Routine surveillance of asymptomatic healthcare personnel for severe acute respiratory coronavirus virus 2 (SARS-CoV-2): Not a prevention strategy

"As capacity for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) diagnostics has expanded, both with assay types (nucleic acid amplification tests, NAATs, antigen tests, and serology) and specimen collection options (nasopharyngeal, NP; oropharyngeal, OP; saliva; mid-turbinate, MT; anterior nares, AN), interest in the use of routine, serial screening of asymptomatic individuals in a variety of settings has expanded. Notably, the use of asymptomatic surveillance in higher education and professional and nonprofessional athletics has become commonplace, but transmission in these settings has also been linked to lapses in implementation of basic infection prevention practices such as masking and physical distancing. Given the considerable interest in asymptomatic surveillance in areas outside of healthcare, the question of the utility of routine screening among healthcare personnel (HCP) in acute-care facilities has been raised. In this focused review, we describe the reported risk of acquisition of infection after HCP exposures to occultly infected patients, the risk acquisition of infection by patients exposed to occultly infected HCP, and the prevalence of asymptomatic infection among HCP in settings where screening has been implemented. We also assess the potential role or routine surveillance of asymptomatic HCP to reduce the risk of nosocomial transmission from HCP-to-HCP and HCP-to-patient. We report on the early experience of acute-care facilities that have offered screening of asymptomatic HCP outside confirmed exposures, and we conclude with considerations for facilities considering offering screening, either “on demand” or as part of routine surveillance.

Mental health among healthcare personnel during COVID-19 in Asia: A systematic review

The COVID-19 pandemic has been associated with an insidious wave of psychological stress among healthcare personnel (HCP) in Asia. Mental exhaustion, burnout, fear, depression, anxiety, insomnia, and psychological stress among HCPs have intensified a daunting challenge during the COVID-19 pandemic. The consequences of such stress may negatively impact patient and HCP safety. This review article reports the associations of mental health status attributed to the COVID-19 pandemic among HCP and their impact on patient safety, and infection prevention and control practices during pandemics

Antimicrobial activity of a continuous visible light disinfection system

We evaluated the ability of high-intensity visible violet light with a peak output of 405 nm to kill epidemiologically important pathogens. The high irradiant light significantly reduced both vegetative bacteria and spores at some time points over a 72-hour exposure period

Reply to Randal W. Eveland regarding comparative evaluation of the microbicidal activity of low-temperature sterilization technologies to steam sterilization

To the Editor—We thank Dr Randal Eveland, Steris Corporation, for his letter regarding our paper that compared the microbicidal activity of low-temperature sterilization technologies (ie, vaporized hydrogen peroxide [VHP], ethylene oxide [ETO], and hydrogen peroxide gas plasma [HPGP]) to steam sterilization in the presence of salt and serum to simulate inadequate precleaning. As noted in our paper, the literature contains a paucity of information on the comparative microbicidal activity of the sterilization technologies cleared by the Food and Drug Administration (FDA) for sterilizing medical and surgical devices. We believe that the data from this study will help clinicians in infection prevention assess the robustness of healthcare sterilization technologies and the risk of infection to patients when an uncleaned instrument is unintentionally brought into the operating room or used on a patient

Academic chartered data safety committees versus industry sponsored data safety committees: The need for different recommendations

Dear Editor, We read with great interest the recently published paper by Calis et al.1 We applaud the authors and the working group for developing this important set of recommendations for data monitoring committees (DMC). Recommendations for organizing a DMC are long overdue. Our academic institution has had a formal DMC for many years which administratively reports to an academic official who directs the research efforts. It has a formal charter and broad membership that includes clinicians, clinical trial specialists, and a biostatistician. It accepts for review studies that require a DMC (usually phase II or III trials) and are not sponsored by industry, which usually set up their own DMC. Most studies are supported by the institution, US Government research funding sources (e.g. National Institutes of Health (NIH), Centers for Disease Control and Prevention), or research foundations

Occupational Health Update: Focus on Preventing the Acquisition of Infections with Pre-exposure Prophylaxis and Postexposure Prophylaxis

Health care personnel are commonly exposed to infectious agents via sharp injuries (eg, human immunodeficiency virus, hepatitis B virus, and hepatitis C virus), direct patient care (eg, pertussis and meningococcus), and the contaminated environment (eg, Clostridium difficile). An effective occupational program is a key aspect of preventing acquisition of an infection by offering the following: (1) education of health care personnel regarding proper handling of sharps, early identification and isolation of potentially infectious patients, and hand hygiene; (2) assuring immunity to vaccine-preventable diseases; and, (3) immediate availability of a medical evaluation after a nonprotected exposure to an infectious disease

Response to letter to the editor regarding “Occupational health risks associated with the use of germicides in health care”

To the Editor: We thank the authors of the letter for their comments on the benefits and risks of using low-level disinfectants on environmental surfaces in hospitals based on our recent article “Occupational health risks associated with the use of germicides in health care.”1 We take exception to many of the issues and criticisms raised by these authors

Monitoring and improving the effectiveness of surface cleaning and disinfection

Disinfection of noncritical environmental surfaces and equipment is an essential component of an infection prevention program. Noncritical environmental surfaces and noncritical medical equipment surfaces may become contaminated with infectious agents and may contribute to cross-transmission by acquisition of transient hand carriage by health care personnel. Disinfection should render surfaces and equipment free of pathogens in sufficient numbers to prevent human disease (ie, hygienically clean)

Disinfection, sterilization, and antisepsis: Principles, practices, current issues, new research, and new technologies

Health care−associated infections are an important source of morbidity and mortality, with an estimated 1.7 million infections and 99,000 deaths annually in the United States.1 The major source of health care−associated pathogens is thought to be the patient’s endogenous flora, but an estimated 20% are acquired via other transmission routes such as the environment, and 20%-40% are attributed to crosstransmission via the contaminated hands of health care personnel

Disinfection, sterilization, and antisepsis: An overview

All invasive procedures involve contact by a medical device or surgical instrument with a patient's sterile tissue or mucous membranes. The level of disinfection or sterilization is dependent on the intended use of the object: critical (items that contact sterile tissue such as surgical instruments), semicritical (items that contact mucous membrane such as endoscopes), and noncritical (devices that contact only intact skin such as stethoscopes) items require sterilization, high-level disinfection and low-level disinfection, respectively. Cleaning must always precede high-level disinfection and sterilization. Antiseptics are essential to infection prevention as part of a hand hygiene program as well as several other uses such as surgical hand antisepsis and pre-operative skin preparation