Hospital environment as a reservoir for cross transmission. Cleaning and disinfection procedures

Background. Healthcare associated infections (HAIs) represent a serious problem for public health, as they increase the morbidity and mortality rates, present a relevant financial burden, and significantly contribute to the antimicrobial resistance. Methods. The aim of this review was to investigate the literature about HAIs, with particular reference to hospital environments and the role of cleaning and disinfection procedures. Hospital environments are an essential reservoir for HAIs cross transmission, and the application of appropriate procedures related to hand hygiene and disinfection/sterilization of surfaces and instruments remain key strategies for controlling HAIs. Results. Different procedures, based on the risk associated with the healthcare procedure, are recommended for hand hygiene: washing with soap and water, antiseptic rubbing with alcohol-based disinfectants, antiseptic and surgical hand washing. Environmental surfaces can be treated with different products, and the mostly used are chlorine-based and polyphenolic disinfectant. The reprocessing of instruments is related to their use according to the Spaulding's classification. In addition, scientific evidence demonstrated the great relevance of the "bundles" (small set of practices performed together) in controlling HAIs. Conclusions. Research agenda should include the improvement of well-known effective preventive procedures and the development of new bundles devoted to high-risk procedures and specific microorganisms

Bioinformatics and microbial biodiversity: analysis of vibrios by the GenEnv system

Sequence-based approaches to prokaryotic systematics and typing represent a modern and promising strategy in epidemiology and environmental microbiology. GenEnv, a database-driven system for bacterial typing, was developed in order to provide user friendly tools for supporting biomolecular analysis of bacteria. The family Vibrionaceae represents a heterogeneous taxon of aquatic microrganisms, harbouring a plethora of genomes currently analyzed by different molecular techniques. Under the query ?Vibrio?, GenEnv retrieved 256 organisms, included in a total number of 19 families. Overall, 548 sequences, comprising 16S rRNA(n = 402), rpoB (n = 1), gyrB (n = 145) were available. In addition, GenEnv system allowed primer design, homology analysis and restriction maps, for immediate applications to the study of Vibrionaceae

The microbiota as a candidate biomarker for SPA pools and SPA thermal spring stability after seismic events.

Worldwide, the location of thermal springs overlaps seismic areas, and the higher occurrence of earthquakes may impact on water stability and safety. The hydrogeological perturbations pose environmental and public health risks that can be monitored by well-established chemical, physical and biological parameters. Specific health concerns involve the exposure of the population to the medical or wellness uses of SPA thermal waters, e.g. in respiratory or hydropinic treatments as well as during rehabilitative or recreational activities in pools. Since SPA waters are characterized by their own microbiota, we analysed by 16S amplicon sequencing the dynamics of water microbial communities after the August 2017 Ischia island earthquake. For the first time, we report the impact of a seismic event on a thermal spring water, whose microbiota was deeply characterized before and immediately after the natural disaster. The biodiversity stability of the water underwent a dramatic disturbance following the earthquake, as summarized by a Shannon index moving from 1.300 during May 2016-July 2017, up to 1.600 during the first 20–70 h after the event and slightly slowing down to 1.500 after 30 days and to 1.400 after 6 months. Microbiota analysis showed a sudden reduction of the relative abundance of autochthone thermophilic species within the first 20 h and a parallel increase of other thermophilic species as well as of ectopic bacteria from soil, sediments, sea, freshwater and wastewaters. Cultivable mesophilic bacteria were observed only in the first 20 h sample (7 × 103/L), even if the presence of faecal contamination traces was detected by Real Time PCR also up to 70 h after the disaster. OTUs analysis of putative metabolic functions showed several changes between pre and post event, such as in the distribution of Sulphur metabolizing and Carbon fixation species. The restoration of the original pattern followed a slow trend, requiring over six months. The observed results confirm the impact of the earthquake on the microbiota structure of the underground thermal spring water, suggesting further perspectives for monitoring water stability and safety issues by a metagenomic approach. Keywords: Earthquake, SPA thermal water, Microbial stability, Biodiversity, Hygien

Untouchability of natural spa waters: Perspectives for treatments within a personalized water safety plan

Natural SPA waters and their environments were known since ancient times and used for health or recreational purposes in different societies, worldwide. The composition and uses of these spring waters may not allow standard disinfection in pools, representing a challenge for hygiene management. Several safety and quality procedures were proposed, but a systematic approach is still needed. Here, we focus on alternative strategies to provide hints for developing a sustainable Water Safety Plan, based on intrinsic water properties and photocatalytic materials. The antimicrobial activity of four different SPA waters with high mineral content and one drinkable spring water with a low mineral content, was assessed and then tested for the additional bactericidal activity of Titanium Dioxide (TiO2) nanomaterials and/or light exposure at different wavelengths (200–635 nm). A native antibacterial activity was observed in all high mineral content waters, with a CFU reduction of 75–80%. The bactericidal action of TiO2 showed an additional incremental effect, with a reduction of over 99% within 2–5 h. Interestingly, the antibacterial photocatalytic effect was detected also in the visible light range, with a possible pick around 450–455 nm, blue-light. Based on observed results, we propose a model for developing a water safety plan, considering water properties and bather exposure. This candidate approach is personalized on water composition and pool use, trying to avoid chemical disinfectants. Photocatalytic nanotechnologies represent one of the promising alternative treatments and can provide novel perspectives for a sustainable managing of natural SPA water hygiene. Keywords: SPA thermal water, Recreational, Treatment, Filtration, Photocatalysi

molecular enrichment for detection of s aureus in recreational waters

The identification of rapid methods for the control of recreational water and of aquatic environments with similar characteristics is necessary to provide adequate levels of health safety for users. Molecular techniques have been proposed in recent years as a viable alternative to traditional microbiological methods, as they offer various advantages and are less time consuming than traditional tests. An innovative protocol based on molecular enrichment that allows the identification of low concentrations of Staphylococcus aureus in recreational water has been developed. The method is based on the specific amplification of prokaryotic genomic DNA by the usage of universal primers for 23S rDNA; subsequently, a second amplification step is performed with specific real-time polymerase chain reaction (PCR) primers and probe. This approach shows sensitivity levels similar to those observed with microbiological tests, with the additional benefits of the specificity typical of nucleic acids techniques. This methodology is easily applicable also to other microbiological parameters, representing an important milestone in hygiene monitoring by the detection of specific pollution indicators

Regulations concerning natural swimming ponds in Europe: considerations on public health issues

Natural swimming ponds (NSPs) are a new type of recreational water facility characterized by the substitution of traditional disinfection with biodepuration. While this feature meets esthetic desires of users, specific concerns on public health issues have been raised by the scientific community and local authorities. The absence of a European directive applicable to these environments leaves each country without specific and harmonized indications. The present work describes the local/national policy situation, describing adopted parameters and monitoring activities. All documents underline the need for appropriate microbiological analysis and correct water management

Sicurezza dell’acqua negli edifici. Traduzione italiana.

Una delle sfide maggiori in ambito sanitario è la gestione dell’acqua negli edifici, spesso trascurata. In molti paesi e regioni, la gestione dell’acqua negli edifici non rientra nelle responsabilità dell’azienda acquedottistica. Per gli edifici generalmente non vengono applicati i cosiddetti Piani di Sicurezza per l’Acqua per la gestione dell’acqua pubblica. Questo testo, traduzione italiana del volume Water Safety in Buildings, fa parte della serie dei documenti di supporto che forniscono indicazioni sull’attuazione delle Linee guida per la qualità dell’acqua potabile dell’Organizzazione Mondiale della Sanità. Può essere un utile supporto per il controllo e il miglioramento della qualità e della sicurezza dell’acqua negli edifici

Disinfection of Water Systems in Accordance with Eu Directives on Health and Safety in Working Environments: Use of A Technologically Advanced ClO2 Generator

One of the main problems in the management of water in buildings is the risk of legionnaires' disease for users and workers..