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Pseudomonas aeruginosa is a significant pathogen in hospital settings, notorious for its role in hospital-acquired infections and its ability to develop resistance to multiple antibiotics. This study investigates the prevalence, distribution, and antibiotic resistance gene profiles of P. aeruginosa in seven hospitals in Sulaymaniyah City. A total of 300 samples were collected from various hospital surfaces including mops, sinks, medical equipment, beds, desks, and floors. Using bacteriological, biochemical, and molecular methods, 66 isolates were confirmed as Pseudomonas species, with 26 identified as P. aeruginosa. Antibiotic susceptibility testing revealed resistance rates of 23.3% to streptomycin, 13.6% to tobramycin, 22.7% to moxifloxacin, 21.2% to levofloxacin, and 22.7% to norfloxacin. Furthermore, the antibiotic resistance gene detection showed the presence of the blaCTX-M, blaSHV, qnrB, and blaACC-1 genes among the isolates. The study highlights a 22% contamination rate of hospital surfaces with Pseudomonas species, emphasizing the urgent need for enhanced infection control measures and targeted antimicrobial stewardship to manage and reduce the spread of multidrug-resistant P. aeruginosa. [ABSTRACT FROM AUTHOR]

Irradiation with violet-blue light (VBL), in the spectrum of 405–450 nm, has been reported to be effective against pathogenic bacteria. To investigate whether VBL irradiation could reduce the level of surface contamination at seven shared patient bathrooms in two wards at a hospital in Sweden. Repeated sampling of five separate surfaces (door handle, tap water handle, floor, toilet seat, and toilet armrest) was performed in the bathrooms where 405 nm light-emitting diode spotlights had been installed. A prospective study with a cross-over design was carried out, which included two study periods, first with the spotlights either switched on or off and a second study period with the opposite spotlight status. In total, 665 surface samples were collected during the study (133 samples per surface). Bacterial growth was found in 84% of all samples. The most common findings were coagulase-negative staphylococci and Bacillus spp. The median number of colony-forming units (cfu)/cm2 was 15 (interquartile range: 5–40) for all surfaces. In our main outcome, mean cfu/cm2 of all surfaces in a bathroom, no difference was observed with or without VBL. Clean surfaces (<5 cfu/cm2) were more commonly observed in bathrooms with VBL, also when controlling for confounding factors. No difference was observed in the number of heavily contaminated surfaces. This study did not safely demonstrate an additive effect on bacterial surface levels when adding VBL to routine cleaning in shared patient bathrooms. [ABSTRACT FROM AUTHOR]

IntroductionInfections acquired during healthcare setting stay pose significant public health threats. These infections are known as Healthcare-Associated Infections (HAI), mostly caused by pathogenic bacteria, which exhibit a wide range of antimicrobial resistance. Currently, there is no knowledge about the global cleaning process of hospitals and the bacterial diversity found in ICUs of Brazilian hospitals contributing to HAI.ObjectiveCharacterize the microbiome and common antimicrobial resistance genes present in high-touch Intensive Care Unit (ICU) surfaces, and to identify the potential contamination of the sanitizers/processes used to clean hospital surfaces.MethodsIn this national, multicenter, observational, and prospective cohort, bacterial profiles and several antimicrobial resistance genes from 41 hospitals across 16 Brazilian states were evaluated. Using high-throughput 16S rRNA amplicon sequencing and real-time PCR, the bacterial abundance and resistance genes presence were analyzed in both ICU environments and cleaning products.ResultsWe identified a wide diversity of microbial populations with a recurring presence of HAI-related bacteria among most of the hospitals. The median bacterial positivity rate in surface samples was high (88.24%), varying from 21.62 to 100% in different hospitals. Hospitals with the highest bacterial load in samples were also the ones with highest HAI-related abundances. Streptococcus spp., Corynebacterium spp., Staphylococcus spp., Bacillus spp., Acinetobacter spp., and bacteria from the Flavobacteriaceae family were the microorganisms most found across all hospitals. Despite each hospital particularities in bacterial composition, clustering profiles were found for surfaces and locations in the ICU. Antimicrobial resistance genes mecA, blaKPC-like, blaNDM-like, and blaOXA-23-like were the most frequently detected in surface samples. A wide variety of sanitizers were collected, with 19 different active principles in-use, and 21% of the solutions collected showed viable bacterial growth with antimicrobial resistance genes detected.ConclusionThis study demonstrated a diverse and spread pattern of bacteria and antimicrobial resistance genes covering a large part of the national territory in ICU surface samples and in sanitizers solutions. This data should contribute to the adoption of surveillance programs to improve HAI control strategies and demonstrate that large-scale epidemiology studies must be performed to further understand the implications of bacterial contamination in hospital surfaces and sanitizer solutions.

Microbial contamination of hospital surfaces remains despite adherence to routine disinfection. Our study demonstrates bioburden from various types of hospital high-touch surfaces and the pathogenicity of all bacteria recovered. Several high-touch hospital surfaces from a single medical-surgical unit were sampled and cultured using replicate organism detection and counting (RODAC) Tryptic Soy agar plates. Colonies were then subcultured to blood agar plates and speciated using MALDI-TOF. The local microbiology laboratory database was queried for any clinical isolate match with the environmental samples recovered. Manikins, bed rails, and workstations-on-wheels were the most contaminated surfaces with the largest variety of bacteria isolated from manikins and bed rails. A total of 60 different types of pathogens were isolated, 18 of which were well-known pathogens, and 7 were classified as important in the health care setting by CDC. Our clinical microbiology laboratory identified 29 of 60 hospital surface bacteria in clinical isolates. Urine, soft tissue, and blood were the most common sources of clinical isolates. Surfaces in the health care environment harbor both well-known and not-so-well-known human pathogens. Several not-so-well-known pathogens are skin flora or environmental bacteria, which in the right setting, can become pathogenic and cause diseases including meningitis, brain abscess, endocarditis, and bacteremia. • Health care surfaces harbor bioburden despite adherence to disinfection policies. • Both human pathogenic and nonpathogenic microorganisms were recovered. • Several not-so-well-known pathogens in the right setting, can become pathogenic. [ABSTRACT FROM AUTHOR]

Biofilm formation and capsule production are known microbial strategies used by bacterial pathogens to survive adverse conditions in the hospital environment. The relative importance of these strategies individually is unexplored. This project aims to compare the contributory roles of biofilm formation and capsule production in bacterial survival on hospital surfaces.Representative strains of bacterial species often causing hospital-acquired infections were selected, including Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa. The importance of biofilm formation and capsule production on bacterial survival was evaluated by comparing capsule-positive wild-type and capsule-deficient mutant strains, and biofilm and planktonic growth modes respectively, against three adverse hospital conditions, including desiccation, benzalkonium chloride disinfection and ultraviolet (UV) radiation. Bacterial survival was quantitatively assessed using colony-forming unit (CFU) enumeration and the 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) assay and qualitatively by scanning electron microscopy (SEM). Correlations between capsule production and biofilm formation were further investigated.Biofilm formation contributed significantly to bacterial survival on hospital surface simulators, mediating high resistance to desiccation, benzalkonium chloride disinfection and UV radiation. The role of capsule production was minor and species-specific; encapsulated A. baumannii but not K. pneumoniae cells demonstrated slightly increased resistance to desiccation, and neither showed enhanced resistance to benzalkonium chloride. Interestingly, capsule production sensitized K. pneumoniae and A. baumannii to UV radiation. The loss of capsule in K. pneumoniae and A. baumannii enhanced biofilm formation, possibly by increasing cell surface hydrophobicity.In summary, this study confirms the crucial role of biofilm formation in bacterial survival on hospital surfaces. Conversely, encapsulation plays a relatively minor role and may even negatively impact bacterial biofilm formation and hospital survival.

Background: Surfaces in healthcare facilities can act as reservoirs of infection. Currently, no standardized protocol on when and how to sample hospital surfaces exists.Aim: A web-based questionnaire was devised to gain insight into current sampling practices and was distributed by email to a targeted infection prevention and control (IPC) audience.Methods: The survey consisted of 26 questions on sample collection and processing for a number of healthcare relevant bacterial species.Findings: The majority of respondents were clinical microbiologists or IPC practitioners, and 57.3% were from either the Netherlands, the United Kingdom, or Ireland. Respondents had high self-reported knowledge, but this was not consistent with response to certain questions. There was no consensus on sample sites, either within or between countries. Indirect sampling methods were preferred for all target microorganisms, and cotton and flocked swabs were the most popular methods.Conclusion: The results of our survey highlight the inconsistencies in environmental sampling between and within countries, and the need for guidance and consensus. [ABSTRACT FROM AUTHOR]

ABSTRACT The emergence of biofilms on dry hospital surfaces has led to the development of numerous models designed to challenge the efficacious properties of common antimicrobial agents used in cleaning. This is in spite of limited research defining how dry surfaces are able to facilitate biofilm growth and formation in such desiccating and nutrient-deprived environments. While it is well established that the phenotypical response of biofilms is dependent on the conditions in which they are formed, most models incorporate a nutrient-enriched, hydrated environment dissimilar to the clinical setting. In this study, we piloted a novel culture medium, artificial human sweat (AHS), which is perceived to be more indicative of the nutrient sources available on hospital surfaces, particularly those in close proximity to patients. AHS was capable of sustaining the proliferation of four clinically relevant multidrug-resistant pathogens (Acinetobacter baumannii, Staphylococcus aureus, Enterococcus faecalis, and Pseudomonas aeruginosa) and achieved biofilm formation at concentration levels equivalent to those found in situ (average, 6.00 log10 CFU/cm2) with similar visual characteristics upon microscopy. The AHS model presented here could be used for downstream applications, including efficacy testing of hospital cleaning products, due to its resemblance to clinical biofilms on dry surfaces. This may contribute to a better understanding of the true impact these products have on surface hygiene. IMPORTANCE Precise modeling of dry surface biofilms in hospitals is critical for understanding their role in hospital-acquired infection transmission and surface contamination. Using a representative culture condition which includes a nutrient source is key to developing a phenotypically accurate biofilm community. This will enable accurate laboratory testing of cleaning products and their efficacy against dry surface biofilms.

Introduction: Infections acquired during healthcare setting stay pose significant public health threats. These infections are known as Healthcare-Associated Infections (HAI), mostly caused by pathogenic bacteria, which exhibit a wide range of antimicrobial resistance. Currently, there is no knowledge about the global cleaning process of hospitals and the bacterial diversity found in ICUs of Brazilian hospitals contributing to HAI., Objective: Characterize the microbiome and common antimicrobial resistance genes present in high-touch Intensive Care Unit (ICU) surfaces, and to identify the potential contamination of the sanitizers/processes used to clean hospital surfaces., Methods: In this national, multicenter, observational, and prospective cohort, bacterial profiles and several antimicrobial resistance genes from 41 hospitals across 16 Brazilian states were evaluated. Using high-throughput 16S rRNA amplicon sequencing and real-time PCR, the bacterial abundance and resistance genes presence were analyzed in both ICU environments and cleaning products., Results: We identified a wide diversity of microbial populations with a recurring presence of HAI-related bacteria among most of the hospitals. The median bacterial positivity rate in surface samples was high (88.24%), varying from 21.62 to 100% in different hospitals. Hospitals with the highest bacterial load in samples were also the ones with highest HAI-related abundances. Streptococcus spp., Corynebacterium spp. , Staphylococcus spp. , Bacillus spp., Acinetobacter spp., and bacteria from the Flavobacteriaceae family were the microorganisms most found across all hospitals. Despite each hospital particularities in bacterial composition, clustering profiles were found for surfaces and locations in the ICU. Antimicrobial resistance genes mecA , bla KPC-like , bla NDM-like , and bla OXA-23-like were the most frequently detected in surface samples. A wide variety of sanitizers were collected, with 19 different active principles in-use, and 21% of the solutions collected showed viable bacterial growth with antimicrobial resistance genes detected., Conclusion: This study demonstrated a diverse and spread pattern of bacteria and antimicrobial resistance genes covering a large part of the national territory in ICU surface samples and in sanitizers solutions. This data should contribute to the adoption of surveillance programs to improve HAI control strategies and demonstrate that large-scale epidemiology studies must be performed to further understand the implications of bacterial contamination in hospital surfaces and sanitizer solutions., Competing Interests: DB, ACh, GC, and LO are currently full-time employees of BiomeHub (SC, Brazil), a research and consulting company specialized in microbiome technologies. BiomeHub funded the study design and analysis. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 de Bastiani, Silva, Christoff, Cruz, Tavares, de Araújo, Tomazini, Arns, Piastrelli, Cavalcanti, de Oliveira and Pereira.)

This research aims to evaluate the relationship between the environmental and design parameters of the air conditioning system, and the presence of colony-forming units (CFUs) of bacteria on surfaces. This retrospective study was carried out in controlled environment rooms in 12 hospitals in Spain, as part of a periodic environmental biosecurity assessment programme. Between 2010 and 2017, a total amount of 1027 samples were collected from floors and 861 from hand contact surfaces (HCSs), and the environmental parameters (temperature, relative humidity, fungal and bacterial CFUs present in the air) and design parameters (air changes per hour (ACH), differential pressure and position of the high efficiency particulate air filter) were monitored. The multivariate analysis concluded that, for each increased degree Celsius of temperature, the bacterial CFUs increased by 22.4% (incidence rate ratio (IRR): 1.224, 1.05–1.43) and by 25.9% (IRR: 1.259, 1.06–1.50) on HCSs and floors, respectively, and for each increase in ACH, the CFUs decreased 3.9% (IRR: 0.961, 0.94–0.99) and 2.5% (IRR: 0.975, 0.95–1.00) on HCSs and floors, respectively. Our results show the influence of the environmental and design parameters of air conditioning on the number of CFUs on surfaces and floors. [ABSTRACT FROM AUTHOR]

The novel coronavirus disease (COVID-19) has rapidly spread across the world and was subsequently declared as a pandemic in 2020. To overcome this public health challenge, comprehensive understanding of the disease transmission is urgently needed. Recent evidences suggest that the most common route of transmission for SARS-CoV-2 is likely via droplet, aerosol, or direct contact in a person-to-person encounter, although the possibility of transmission via fomites from surfaces cannot be ruled out entirely. Environmental contamination in COVID-19 patient rooms is widely observed due to viral shedding from both asymptomatic and symptomatic patients, and SARS-CoV-2 can survive on hospital surfaces for extended periods. Sequence of contact events can spread the virus from one surface to the other in a hospital setting. Here, we review the studies related to viral shedding by COVID-19 patients that can contaminate surfaces and survival of SARS-CoV-2 on different types of surfaces commonly found in healthcare settings, as well as evaluating the importance of surface to person transmission characteristics. Based on recent evidences from the literature, decontamination of hospital surfaces should constitute an important part of the infection control and prevention of COVID-19. [ABSTRACT FROM AUTHOR]

Abstract Background Objects frequently touched by patients and healthcare workers in hospitals harbor potential pathogens and may act as source of infectious agents. This study aimed to determine the bacterial contamination of common hospital objects frequently touched by patients, visitors and healthcare workers. Methods A total of 232 samples were collected from various sites like surface of biometric attendance devices, elevator buttons, door handles, staircase railings, telephone sets and water taps. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Biofilm forming ability of the S. aureus isolates was tested by a microtitre plate method. Results A total of 232 samples were collected and 219 bacterial isolates were recovered from 181 samples. Staphylococcus aureus was the most common bacterial isolate (44/219). Majority of S. aureus isolates were recovered from elevator buttons, biometric attendance devices and door handles. Among the S. aureus isolates, 36.3% (16/44) were methicillin resistant Staphylococcus aureus (MRSA) while remaining were methicillin sensitive Staphylococcus aureus (MSSA). Out of 44 S. aureus isolates, 12 (29.5%) were multidrug resistant and 14 (31.8%) were biofilm producers. The majority of MRSA isolates 62.5% (10/16) were biofilm producers. Acinetobacter was the most common Gram negative isolate followed by E coli and Pseudomonas species. Conclusions High bacterial contamination of frequently touched objects with variety of potential pathogens and normal flora was detected. S. aureus was the most common bacterial isolate. Biofilm forming ability offers additional survival advantage to the organisms on these objects. Present study highlights the need of improved hand hygiene among healthcare workers and regular cleaning/disinfection of sites of frequent public contact.

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• Breastmilk and NICU surfaces are possible mycobiome sources for hospitalized infants. • Human milk mycobiomes are significantly different from those of hospital surfaces. Surfaces within the neonatal intensive care unit (NICU), especially those handled frequently by hospital staff, provide sources of gut-colonizing bacteria for hospitalized infants, in addition to those acquired perinatally from maternal sources such as breastmilk. In comparison to bacteria, very little is known about potential sources of colonizing fungi in the NICU setting. Thus, the objective of this study was to characterize fungal communities (mycobiomes) of potential colonization sources for neonates hospitalized in a large university NICU. We hypothesized that the unit surfaces would contain different mycobiomes than those of human-associated (breastmilk) sources. We characterized mycobiomes of NICU surfaces of multiple individual patient care areas as well as those of breastmilk samples by sequencing the internal transcribed spacer region 2 (ITS2) of the fungal rDNA locus. We found that, across all samples, Candida and Saccharomyces species were the most prevalent taxa and had the greatest relative abundances. Breastmilk samples had significantly higher fungal alpha-diversities than NICU surface samples and fungal community compositions (beta diversities) differed significantly between the two sample types. Mycobiome compositions were predominantly driven by the relative abundances of three fungal taxa: Candida albicans , Candida parapsilosis , and Saccharomyces cerevisiae. In total, 21 individual fungal taxa showed significantly greater relative abundances in breastmilk as compared to NICU surfaces, with three being of particular interest to human health: Candida glabrata , Candida tropicalis , and Cryptococcus neoformans. Since no fungal DNA was detected when whole breastmilk was used as the DNA template, as opposed to breastmilk subjected to cell lysis during the DNA isolation procedure, our results indicate that DNA is from fungal cells and is not cell-free DNA. In summary, both NICU surfaces and human breastmilk harbor distinct fungal communities that could provide a source of fungi for the developing infant gut mycobiota. In particular, Candida and Saccharomyces species are abundant and prevalent for both of these potential sources that infants are exposed to. [ABSTRACT FROM AUTHOR]

Nosocomial infections caused by pathogenic microorganisms including Staphylococcus aureus, Acinetobacter baumannii, Clostridium difficile or Streptococcus pneumoniae pose a serious threat to public health. This is associated with increased morbidity and mortality of patients. Contamination of hospitals has a major effect on the transmission of infections, therefore disinfection plays an important role in their prevention. The improvement of disinfection techniques may prevent contamination of areas where people are present, as well as increase the safety of patients and medical personnel. [ABSTRACT FROM AUTHOR]

Background Healthcare-associated infections (HAIs) affect millions of patients every year. Pathogen transmission via fomites and healthcare workers (HCWs) contribute to the persistence of HAIs in hospitals. A critical parameter needed to assess risk of environmental transmission is the pathogen transfer efficiency between fomites and fingers. Recent studies have shown that pathogen transfer is not symmetric. In this study,we evaluated how the commonly used assumption of symmetry in transfer efficiency changes the dynamics of pathogen movement between patients and rooms and the exposures to uncolonized patients. Methods We developed and analyzed a deterministic compartmental model of Acinetobacter baumannii describing the contact-mediated process among HCWs, patients, and the environment. We compared a system using measured asymmetrical transfer efficiency to 2 symmetrical transfer efficiency systems. Results Symmetric models consistently overestimated contamination levels on fomites and underestimated contamination on patients and HCWs compared to the asymmetrical model. The magnitudes of these miscalculations can exceed 100%. Regardless of the model, relative percent reductions in contamination declined after hand hygiene compliance reached approximately 60% in the large fomite scenario and 70% in the small fomite scenario. Conclusions This study demonstrates how healthcare facility-specific data can be used for decision-making processes. We show that the incorrect use of transfer efficiency data leads to biased effectiveness estimates for intervention strategies. More accurate exposure models are needed for more informed infection prevention strategies. [ABSTRACT FROM AUTHOR]

Purpose of Review: Cleaning and disinfection in healthcare facilities is essential to ensure patient safety. This review examines practical strategies used to assess and improve the effectiveness of daily and post-discharge manual cleaning in healthcare facilities. Recent Findings: Effective implementation of cleaning interventions requires objective monitoring of staff performance with regular feedback on performance. Use of fluorescent markers to assess thoroughness of cleaning and measurement of residual ATP can provide rapid and objective feedback to personnel and have been associated with improved cleaning. Direct observation of cleaning and interviews with front-line staff are useful to identify variations and deficiencies in practice that may not be detected by other methods. Although not recommended for routine monitoring, cultures can be helpful for outbreak investigations. Summary: Monitoring and feedback can be effective in improving cleaning and disinfection in healthcare facilities. Ongoing commitment within institutions is needed to sustain successful cleaning and disinfection programs. [ABSTRACT FROM AUTHOR]

Background: Hospital surfaces and Staff hands are most common sources to transmission and spread Bacteria from hospital. β-lactame antibiotics are very important agents to control nosocomial infections. The spread of β-lactamase bacteria can disrupt the treatment process. This study was done to evaluate the frequency of β-lactamase bacteria isolated from staff hands and hospital surfaces. Methods: This study was a laboratory study and was performed in the years 2005 to 2007 in Al-Zahra (SA) hospital in Isfahan. 274 samples were selected randomly from stuff hands and hospital surfaces. Hospital surface samples were collected with swab and NB (Nutrient Broth), from high and low contact surface and staff hand samples were collected with Finger Print method. Bacterial identification was performed with microbiological methods and β–lactamase production survey was performed with Acidometric method. Finding: Staphylococcus species were seen in 55% of 194 isolated Bacteria from hospital surface. Other bacteria that isolated from hospital surface were Bacillus species in 26.29%, Enterobacteriaceae in 9.80%, Pseudomonas species in 3.9%, other gram negative Bacteria in 4.51%, Streptococcus species in 0.5% of samples. 60% of 80 isolated Bacteria from staff hand were Bacillus species. Staphylococcus species in 36.25% and Enterobacteriaceae in 3.75% were seen in stuff hands samples. According to β–lactamase test result, respectively 75.43% and 71.23% of isolate Bacteria from hospital surfaces and staff hands, produced β-lactamase Conclusion: The results of this study have shown the high frequency of β–lactamase enzyme in isolated Bacteria from staff hands and hospital surfaces. Improving quality of hand washing and disinfectant agent are very important methods to control nosocomial infections.

Bachground and objectives: Hospital surfaces can serve as reservoirs of potential pathogen bacteria. Staff hands are the most important source of transmission in hospital. The prevalence of β–lactamase producer bacteria in staff hands and hospital surfaces, increase antibiotic resistance nosocomial infection. The aim of this study was to survey the spread of beta-lactam resistance Staphylococcus sp. in Al-zahar hospital in Isfahan. Material and Methods: The research was carried out during 2005-2007 years in Al-zahra hospital in Isfahan. Overall, 274 samples (194 strains from surface and 80 strains from staff hands).The surface samples collected by using swab in Nutrient Broth (NB) and staff hand samples collected using Finger Print method. Bacterial identification was performed by Bacteriological methods, β–lactamase production by acidimetric method and antibiogram pattern by Kirby Bauer method. Results: Of 194 strains isolated from hospital surfaces, 105 (53.7%) strains, and of 80 strains isolated from staff hands, 28 (35%) are related to Staphylococcus sp. According to acidimetric test, 79.8% of S.aureus strains and 68.55% of S.epidermidis strains produce β-lactamase. Conclusion: Results show high frequency of antibiotic resistance and β– lactamase producer Staphylococcus sp. on staff hands and hospital surfaces. Reduction of bacteria in these sources is the most important manner to control transfer of virulence agents in bacteria and create of antibioticresistant strains. Key words: Staphylococcus aureus, Staphylococcus epidermidis, β– lactamase, Antibiotic-resistant, Hospital surfaces, staff hands.

Biofilm formation and capsule production are known microbial strategies used by bacterial pathogens to survive adverse conditions in the hospital environment. The relative importance of these strategies individually is unexplored. This project aims to compare the contributory roles of biofilm formation and capsule production in bacterial survival on hospital surfaces. Representative strains of bacterial species often causing hospital-acquired infections were selected, including Acinetobacter baumannii , Klebsiella pneumoniae , Staphylococcus aureus , Staphylococcus epidermidis and Pseudomonas aeruginosa . The importance of biofilm formation and capsule production on bacterial survival was evaluated by comparing capsule-positive wild-type and capsule-deficient mutant strains, and biofilm and planktonic growth modes respectively, against three adverse hospital conditions, including desiccation, benzalkonium chloride disinfection and ultraviolet (UV) radiation. Bacterial survival was quantitatively assessed using colony-forming unit (CFU) enumeration and the 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) assay and qualitatively by scanning electron microscopy (SEM). Correlations between capsule production and biofilm formation were further investigated. Biofilm formation contributed significantly to bacterial survival on hospital surface simulators, mediating high resistance to desiccation, benzalkonium chloride disinfection and UV radiation. The role of capsule production was minor and species-specific; encapsulated A. baumannii but not K. pneumoniae cells demonstrated slightly increased resistance to desiccation, and neither showed enhanced resistance to benzalkonium chloride. Interestingly, capsule production sensitized K. pneumoniae and A. baumannii to UV radiation. The loss of capsule in K. pneumoniae and A. baumannii enhanced biofilm formation, possibly by increasing cell surface hydrophobicity. In summary, this study confirms the crucial role of biofilm formation in bacterial survival on hospital surfaces. Conversely, encapsulation plays a relatively minor role and may even negatively impact bacterial biofilm formation and hospital survival., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Francesca Short reports financial support was provided by the 10.13039/501100000923Australian Research Council., (© 2023 The Authors.)

The contaminated surface environment in hospitals is associated with an important risk for transmission of pathogens that cause nosocomial infections. A recent studies show the correlation between quality of cleaning in healthcare centers and the rate of colonization or infections in hospitalized patients. The improvement in cleaning and disinfection procedures, especially of „high-touch" (i.e. frequently touched) surfaces, which are the most important for transmission of pathogens in hospital environment, may limit the potential spread of nosocomial infections. Regular and periodic evaluating environmental cleaning should be performed. In order to ensure proper decontamination in hospital environment, all hospitals are encouraged to monitor the thoroughness of surface cleaning process with available methods such as fluorescent marker, ATP bioluminescence assay or assess the number of aerobic colony counts on surfaces with an increased risk of contamination. [ABSTRACT FROM AUTHOR]

Background: Health care-associated infections (HAIs) are a significant problem in hospitals, and environmental surfaces have been implicated as a source of HAIs in the hospital environment. Furthermore, Gram-negative and Gram-positive bacteria can persist on dry environmental surfaces for as long as several months. Poorly cleaned surfaces may serve as vehicles for microbes, which may then be transferred to patients. Methods: Cotton and microfiber towels were both tested for their abilities to bind quaternary ammonium compounds (QACs). The towels were exposed to 3 commercially available disinfectants for 0.5, 30, and 180 minutes. Germicidal spray tests (GSTs) were performed for all towel eluates in accordance with the AOAC International method 961.02. Cotton towel eluates were analyzed for QAC concentration using high-performance liquid chromatography. Results: QAC concentrations were reduced by up to 85.3% after exposure to cotton towels, resulting in failure of the disinfectants exposed to cotton towels in 96% of the GSTs. Conclusion: The use of cotton towels with QAC-based cleansers should be reconsidered, particularly in hospitals where effective cleaning of the patient environment is needed to reduce the risk of HAIs. [Copyright &y& Elsevier]

Background: Hospital surfaces and Staff hands are most common sources to transmission and spread Bacteria from hospital. β-lactame antibiotics are very important agents to control nosocomial infections. The spread of β-lactamase bacteria can disrupt the treatment process. This study was done to evaluate the frequency of β-lactamase bacteria isolated from staff hands and hospital surfaces. Methods: This study was a laboratory study and was performed in the years 2005 to 2007 in Alzahra (SA) hospital in Isfahan. 274 samples were selected randomly from stuff hands and hospital surfaces. Hospital surface samples were collected with swab and NB (Nutrient Broth), from high and low contact surface and staff hand samples were collected with Finger Print method. Bacterial identification was performed with microbiological methods and β-lactamase production survey was performed with Acidometric method. Findings: Staphylococcus species were seen in 55% of 194 isolated Bacteria from hospital surface. Other bacteria that isolated from hospital surface were Bacillus species in 26.29%, Enterobacteriaceae in 9.80%, Pseudomonas species in 3.9%, other gram negative Bacteria in 4.51%, Streptococcus species in 0.5% of samples. 60% of 80 isolated Bacteria from staff hand were Bacillus species. Staphylococcus species in 36.25% and Enterobacteriaceae in 3.75% were seen in stuff hands samples. According to β-lactamase test result, respectively 75.43% and 71.23% of isolate Bacteria from hospital surfaces and staff hands, produced β-lactamase Conclusion: The results of this study have shown the high frequency of β-lactamase enzyme in isolated Bacteria from staff hands and hospital surfaces. Improving quality of hand washing and disinfectant agent are very important methods to control nosocomial infections. [ABSTRACT FROM AUTHOR]

Rotavirus A and human adenovirus dissemination were demonstrated both in a pediatric ward and in a neonatal intensive care unit (NICU) of the same pediatric hospital. Virus detection from fomites samples were higher in the pediatric ward (42.3% [137 out of 324]) than in the NICU (4.5% [7 out of 156]), revealing that cleaning processes used in our NICU are effective in reducing viral contamination, suggesting human adenovirus as a potential biomarker of contamination of hospital fomites. [ABSTRACT FROM AUTHOR]

Background: S-layer protects bacteria to the phagocytosis and prohibits the entry of some biomolecules and adhesion molecules to the matrix proteins which increase the stability of infection and antibiotic resistance in virulence agents. Therefore the spread of bacteria which have S-layer in the hospitals should be avoided. Surfaces can serve as reservoirs of potential pathogen and is important in the chain of infection. Surfaces bacteria have low potential to spread, but staff hands have many contacts with hospital surfaces, especially with high contact surfaces. Therefore it could be a potential source of bacteria transmission from surfaces. Methods: This research was performed in the Al-zahra hospital of Isfahan University of Medical Sciences (2005 to 2007). 274 samples were randomly selected (194 sample from surface and 80 sample from staff hand). Environmental samples collected, from high and low contact surface with swab in NB and staff hand. Samples were collected through finger print method and identification of bacteria, were performed with microbiological methods: staining, chemical test, use of differential and selective media. Isolated Bacillus cereus strains, performed with Bacillus cereus Selective Agar, for preparation samples, in first culture Bacteria in TSA, for 16h, then separated surface proteins and finally, specimen's electrophoresis proximally molecular weight marker. S-layer in Bacillus cereus has 97KD molecular weight. Findings: According to the results, the prevalence of Bacillus cereus strains was 9.49%. The prevalence of Bacillus cereus strains in environmental and staff hands were respectively 6.7% and 16.25%, and of 13 isolated Bacillus cereus from, staff hand 11 strain (84.6%) and from 13 isolated Bacillus cereus from environmental samples 1 strain (7.7%) production S-layer. Conclusion: We found a high prevalence Bacillus cereus in staff hands and hospital surfaces and frequency surface layer in Bacillus cereus isolated of staff hands into hospital surfaces. [ABSTRACT FROM AUTHOR]

The emergence of biofilms on dry hospital surfaces has led to the development of numerous models designed to challenge the efficacious properties of common antimicrobial agents used in cleaning. This is in spite of limited research defining how dry surfaces are able to facilitate biofilm growth and formation in such desiccating and nutrient-deprived environments. While it is well established that the phenotypical response of biofilms is dependent on the conditions in which they are formed, most models incorporate a nutrient-enriched, hydrated environment dissimilar to the clinical setting. In this study, we piloted a novel culture medium, artificial human sweat (AHS), which is perceived to be more indicative of the nutrient sources available on hospital surfaces, particularly those in close proximity to patients. AHS was capable of sustaining the proliferation of four clinically relevant multidrug-resistant pathogens (Acinetobacter baumannii, Staphylococcus aureus, Enterococcus faecalis, and Pseudomonas aeruginosa) and achieved biofilm formation at concentration levels equivalent to those found in situ (average, 6.00 log 10 CFU/cm 2 ) with similar visual characteristics upon microscopy. The AHS model presented here could be used for downstream applications, including efficacy testing of hospital cleaning products, due to its resemblance to clinical biofilms on dry surfaces. This may contribute to a better understanding of the true impact these products have on surface hygiene. IMPORTANCE Precise modeling of dry surface biofilms in hospitals is critical for understanding their role in hospital-acquired infection transmission and surface contamination. Using a representative culture condition which includes a nutrient source is key to developing a phenotypically accurate biofilm community. This will enable accurate laboratory testing of cleaning products and their efficacy against dry surface biofilms.

Contamination of hospital surfaces by bacteria is increasingly recognized. We assessed commonly touched surfaces using contact plates and Petrifilms (3M, St. Paul, MN) and compared the results against proposed microbiology standards. Toilet door handles were the most heavily contaminated (7.97 ± 0.68 colony forming units [CFU]/cm 2 ) and exceeded proposed standards on 74% of occasions. Petrifilms detected statistically higher CFU from bedside lockers. Further research is required on the use of standards and methods of sampling. [ABSTRACT FROM AUTHOR]

Purpose Antimicrobial resistance (AMR) has become a worldwide environmental and public health problem, causing more than 250,000 deaths per year. Unregulated usage, unsafe hospital practices, and misuse in veterinary contribute to the development of multidrug resistance in various bacteria. Hospital water was hypothesized to be a hotspot for AMR transmission because of (1) increased exposure to antibiotic load, (2) poor drainage and sanitation system, (3) interaction between environmental and clinical microbes. The purpose of the research was to assess the biodiversity and AMR in hospital tap waters. Methodology In this study, the microflora of the hospital tap water and hospital surfaces was observed by obtaining water samples from the intensive care unit (ICU), surgical wards, and washrooms. These were processed through membrane filtration and spread on seven different media (Aeromonas Medium, Azide Dextrose Agar, MacConkey Agar, Mannitol Salt Agar, Pseudomonas Cetrimide Agar, Salmonella Shigella Agar, and Thiosulfate Citrate Bile Salts Sucrose Agar). Surface samples were collected from the faucet, basin, and drain and directly spread on the media plates. Isolates were identified using standard bacteriological and biochemical tests. Kirby-Bauer disk diffusion method was performed using 21 antibiotic disks from 10 different antibiotic classes. They included ampicillin (AMP), amoxicillin (AML), piperacillin-tazobactam (TZP), cefipime (FEP), cefoxitin (FOX), ceftazidime (CAZ), ceftriaxone (CRO), imipenem (IMP), meropenem (MEM), ciprofloxacin (CIP), moxifloxacin (MXF), levofloxacin (LEV), amikacin (AK), gentamicin (CN), tigecycline (TGC), aztreonam (ATM), erythromycin (E), clindamycin (DA), rifampicin (RD), colistin (CT), and chloramphenicol (C). The results were interpreted according to EUCAST guidelines for the antibiogram of the isolates; 38 isolates were selected out of 162 based on different parameters for genotyping and detection of six beta-lactamase genes ( bla SHV, bla TEM, bla CTX-M, bla OXA, bla KPC, bla NDM). Results Among these 162 isolates, 82 were obtained from water sources and 80 were collected from surfaces (faucet, basin, drain). The isolates included a variety of bacteria including  Aeromonas  spp. (20%),  Klebsiella  spp. (13%),  Staphylococcus aureus  (13%),  Pseudomonas  spp.(10%),  Escherichia coli  (9%),  Vibrio  spp. (8%),  Enterococcus  spp. (6%),  Shigella  spp. (6%),  Salmonella  spp. (4%),  Acinetobacter  spp. (3%),  Staphylococcus epidermitis  (3%),  Streptococci  spp. (2%),  Proteus  spp. (1%),  Citrobacter  spp. (1%), and  Serratia  spp. (1%). A diverse range of microbes were identified including clinically relevant bacteria, which shows that the urban water cycle is already contaminated with multidrug-resistant microflora of the hospital settings. Macrolide and lincosamide showed the highest resistance followed by penicillin, monobactam, and cephalosporins. bla SHV and bla TEM were prevalent in samples. bla NDM was also found which manifests as a real threat since it causes resistance against carbapenems and colistin, antibiotics reserved as a last resort against infections. Conclusions This study presented the ground reality of antibiotic resistance in Pakistan and how its subsequent spread poses a great threat to the strides made in the field of medicine and public health. Strict regulations regarding antibiotic usage, hospital effluent, and urban water sanitation must be imposed to curb the devastating effects of this increasing phenomenon., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Aleem et al.)

Yeasts of the Candida parapsilosis complex have frequently been reported as agents of fungal infection in Brazil and worldwide, most of the cases are related to hospital-acquired infection. C. parapsilosis is the third most common cause of candidemia, and the hands of hospital workers as well as hospital surfaces have been suggested as possible sources. In this study we verified the frequency of C. parapsilosis on the hands of workers and on surfaces in the adult intensive care unit (AICU) of a tertiary hospital in Paraná-Brazil. Surface samples were collected with swabs moistened with saline, and a plastic bag with distilled water was used to collect samples from hands. The yeasts were identified by morphology, MALDI-TOF mass spectrometry and PCR-RFLP of the secondary alcohol dehydrogenase-encoding gene (SADH) after digestion with the restriction enzyme Ban I. A total of 223 yeast were found, of which 101 (45.29%) were identified as C. parapsilosis sensu stricto. Of these, 46.66% (n = 35) were found on surfaces and 44.59% (n = 66) on the hands of the employees. The analysis of C. parapsilosis strains by microsatellite loci (CP1, CP4, CP6 and B5) showed 80 different genotypes. Their antifungal susceptibility profile, evaluated by the microdilution broth method, revealed that C. parapsilosis was sensitive to amphotericin B, fluconazole and voriconazole, but not to micafungin. The results revealed the heterogeneity of the yeast population, suggesting that there is no common source of contamination in the AICU of this hospital. [ABSTRACT FROM AUTHOR]

• Biosept Home© UV-C eliminates colonies of pathogenic bacteria strains. • Biosept Home© UV-C reduces the microbial colony count in all hospital surfaces. • Biosept Home© UV-C has been proven efficient in the decontamination of surface. Surface decontamination of hospital environments is essential to ensure the safety of health professionals and patients. This process is usually performed through active chemicals substances with high toxicity, and new decontamination technologies that do not leave residues have been currently used, such as UV-C light. Thus, the objective of the present study is to evaluate the effectiveness of a portable UV-C light device on the viability of standard pathogenic strains and other microorganisms isolated from different surfaces of a public health hospital. In vitro decontamination was performed by applying Biosept Home© UV-C to Staphylococcus aureus , Staphylococcus epidermidis , Escherichia coli , Pseudomonas aeruginosa , Salmonella enterica and Candida albicans. In real conditions, the application was made on different surfaces of a hospital. The device used in the experiment haa a 254 nm UV-C light and a radiation intensity of 45.6 mW/cm2 over a distance of 1 cm from the surfaces. The light dose was 0.912 J/cm2 for 20 s of application in both conditions (in vitro and hospital). After in vitro decontamination with UV-C light no bacterial growth was observed, demonstrating 100 % of bacterial inactivation under the conditions tested. Additionally, there was a reduction of approximately 4 logs for the yeast C. albicans. In all hospital surfaces, the number of colonies of microorganisms was significantly reduced after the procedure. The results suggest that Biosept Home© UV-C is efficient and constitutes a promosing intervention for disinfection protocols in hospitals and clinics. [ABSTRACT FROM AUTHOR]

Background: Yeasts of the Candida parapsilosis complex have frequently been reported as agents of fungal infection in Brazil and worldwide, most of the cases are related to hospital-acquired infection. C. parapsilosis is the third most common cause of candidemia, and the hands of hospital workers as well as hospital surfaces have been suggested as possible sources., Objectives: In this study we verified the frequency of C. parapsilosis on the hands of workers and on surfaces in the adult intensive care unit (AICU) of a tertiary hospital in Paraná-Brazil., Methods: Surface samples were collected with swabs moistened with saline, and a plastic bag with distilled water was used to collect samples from hands. The yeasts were identified by morphology, MALDI-TOF mass spectrometry and PCR-RFLP of the secondary alcohol dehydrogenase-encoding gene (SADH) after digestion with the restriction enzyme BanI., Results and Conclusions: A total of 223 yeast were found, of which 101 (45.29%) were identified as C. parapsilosis sensu stricto. Of these, 46.66% (n=35) were found on surfaces and 44.59% (n=66) on the hands of the employees. The analysis of C. parapsilosis strains by microsatellite loci (CP1, CP4, CP6 and B5) showed 80 different genotypes. Their antifungal susceptibility profile, evaluated by the microdilution broth method, revealed that C. parapsilosis was sensitive to amphotericin B, fluconazole and voriconazole, but not to micafungin. The results revealed the heterogeneity of the yeast population, suggesting that there is no common source of contamination in the AICU of this hospital., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Introduction: Contamination of hospital surfaces plays an important role in the transmission of several healthcare-associated microorganisms, therefore methods for evaluating hospital surfaces' cleaning gain particular importance. Among these, there are visual inspection, quantitative microbiology, fluorescent markers and adenosine triphosphate (ATP) bioluminescence. The latter seems to provide interesting features, detecting the presence of ATP on surface (as Relative Light Units, RLU), a proxy of organic matter and microbial contamination. Several studies have investigated the effectiveness of this technology; with this research, we aim to summarize the most significant results., Methods: A systematic review was conducted. The keywords (namely, "ATP", "bioluminescence", "hospital" and "surfaces") were searched in PubMed/MEDLINE and Scopus databases, in order to find relevant data, from January 2000 to October 2014. After the selection, we globally considered 27 articles., Results: Most of the studies were conducted in United Kingdom and in USA. Different threshold RLU benchmark values were identified by analyzed studies. Fourteen of these researches compared the ATP bioluminescence with microbiological methods, 11 identified a significant correlation between the two methods, although poor or not complete for 5., Discussion: ATP bioluminescence is not a standardized methodology: each tool has different benchmark values, not always clearly defined. At the moment, we can say that the technique could be used to assess, in real time, hospital surfaces where cleanliness is required, but not sterility.

Frequently used hand-touch surfaces in hospital settings have been implicated as a vehicle of microbial transmission. In this study, we aimed to investigate the overall bacterial population on four frequently used surfaces using a culture-independent Illumina massively parallel sequencing approach of the 16S rRNA genes. Surface samples were collected from four sites, namely elevator buttons (EB), bank machine keyboard buttons (BMKB), restroom surfaces, and the employee biometric time clock system (EBTCS), in a large public and teaching hospital in São Paulo. Taxonomical composition revealed the abundance of Firmicutes phyla, followed by Actinobacteria and Proteobacteria, with a total of 926 bacterial families and 2832 bacterial genera. Moreover, our analysis revealed the presence of some potential pathogenic bacterial genera, including Salmonella enterica, Klebsiella pneumoniae, and Staphylococcus aureus. The presence of these pathogens in frequently used surfaces enhances the risk of exposure to any susceptible individuals. Some of the factors that may contribute to the richness of bacterial diversity on these surfaces are poor personal hygiene and ineffective routine schedules of cleaning, sanitizing, and disinfecting. Strict standards of infection control in hospitals and increased public education about hand hygiene are recommended to decrease the risk of transmission in hospitals among patients.