Journal of Hospital Infection

The spread of COVID-19 in healthcare settings is concerning, with healthcare workers representing a disproportionately high percentage of confirmed cases. Although SARS-CoV-2 virus has been found to persist on surfaces for a number of days, the extent and duration of fomites as a mode of transmission, particularly in healthcare settings, has not been fully characterized. To shed light on this critical matter, the present study provides the first comprehensive assessment of SARS-CoV-2 stability o...

Structured summaryThe hospital environment plays a crucial role in healthcare associated infections. Current cleaning protocols to address this are costly and labour intensive, with further complications related to compliance, efficiency and the environmental impact of cleaning agents. We developed a nano-structured coating, iC-nano, which exhibits high antimicrobial activity. The 73 unique formulations assessed showed a range of activity in vitro. The best coatings displayed high activity with...

BackgroundIsolation space must be expanded during pandemics involving airborne transmission. Little to no work has been done to establish optimal design strategies and implementation plans to ease surge capacity and expand isolation capacity over long periods in congregate living facilities. The COVID-19 pandemic has an airborne transmission component and requires isolation, which is difficult to accomplish in skilled nursing facilities. PurposeIn this study we designed, implemented, and valida...

BackgroundAirborne microorganisms contribute significantly to hospital-associated infections (HAIs), particularly causing respiratory tract infections (RTIs). Multi-drug resistant (MDR) airborne pathogens pose a global clinical threat, challenging existing air decontamination technologies. While current methods effectively trap microbes, they often lack microbicidal properties. Exploitation of Zeta potential of microbes which are naturally charged could be a potential strategy for air decontamin...

The disease COVID-19 has turned out to be a tremendous slayer and has had some of the most devastating impacts on human beings ever seen in history. To overcome this major public health crisis, an understanding of the transmission of the virus underlying this disease is of paramount importance. Evidence suggests that the most common route of transmission for the SARS-CoV-2 virus is likely via direct contact in person-to-person encounter with aerosol droplets. However, the possibility of transmis...

The disinfection of high-contact surfaces is seen as an infection control practice to prevent the spread of pathogens by fomites. Unfortunately, recontamination of these surfaces can occur any time after the use of common disinfectants. We recently reported on a novel continuously active antimicrobial coating which was shown to reduce the spread of healthcare acquired infections in hospitals. We evaluated a modified coating that demonstrated a residual efficacy against viruses. The coated surfac...

IntroductionIn accordance with AS5369:2023 and ISO 15883-1:2024 Standards, in-field validation testing of automated high-level disinfection (HLD) devices in clinical settings is necessary to qualify their performance. Responding to reports that some ultraviolet-C (UV-C) devices were failing to achieve sporicidal efficacy during routine in-field validation, we evaluated the sporicidal efficacy of these devices via a performance qualification test. MethodsSporicidal efficacy was assessed using co...

IntroductionSevere Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the global pandemic of Coronavirus disease-2019 (COVID-19). From the first reported cases in December 2019, the virus has spread to over 4 million people worldwide. Human-to-human transmission occurs mainly through the aerosolization of respiratory droplets. Transmission also occurs through contact with contaminated surfaces and other fomites. Improved antisepsis of human and non-human surfac...

BackgroundThe clinical diagnosis of sepsis is based on non-specific criteria and blood culture remains the gold standard confirmatory test. While early results are of wide clinical benefit delayed reports lead to prolonged anti-microbial therapy which fosters the emergence of antimicrobial resistance. Pre-analytical delay of a blood culture delays or decreases the chance of a positive report and a maximal four-hour delay between collection and incubation of the specimen is recommended by the Uni...

BackgroundThis study compared the susceptibility of environmental yeast isolates from indoor and outdoor air collected at an electronics factory, an office, and a winery in Malaysia to various antifungal agents MethodsSabourauds Dextrose Agar (SDA) (supplemented with 0.05g/L Chloramphenicol to inhibit bacterial growth) and Dichloran Glycerol Agar (DG-18) (for xerophilic yeasts) were used for the isolation of yeasts. Air sample volumes ranging from 10 to 250 litres were drawn using the Ideal Air...

BackgroundHealthcare-associated infections (HAIs) constitute a significant financial strain on healthcare systems across the world, with surgical site infections (SSIs) being the costliest form. Despite the existence of diverse sources of infection in the operating room (OR), current literature focuses on human and procedural sources of contamination that could lead to an infection. Comparatively, the OR built environment is understudied as a potential disease transmission interface between the ...

BackgroundEvaluation of SARS-CoV-2 surface and air contamination during the COVID-19 pandemic in London. MethodsWe performed this prospective cross-sectional observational study in a multi-site London hospital. Air and surface samples were collected from seven clinical areas, occupied by patients with COVID-19, and a public area of the hospital. Three or four 1.0 m3 air samples were collected in each area using an active air sampler. Surface samples were collected by swabbing items in the immed...

BackgroundThe sudden increase in COVID-19 admissions in hospitals during the SARS-CoV2 pandemic of 2020 has led to onward transmissions among vulnerable inpatients. AimsThis study was performed to evaluate the prevalence and clinical outcomes of Healthcare-associated COVID-19 infections (HA-COVID-19) during the 2020 epidemic and study factors which may promote or correlate with its incidence and transmission in a London Teaching Hospital Trust. MethodsElectronic laboratory, patient and staff s...

BackgroundDuring the COVID-19 pandemic, aerosol spread of SARS-CoV-2 has been a major problem in healthcare facilities, resulting in increased use of supplementary HEPA filtration to mitigate transmission. We report here a natural experiment that occurred when an air filtration unit (AFU) on an inpatient ward for older people was accidentally switched off. AimTo assess aerosol transport within the ward and determine whether the AFU reduced particulate matter (PM) levels in the air. MethodsTime...

Understanding how Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is spread within the hospital setting is essential if staff are to be adequately protected, effective infection control measures are to be implemented and nosocomial transmission is to be prevented. The presence of SARS-CoV-2 in the air and on environmental surfaces around hospitalised patients, with and without respiratory symptoms, was investigated. Environmental sampling was carried out within eight hospitals in En...

The National Institute of Occupational Safety and Health procedure No. TEB-APR-STP-0059 recommend of measuring the respirator filtration efficiency using sodium chloride aerosol with count median diameter of 75 nm {+/-} 20 nm and geometric standard deviation [≤]1.86. This study showed that this method would overestimate the respirators ability to protect against submicrometer particles. In this study, we converted both mobility diameter and equivalent volume diameter to aerodynamic diameter f...

Healthcare linens act as a vector of microbial transmission through use, storage and handling. In this retrospective multi-year, multi-site study, the impact of an infection prevention program, that included an automated silver ion-based antimicrobial laundry treatment, was studied. A composite reduction of 42% in healthcare associated infection (HAI) rates was observed, with the biggest reductions associated with CAUTI and CDI rates. Although further study is needed to better understand the exa...

Nosocomial infections, also known as hospital-acquired infections (HAI), appear 48 hours or more after hospital admission and are independent of the original infirmity of the patient. To prevent or to reduce HAI, the central paradigm is to construct protective barriers between the large number of people who are sick and whose immune systems are compromised in the precincts of the hospital. Microbes that result in HAI do so by two routes of infection: touch and aerosol. We describe here ZeBox tec...

The unprecedented pandemic of SARS-CoV-2 has created worldwide shortages of personal protective equipment, in particular respiratory protection such as N95 respirators. SARS-CoV-2 transmission is frequently occurring in hospital settings, with numerous reported cases of nosocomial transmission highlighting the vulnerability of healthcare workers. In general, N95 respirators are designed for single use prior to disposal. Here, we have analyzed four readily available and often used decontamination...

BackgroundHealthcare workers treating patients with SARS-CoV-2 are at risk of infection from patient-emitted virus-laden aerosols. We quantified the reduction of airborne infectious virus in a simulated hospital room when a ventilated patient isolation (McMonty) hood was in use. MethodsWe nebulised 109 plaque forming units (PFU) of bacteriophage PhiX174 virus into a 35.1m3 room with a hood active or inactive. The airborne concentration of infectious virus was measured by BioSpot-VIVAS and settl...