How long do nosocomial pathogens persist on inanimate surfaces? A systematic review

BACKGROUND: Inanimate surfaces have often been described as the source for outbreaks of nosocomial infections. The aim of this review is to summarize data on the persistence of different nosocomial pathogens on inanimate surfaces. METHODS: The literature was systematically reviewed in MedLine without language restrictions. In addition, cited articles in a report were assessed and standard textbooks on the topic were reviewed. All reports with experimental evidence on the duration of persistence of a nosocomial pathogen on any type of surface were included. RESULTS: Most gram-positive bacteria, such as Enterococcus spp. (including VRE), Staphylococcus aureus (including MRSA), or Streptococcus pyogenes, survive for months on dry surfaces. Many gram-negative species, such as Acinetobacter spp., Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Serratia marcescens, or Shigella spp., can also survive for months. A few others, such as Bordetella pertussis, Haemophilus influenzae, Proteus vulgaris, or Vibrio cholerae, however, persist only for days. Mycobacteria, including Mycobacterium tuberculosis, and spore-forming bacteria, including Clostridium difficile, can also survive for months on surfaces. Candida albicans as the most important nosocomial fungal pathogen can survive up to 4 months on surfaces. Persistence of other yeasts, such as Torulopsis glabrata, was described to be similar (5 months) or shorter (Candida parapsilosis, 14 days). Most viruses from the respiratory tract, such as corona, coxsackie, influenza, SARS or rhino virus, can persist on surfaces for a few days. Viruses from the gastrointestinal tract, such as astrovirus, HAV, polio- or rota virus, persist for approximately 2 months. Blood-borne viruses, such as HBV or HIV, can persist for more than one week. Herpes viruses, such as CMV or HSV type 1 and 2, have been shown to persist from only a few hours up to 7 days. CONCLUSION: The most common nosocomial pathogens may well survive or persist on surfaces for months and can thereby be a continuous source of transmission if no regular preventive surface disinfection is performed

Success Rate of CPR and the Effective factors

Background: Cardiopulmonary arrest is one of the most important affairs in pediatric emergency room. Medical identification of causes of cardiopulmonary arrest, the success rate and effective factors of resuscitation can lead to development of new methods to protect children from dangerous situations.Methods: This is an observational retrospective and case-series study. All of the children who underwent cardiopulmonary resuscitation (CPR) in Children's Medical Center, Tehran, entered this study. Findings: Totally 71 children entered the study (57.7% boys, 42.3% girls). 69.1% of these children were younger than 1 year. Almost half of them didn’t have any history of chronic illness before cardiopulmonary arrest. CPR was successful in 45 (68.4%) children. The most common causes necessitating CPR were respiratory and cardiac problems, seizure, hypothermia and intoxication. Conclusions: Regarding the dominancy of the respiratory causes of cardiopulmonary arrest in children, many of CPR cases will recover by simple procedures like opening the airway and applying ventilation. So, morbidity and mortality can be reduced by educating the families in primary resuscitation car

Pine heartwood and glass surfaces: easy method to test the fate of bacterial contamination

Wooden surfaces in interior use hold potential for improving human health and wellbeing. The antibacterial properties of wood might reduce the possibility of cross-contamination from surfaces. In order to be able to control the hygienic quality of the wooden surface, the antibacterial effect should be better understood. The main aim of this thesis was to identify and evaluate the antibacterial properties of wood and its components.  Different methods were developed and used to study the antibacterial properties of Scots pine and Norway spruce, heartwood and sapwood. The solid wood surface showed clear antibacterial properties, even when the extractives had been removed with acetone. Studies with the extracts showed several human pathogens, including methicillin-resistant Staphylococcus aureus, to be susceptible to pine heartwood and sapwood in particular, and also, to some extent, spruce. Besides extractives, lignin was the only separate wood component showing antibacterial properties. Wood volatile organic compounds (VOCs), which were studied in gaseous form, showed an antibacterial effect against various human pathogens.  Several antibacterial compounds were found in all the extracts, however, they did not always explain the order of antibacterial activity between wood species. No single compound could alone explain the effect, hence the antibacterial effect derives either from different mechanisms in different species or from a synergistic effect. α-pinene and limonene could partly explain the antibacterial effect of the VOCs, but other components were also found to have an influence.  Wood was found to have various antibacterial parts and a diverse range of bacterial pathogens that were sensitive to it. These results offer a good ground for the exploitation of the hygienic properties of wood and a good starting point for enhancing them further. Additionally, the extracts showed promising qualities and they should be studied further in regard to resistant pathogens.Puupinnat sisätiloissa vaikuttavat positiivisesti ihmisten terveyteen ja hyvinvointiin. Puun antibakteeriset ominaisuudet saattavat vähentää pintojen kautta tapahtuvan kontaminaation todennäköisyyttä. Antibakteeristen ominaisuuksien parempi ymmärrys mahdollistaa puupintojen hygieenisen laadun paremman hallinnan. Tämän väitöskirjan päätavoite oli selvittää puun ja sen komponenttien antibakteerisia ominaisuuksia.  Männyn ja kuusen sydän- ja pintapuun antibakteerisuuden tutkimiseen käytettiin osin tätä työtä varten kehitettyjä menetelmiä. Puupinnan todettiin olevan antibakteerinen myös silloin, kun puun uuteaineet oli poistettu asetonilla. Uutteiden tarkempi tutkimus osoitti erityisesti männyn sydän- ja pintapuun, mutta jonkin verran myös kuusen uutteiden ehkäisevän useiden tautia aiheuttavien bakteereiden mm. metisilliinille resistentin Staphylococcus aureuksen (MRSA) kasvua. Uutteiden lisäksi ligniini oli ainoa erillinen komponentti, jolla todettiin antibakteerisia ominaisuuksia. Puusta haihtuvilla orgaanisilla yhdisteillä (VOC) todettiin antibakteerisia ominaisuuksia useita tautia aiheuttavia bakteerikantoja kohtaan.  Kaikissa uutteissa todettiin useita antibakteerisia yhdisteitä, mutta niiden määrä ei aina selittänyt eri puulajien antibakteerisuutta suhteessa toisiin puulajeihin. Mikään yksittäinen yhdiste ei yksin selittänyt antibakteerista vaikutusta, joten ilmiö johtuu joko eri puulajeilla eri mekanismeista tai synergisistä vaikutuksista. α-pineeni ja limoneeni selittivät osin VOCien antibakteerisia ominaisuuksia, mutta myös muilla yhdisteillä todettiin olevan vaikutusta.  Puun antibakteerisuuden todettiin johtuvan useista eri aineista ja tehoavan useisiin eri bakteereihin. Nämä tulokset tarjoavat hyvän lähtökohdan puun hygieenisten ominaisuuksien hyödyntämiseen ja niiden kehittämiseen. Uutteet osoittautuivat myös tehokkaiksi ja niiden ominaisuuksia erityisesti suhteessa resistentteihin bakteereihin kannattaisi tutkia lisää