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Infection precautions (IP) facilitate standardized and safe patient care. Research has demonstrated several barriers to IP adherence among health care personnel (HCP) but potential exposure risk to SARS-CoV-2 and job role has not been considered. Researchers used self-reported baseline surveys with 191 HCPs at a university medical center to examine factors that may have affected IP adherence (eg, personal protective equipment [PPE] and hand hygiene errors) over the 2 weeks prior to the survey. Chi-square tests were used to determine if differences existed first, among job role and IP adherence, and second, the potential risk of exposure to SARS-CoV-2 and IP adherence. A binary logistic regression estimated if PPE nonadherence was associated with COVID-19 stress, job role, and potential exposure risk to SARS-CoV-2. PPE nonadherence varied by job role. Those in the Other group (ie, nonphysician/non-nursing HCP) reported significantly fewer errors (9.6%) compared to Physicians (26.5%) and Registered Nurses (33.3%). Hand/glove hygiene errors between COVID-19 patient rooms varied by job role. Respondents who had higher risks of exposure to SARS-CoV-2 were 5.74 times more likely to experience errors. The results provide implications for adopting systems-level approaches to support worker knowledge and engagement across job roles to improve IP adherence. • HCP self-reported and were observed to make PPE errors during the COVID-19 pandemic. • Less common HCP roles need training and education during a public health emergency. • The combination of repetitive job tasks and demands may contribute to PPE errors. • A systems-level approach to support HCP knowledge may improve adherence behavior. [ABSTRACT FROM AUTHOR]

Biofilms are surface-attached communities of bacteria embedded in an extracellular matrix. This matrix shields the resident cells from desiccation, chemical perturbation, invasion by other bacteria, and confers reduced susceptibility to antibiotics and disinfectants. There is growing evidence that biofilms on medical instruments (especially endoscopes) and environmental surfaces interfere with cleaning and disinfection. The English literature on the impact of biofilms in medicine was reviewed with a focus on the impact of biofilms on reusable semicritical medical instruments and hospital environmental surfaces. Biofilms are frequently present on hospital environmental surfaces and reusable medical equipment. Important health care...associated pathogens that readily form biofilms on environmental surfaces include Staphylococcus aureus, Pseudomonas aeruginosa , and Candida auris. Evidence has demonstrated that biofilms interfere with cleaning and disinfection. New technologies such as..úself-disinfecting..Ñ surfaces or continuous room disinfection systems may reduce or disrupt biofilm formation and are under study to reduce the impact of the contaminated surface environment on health care...associated infections. Future research is urgently needed to develop methods to reduce or eliminate biofilms from forming on implantable medical devices, reusable medical equipment, and hospital surfaces. ... Biofilms are surface-attached communities of bacteria embedded in an extracellular matrix.... Biofilms may form on implanted medical devices and human skin.... Biofilms may form on water sources, dry surfaces, surgical instruments and medical devices.... Biofilms contribute to prolonger survival of microbes and interfere with disinfection.... Cleaning of.ßsurgical instruments and medical devices should precede disinfection.... New technologies may reduce or disrupt biofilm formation. [ABSTRACT FROM AUTHOR]

Hospital patient room surfaces are frequently contaminated with multidrug-resistant organisms. Since studies have demonstrated that inadequate terminal room disinfection commonly occurs,..úno touch..Ñ methods of terminal room disinfection have been developed such as ultraviolet light (UV) devices and hydrogen peroxide (HP) systems. This paper reviews published clinical trials of..úno touch..Ñ methods and..úself-disinfecting..Ñ surfaces. Multiple papers were identified including clinical trials of UV room disinfection devices (N.ß=.ß20), HP room disinfection systems (N.ß=.ß8), handheld UV devices (N.ß=.ß1), and copper-impregnated or coated surfaces (N.ß=.ß5). Most but not all clinical trials of UV devices and HP systems for terminal disinfection demonstrated a reduction of colonization/infection in patients subsequently housed in the room. Copper-coated surfaces were the only..úself-disinfecting..Ñ technology evaluated by clinical trials. Results of these clinical trials were mixed. Almost all clinical trials reviewed used a..úweak..Ñ design (eg, before-after) and failed to assess potential confounders (eg, compliance with hand hygiene and environmental cleaning). The evidence is strong enough to recommend the use of a..úno-touch..Ñ method as an adjunct for outbreak control, mitigation strategy for high-consequence pathogens (eg, Candida auris or Ebola), or when there are an excessive endemic rates of multidrug-resistant organisms. ... Hospital room surfaces are frequently contaminated with multidrug-resistant organisms.... Contaminated hospital room surfaces serve as a reservoir and source of colonization or infection......úNo touch..Ñ room disinfection technologies have the potential for decreasing contamination.... UV-C.ßdevices and hydrogen peroxide systems may be used for terminal disinfection.... UV-C devices and hydrogen peroxide systems have been demonstrated effective. [ABSTRACT FROM AUTHOR]

• New and emerging infectious diseases continue to represent a public health threat. It is never a question of "if" we will experience a multi-country outbreak or pandemic, but a question of "when." • Emerging infectious disease threats include pathogens increasing in range (eg, Mpox, Zika), zoonotic microbes jumping species lines to cause sustained infections in humans via person-to-person transmission (eg, HIV-1, SARS-CoV-2), biothreats (eg, anthrax), and multidrug-resistant pathogens (eg, Candida auris). • The risk of environment-to-patient transmission of SARS-CoV-2, Mpox and Candida auris , is very low, low-moderate and high, respectively. • In the absence of appropriate patient isolation and use of personal protection equipment, the risk of patient-to-health care provider transmission of SARS-CoV-2, Mpox and Candida auris is high, moderate and low, respectively. • Currently available antiseptics (eg, 70%-90% alcohol hand hygiene products) are active against SARS-CoV-2, Mpox and Candida auris. The U.S Environmental Protection Agency provides separate lists of surface disinfectants active against SARS-CoV-2, Mpox, and Candida auris. New and emerging infectious diseases continue to represent a public health threat. Emerging infectious disease threats include pathogens increasing in range (eg, Mpox), zoonotic microbes jumping species lines to cause sustained infections in humans via person-to-person transmission (SARS-CoV-2) and multidrug-resistant pathogens (eg, Candida auris). We searched the published English literature and reviewed the selected articles on SARS-CoV-2, Mpox, and Candida auris with a focus on environmental survival, contamination of the patient's hospital environment, susceptibility of the pathogen to antiseptics and disinfectants and infection prevention recommendations. All three pathogens (ie, SARS-CoV-2, Mpox, and Candida auris) can survive on surfaces for minutes to hours and for Mpox and C auris for days. Currently available antiseptics (eg, 70%-90% alcohol hand hygiene products) are active against SARS-CoV-2, Mpox and C auris. The U.S Environmental Protection Agency provides separate lists of surface disinfectants active against SARS-CoV-2, Mpox, and C auris. The risk of environment-to-patient transmission of SARS-CoV-2, Mpox and Candida auris , is very low, low-moderate and high, respectively. In the absence of appropriate patient isolation and use of personal protection equipment, the risk of patient-to-health care provider transmission of SARS-CoV-2, Mpox, and C auris is high, moderate and low, respectively. Appropriate patient isolation, use of personal protective equipment by health care personnel, hand hygiene, and surface disinfection can protect patients and health care personnel from acquiring SARS-CoV-2, Mpox, and C auris from infected patients. [ABSTRACT FROM AUTHOR]

• Microbial load on surgical instruments is low. • Steam sterilization is extraordinarily robust. • Risk of acquiring an SSI from surgical instruments is essentially zero if sterilization validated. There are several sources of pathogens that cause surgical site infections (SSI) to include the patients endogenous microflora and exogenous sources (e.g., air, surfaces, staff, surgical equipment). We searched the published English literature (Google, Google Scholar, PubMed) for articles on reprocessing surgical instruments, effectiveness of sterilization methods, microbial load on surgical instruments, frequency of "contaminated" instruments, and the infection risk associated with "contaminated" surgical instruments and immediate use steam sterilization. There is substantial redundancy in instrument reprocessing to include: even if a patient was exposed to a "contaminated" instrument, the decontamination and sterilization process would have removed and/or inactivated the contaminating pathogens due to the exceptional effectiveness of the manual and mechanical cleaning (i.e., washer-disinfector) and the remarkable robustness of sterilization technology; and the low-level of microorganisms on surgical instruments after use and before cleaning. A critical review of the literature suggests that the risk of acquiring an SSI from instruments used in surgery is essentially zero if the sterilization cycle is validated. [ABSTRACT FROM AUTHOR]