashing water had lower qualification rates, with pathogenic bacteria such as P. aeruginosa and S. spiritivorum detected in dental water. Over time, the qualification rates of dental unit water and endoscope rinse water significantly improved (P<0.05). Primary hospitals demonstrated a notable upward trend in water qualification rates (χ2=12.038，P<0.01), no significant differences were observed among different grade hospitals(P>0.05). Among departments, the lowest qualification rates were found in respiratory, dental, and surgical units, followed by neonatology, while endoscopy and hemodialysis units had higher rates. Conclusion Microbial contamination persists in medical water from Xinjiang sentinel hospitals, particularly in dental unit water, surgical handwashing water, and humidification water.
Objective To investigate the contamination status of disinfection by-products (DBPs) in domestic drinking water in Songjiang District and to provide a theoretical basis for health risk management of drinking water. Methods From 2020 to 2022, a total of 92 water samples were collected during wet and dry seasons across the water supply areas of Songjiang District. The DBPs in the samples were monitored, and health risk assessments were conducted using the risk model recommended by the U.S. Environmental Protection Agency (USEPA). Results Nine types of DBPs were detected in finished water, pipe network water, and tap water: trichloromethane, chlorodibromomethane, dichlorobromomethane, tribromomethane, dichloroacetic acid, trichloroacetic acid, chlorate, chlorite, and 2,4,6-trichlorophenol. Their concentrations all complied with the Standards for Drinking Water Quality. The carcinogenic risk of DBP intake by residents was 4.47×10-5, and the non-carcinogenic risk was 3.54×10-2. Chlorodibromomethane contributed the highest carcinogenic risk (1.93×10-5) and non-carcinogenic risk (1.15×10-2), accounting for 42.4% and 32.5% of the total risks, respectively. Conclusion The primary DBPs in Songjiang District’s drinking water were trihalomethanes, haloacetic acids, and chlorate, with both carcinogenic and non-carcinogenic risks within acceptable ranges. Chlorodibromomethane should be prioritized for risk management.
Objective To systematically evaluate the cleaning quality and related influencing factors of instruments in central sterile supply department of domestic hospitals. Methods ThePubMed, CNKI and other databases were searched from inception to May 2024. Meta-analysis was performed using Review Manager 5.4.1 software. Results A total of 17 articles were included, involving 16 946 samples. The study showed that the unqualified rate of equipment cleaning in the central sterile supply departmentof domestic hospitals was 11 %. Among the 21 factors investigated, 13 were related to the quality of instrument cleaning: pretreatment standardization, operation process standardization, strictness of supervision system, layout of cleaning equipment, application of cleaning equipment, selection of cleaning tools, selection of cleaning agent, cleaning method, time of instrument soaking cleaning agent, presence of rust remover or cleaning agent residue, quality detection method, knowledge of operators and protection of cleaning personnel. Conclusion The unqualified rate of instrument cleaning in the CSSD of domestic hospitals is high, and many factors may lead to the decline of instrument cleaning quality.
Objective To investigate the current status of infectious disease and disinfection management in elderly care institutions with integrated medical and nursing services in Wuxi City. Methods A baseline survey was conducted using questionnaires and qualitative interviews to assess infectious disease and disinfection management practices in 31 institutions. Disinfection quality monitoring was performed to evaluate effectiveness. Risk assessment for disinfection protocols was carried out through brainstorming sessions and expert reviews, with risk levels determined using a risk assessment matrix. Results Among the 31 institutions, 11 were public-private partnerships and 20 were private-operated. Only 19 institutions (61.29%) demonstrated fully correct procedures and knowledge of statutory infectious disease management, 21 (67.74%) adhered to proper reporting protocols, and 28 (90.32%) had designated personnel for infectious disease management. Disinfection quality monitoring was implemented in 24 institutions (77.42%), 20 (64.52%) had improvement measures, 19 (61.29%) had dedicated disinfection rooms, and 29 (93.55%) assigned staff for disinfection management. Only 15 institutions (48.39%) ensured cafeteria staff correctly understood disinfection methods and sequences for suspected contaminated utensils. A total of 1,075 samples were collected, with an overall qualification rate of 89.11%. The lowest qualification rate was observed on utensil surfaces (73.13%), and no statistically significant difference existed between public-private and private institutions (89.9% vs. 88.7%, P > 0.05). Conclusion In Wuxi City, utensil surfaces in integrated medical-nursing elderly care institutions are identified as an extremely high-risk item, while hand hygiene, environmental disinfection, and medical supplies are classified as high-risk items.
Objective To investigate the current situation of cleaning and disinfection management of environment and articles in pharmacy intravenous admixture service (PIVAS) in Henan province, so as to provide reference for regulated management in medical institutions. Methods A cross-sectional study was conducted in PIVAS in Henan province. The current situation of management on infection prevention and control was surveyed. Results Among the 81 surveyed PIVAS, there were 63 (77.78%) PIVAS would clean and disinfect the air outlet filter net of air purification system every week and 47 (58.02%) PIVAS would disinfect the filter material of horizontal laminar flow clean tables and replace it regularly. 58 (71.60%)PIVAS disinfected the bottleneck of drugs or infusion container by the spray method. There were 37 (45.68%) and 22 (27.16%)PIVAS used two different concentration (250 mg/L and 500 mg/L) of chlorine-containing disinfectants to disinfect the drug trays, respectively. Seventy-one (87.65%) PIVAS would be disposed of cleaning tools by themselves. There were 26 (32.10%) PIVAS used automatic dryer to deal with the reused tools. Conclusion The PIVAS can clean and disinfect the environment and common items as required, but it needs to strengthen the operation details and quality management.
Objective Constructing a core competency evaluation index system for Central Sterile Supply Department （CSSD）specialized nurses to provide a reference basis for the training of disinfection supply specialized nurses. Methods Based on literature review, semi-structured interviews, and the Delphi method, we constructed a core competency evaluation index system for disinfection supply specialized nurses. Results Two rounds of expert consultations were conducted, with questionnaire response rates of 95% and 85.00%, and expert authority coefficients of 0.834 and 0.876, respectively. The Kendall's W coefficients for each level of indicators in the two rounds fluctuated between 0.143-0.221 and 0.267-0.368, respectively, with statistically significant differences (P<0.05). Finally, a core competency evaluation index system for disinfection supply specialized nurses was established, consisting of 4 primary indicators, 10 secondary indicators, and 59 tertiary indicators. Conclusion The core competency evaluation index system is a comprehensive and objective reflection of the core competencies that CSSD nurses should have, which provides a basis for the training of specialist nurses in CSSD.
Objective To explore the application of ATP bioluminescence assay in monitoring the hygiene of various catering utensils and hand sanitation of staff in cafeterias. Methods From January to June 2023, ATP bioluminescence assay was used to assess the cleanliness of 283 disinfected catering utensils and staff hands in a tertiary hospital cafeteria. The specificity, sensitivity, and positive rates of ATP bioluminescence assay were compared with the "gold standard method" (coliform rapid detection paper strip method). Results Compared to the coliform rapid detection paper strip method, the ATP bioluminescence assay showed a lower positive rate (4.9% vs 12%), lower sensitivity (29%), high specificity (98%), and poor agreement between the two methods ( k value = 0.375). Conclusion ATP bioluminescence assay is significantly influenced by material properties and environmental factors in food hygiene supervision. Its application should be tailored based on the surrounding environment, sampled specimen types, and sampling sites.
Objective To investigate the detection of multidrug-resistant organisms (MDROs) in hospitals of different levels in Suzhou City and to explore the relationship between antimicrobial usage and MDRO detection. Methods Statistical analysis was performed on MDRO infections, detection rates, and antimicrobial usage patterns across 17 secondary hospitals and 19 tertiary hospitals participating in the regional healthcare-associated infection surveillance platform from January to December 2020. Results Except for carbapenem-resistant Klebsiella pneumoniae (CRKP), the MDRO detection rates in tertiary hospitals were significantly higher than those in secondary hospitals (P<0.05). Similarly, tertiary hospitals reported higher MDRO infection case rates for all pathogens except carbapenem-resistant Escherichia coli (CREC) (P<0.05). In secondary hospitals, MDRO infection case rates ranked as CRKP, carbapenem-resistant Acinetobacter baumannii (CRAB), methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and CREC. In tertiary hospitals, the order was CRAB, CRKP, CRPA, MRSA, and CREC. The overall inpatient antimicrobial usage rate was 42.68%, with significantly higher rates in tertiary hospitals compared to secondary hospitals (P<0.05). Conclusion Antimicrobial usage is strongly associated with MDRO detection. Targeted surveillance should be conducted to guide anti-infective therapy and infection control measures, thereby reducing MDRO-related risks.
Objective To investigate the risk factors and prognosis of elderly patients hospital-acquired pneumonia of carbapenem-resistant Enterobacteriaceae (CRE) infection. Methods A retrospective study was conducted on 181 elderly patients with hospital-acquired pneumonia of enterobacteriaceae from a hospital from January 2019 to December 2023. Based on the CRE infection group and carbapenem-sesitive enterobacteriaceae (CSE) control group, we analyzed the risk factors for drug resistance. The results were expressed as odds ratios (OR) and 95% confidence intervals (95%CI). The mortality status of the two groups was followed up to analyze their prognostic factors. The results were expressed as risk ratios (HR) and 95%CI. Results Concomitant hypoalbuminemia(OR=6.582, 95%CI 1.459 ~ 29.701, P=0.014), hospitalization history within 90 days prior to infection(OR=3.569, 95%CI 1.123 ~ 11.339, P=0.031), ICU history prior to infection (OR=6.699, 95%CI 1.406 ~ 31.917, P=0.017), use of third/fourth generation cephalosporins(OR=4.927, 95%CI 1.748 ~ 13.888, P=0.003), and use of carbapenems 30 days prior to infection(OR=5.892, 95%CI 2.082 ~ 16.674, P=0.001) increase the risk of hospital-acquired CRE pneumonia in elderly patients. Conclusion There are many risk factors for CRE pulmonary infection in elderly patients. Individuals infected with CRE have a poorer prognosis and are more prone to death than those infected with CSE.
