Welcome to Professional and Technical Services (PTS) – experts in chemical disinfection for infection prevention. Our goal is to educate and provide you the latest resources related to cleaning and disinfection of environmental surfaces, medical devices and hands. As specialists in disinfectant chemistries, microbiology, environmental cleaning and disinfection, facility assessments and policy and procedure creation we are dedicated to helping any person or facility who uses chemical disinfectants.
Our expertise is utilized by Infection Preventionists, Public Health Experts, First Responders, Dentists, Physicians, Nurses, Veterinarians, Aestheticians, Environmental Services professionals and janitorial product distributors to develop more sustainable cleaning and disinfection practices in North America.
Our commitment to providing chemical disinfectant education is more than business, it is a passion.
Our expertise is utilized by Infection Preventionists, Public Health Experts, First Responders, Dentists, Physicians, Nurses, Veterinarians, Aestheticians, Environmental Services professionals and janitorial product distributors to develop more sustainable cleaning and disinfection practices in North America.
Our commitment to providing chemical disinfectant education is more than business, it is a passion.
Tuesday, October 17, 2017
According to Dr. Karl Pillemer of Cornell University, the relationship between grandparents and their grandchildren is second in emotional importance only to the relationship between parent and child. I could not agree more. I was fortunate to have grown up knowing both of my Great-Grandmothers and both sets of my Grandfathers and Grandmothers. In fact, in my mid-forties I am still fortunate to have a living Grandmother who is very much with it and at 86 is still driving and only just moving into a retirement home. Even then she’s only moving because she was able to find a 2 bedroom condo that would meet her needs…… Ask my mother, it was no easy feat!
For many of us, our grandparents hold a very dear spot in our hearts. You may have fond memories of spending the night at their house, going on vacation with them, eating “special meals or treats” that your grandma always made the best – even if your mom used the same recipe! In one article I read, the author states that “Grandparents are like shady trees that have an ever welcoming attitude towards life. They are always there to offer their cool shade to the next generation. It seems that they have all the love, affection and warmth in the world stored within them.” I can’t speak for you, but this sums up my relationship with my great-grandmothers and grandparents perfectly and I think my colleagues who provided the stories I’m sharing today will agree.
Today’s blog is dedicated to the memories of the grandfather of our Marketing Assistant Brandon Petrasso and the grandmother of our R&D Laboratory Technician, Shukria Atta. I hope you caught the fact that I said “memories”.
The story of Brandon’s grandfather goes something like this. He went in to the hospital for his routine daily dialysis treatment, but after his usual treatment his care team noticed his vitals were reading a little lower than they should be. To be on the safe side, rather than letting him go home as he normally would, they felt it would be in his best interest to be admitted into the hospital for observation as a precautionary measure. In trying to determine what was causing his poor health, they realized he contracted Clostridium difficile at the hospital. Brandon’s grandpa ended up passing away due to complications associated with C.diff.
Patients who undergo dialysis treatment have an increased risk for getting an infection because of their weakened immune systems due to the fact that the process of hemodialysis requires frequent use of catheters or insertion of needles to access the bloodstream. However, it should not be a given that every dialysis patient will get a HAI. In fact there is a wealth of supporting documentation to help ensure that infection prevention programs can be put in place to ensure the health and safety of dialysis patients.
The truth is that as we age, our immune systems have to work harder to fight off infections. There have been a number of studies that look at HAIs and mortality in the elderly population showing that HAIs were more frequent in the elderly population particularly with respect to VAP and infections by Gram-negative pathogens. The overall mortality has also been shown to be greater in the elderly group.
This is the likely case of Shukria’s grandmother. She was admitted to the hospital for something that was not serious and while there, caught something from the hospital. Because of the fact that she was already too weak and frail, Shukria’s grandmother could not fight the infection and passed away. She was in Dushanbe, Tajikistan so Shukria was not able to say good bye and even a year later really misses her grandma.
When Shukria shared her story with me she said “I hope we can save lives by educating the hospitals and clinics.” This really sums up the spirit of the Talk Clean To Me blog and the reason for asking my colleagues and coworkers to share their stories. I’m not an expert by any means in every facet of infection prevention, but I certainly know how to clean and how to use disinfectants so that we get them to do what we need them to do. In the case of the stories I shared today, cleaning certainly saves lives.
Thanks Brandon and Shukria for sharing your stories and allowing me to honour the memories of your grandparents.
Monday, October 16, 2017
The theme across Canada for International Infection Prevention Week is “It’s a Team Thing”. It’s a perfect theme and without a doubt 100% accurate. Lapses in infection prevention in most cases are not attributed to a single thing, but a number of factors. As mentioned last week, to celebrate IIPW I will be posting a daily blog sharing stories of friends and colleagues I work with at Virox whose lives either directly or indirectly have been touched by an HAI. It’s easy to play the blame game and point fingers, but I am hoping that by sharing these stories, we can instead think of how as a team we can work together to try and prevent HAIs from happening and reinforce the importance of infection prevention in saving lives.
When I sent the email out to our company asking if anyone had been impacted by an HAI in some way, I was hoping no one had a story to share. That unfortunately, wasn’t the case. The truth was many of us had. What was most alarming is that several shared stories that were almost identical. The stories I am sharing today are one of those.
The birth of a child should be the most amazing day or your life. After waiting for 9 months, you get to meet the child that you have felt growing in your belly or seen growing in your wife’s belly. Let’s be honest, giving birth to a child is not all sunshine and roses. It’s messy. It’s painful and yes, it can be deadly.
Today, I share the stories of the birth of my VP of Manufacturing's first child and the birth of my CEO's third child. Both stories follow the same path, an SSI after a C-section. In Zubair's story, his wife, Mehwish, spent two weeks in the hospital following the birth of their daughter, Zara. Mehwish was put on antibiotics, needed blood transfusions, and as one can expect, it took a while for her to recover, but she eventually went back to full health. Zara was born March 15, 2016 and today is a health, beautiful little girl.
My CEO, Randy, had the same thing happen to his wife Catherine. With 2 children at home, they thought they knew the game plan. Instead Catherine ended up with a staph infection, spent 2 weeks in quarantine and ICU where she had multiple cocktails of antibiotics. In fact at one point, his wife’s health had deteriorated so badly they actually had a priest come to her room. Even after the SSI cleared, she had 3 to 4 years of poor health due to the impact of the ordeal on her immune system. As Randy tells the story, Malory who is now 20 would sit on his desk while he worked after he had sent his 2 older children who were 7 and 5 at the time to school wearing pyjamas (Little Mermaid and Batman) which he thought was perfectly acceptable clothing…
SSIs are the most common and costly of all hospital-associated infections. In fact in the US, they account for 20% of all hospital-associated infections, meaning they occur in an estimated 2% – 5% of patients or 160,000 to 300,000 people each year. The most common pathogens to cause SSIs include bacteria such as Staphylococcus, Streptococcus, and Pseudomonas. So how do SSIs occur? Unfortunately, it’s really not that difficult. They can infect a surgical wound through various forms of contact, such as contaminated surgical instruments, the hands of a Healthcare worker or caregiver, through germs in the air, or through germs that are already on or in your body that get spread to the wound.
Luckily for my colleagues, while the start to what should have been one of the most joyous occasions of their lives got off to a rocky start, the story ended with a happily ever after for 2 very proud papas and 2 very beautiful girls. I hope we can use their stories to learn from our mistakes, learn that the cause of an HAI cannot be pinned on a single person or event, but that we all need to pull our weight to try and help stop them from happening to others – others who may be less fortunate.
Friday, October 13, 2017
Next week is International Infection Prevention Week. It’s always a fun time of the year with opportunities to provide education, particularly through games. In fact I came across an on-line quiz that will tell you “What Germ you are” – if of course you were a pesky pathogen. I’m happy to say I would be MRSA. As part of celebrating IIPW, next week I will be doing daily blogs sharing stories of how friends and colleagues I work with have been impacted by HAIs. There are some stories with happy endings and, well, as you can guess, some not so happy endings.
Knowing what I will be writing about next week, this week I wanted to share a survey I came across that was conducted by Canada Life looking at presenteeism. I would hazard a guess that most of us can attest to the fact that we to have gone to work despite being ill and knowing we’ll not be functioning fully. According to the Canada Life survey, 1 in 4 workers would need to be in the hospital before they would call in sick. Sound familiar to anyone? When trying to tease out why people pick presenteeism over caring for themselves the following were the primary reasons:
· People did not want to appear “weak” for not coming in over a “short- term illness”
· People were nervous of being seen as “lazy”
· People were nervous about being considered as “not dedicated”
· People were made to feel “guilty for taking time off even if ill” by coworkers and company leaders
While the survey was conducted in the UK, this trend is not limited to the UK. Results from the NSF Workplace Flu Survey showed that 98% of American workers judge their colleagues for coming into work sick……BUT it’s the minority that actually feel negative about it! In fact 67% thought those that do come in when sick are hard workers and only 57% of those surveyed said they would encourage a fellow employee to go home “if they thought they were too sick to be at work”.
I know for a fact that presenteeism is not just related to the corporate world. In my “Who’s the last man/women (girl) standing” blog I discussed a study published in JAMA Pediatrics that looked at presenteeism in healthcare workers finding the top reasons for working while sick included; concern over who would fill in for them, concern that their patients could not get by without them and a widespread belief that if they stayed home because of a cold or flu they would be perceived as being weak or unprofessional.
What does this say about us? I’ll admit, I’ve been known to come in with a cold, but that’s because I firmly believe if I can spread it to one person I instantly start to feel better. If I’m running a fever, I stay home. I also send people home, admittedly less about concerns for their health, but for the fact that I don’t want to get sick (or get the rest of the team sick)! I will even admit, upon occasion, I wonder why someone can’t just “suck it up”….
So what group are you in?
Friday, October 6, 2017
Unless you’re completely without feeling, I would hazard a guess that when you hear of something bad happening to a child be it abuse or neglect, injury or disease or even death your heart hurts a little. Many of us cannot fathom having a deathly ill child. I’ve been lucky, but I have a close friend whose son at the age of 19 months was diagnosed with a very rare cancer. The treatment was long, hard, and heartbreaking, and made worse by the fact that my friend was also a childhood cancer survivor so knew exactly what his son was going through. I’m happy to say that Liam beat the odds and while he remains cancer free, he will continue to be closely monitored.
While not a brand new issue, heater-cooler units that are used during heart surgeries to regulate the temperature of patients on bypass continue to plague Infection Preventionists, since they are difficult to disinfect, but much needed machines that have been the root cause of several outbreaks. The most recent I’ve read about impacted 12 patients at a children’s hospital who underwent cardiac surgery this summer. The outbreak was blamed on a single heater-cooler unit used in a single operating room.
Patients exhibited signs of surgical site infections including swelling, wound drainage, redness and fever caused by Mycobacterium abscessus. This bacterium is an environmental bacteria that is routinely found in water, soil and dust and while perhaps not the most common bacteria to cause SSIs, it has been known to contaminate medications and other products including medical devices. Transmission of this bacterium generally occurs by injections of substances contaminated with the bacterium or through invasive medical procedures such as open heart surgery that use medical devices, equipment or material that is contaminated with the bacteria.
In order to ensure more patients were not infected the hospital has replaced the heater-cooler device and completed a thorough cleaning and disinfection of the operating room to remove any chance of future environmental contamination. As for the 12 patients infected, while they have all been hospitalized, the good news is that some are very close to going home!
This story parallels the story of duodenoscopes. As we improve our ability to develop more and more technically savvy instruments that can aid in the treatment of patients we increase our risk of developing instruments that are more difficult or nearly impossible to reprocess in a way that we can ensure they are safe to use on the next patient. I’m not saying that we should halt innovation. What I am saying is that we should, when bringing these devices into our facilities, consider conducting validation studies to ensure that we can safely reprocess in a manner that is reproducible each and every time. My motto is if we would not use the device on a loved one, we should not use it on a patient!
Friday, September 29, 2017
I admit, I troll for articles on cleaning, disinfection, outbreaks and whatever else tickles my fancy as a way to find potential blog topics. Picking a topic for the blog is not just about finding an article or using a question that has been posed. The hardest part, at least for me, is finding a connection to the story. Some weeks I know exactly how I’ll start the blog or how I may personalize the story, while other weeks I have a topic that just doesn’t “speak to me”. This week’s topic speaks to me and will likely speak to you too!
How many of you share the office fridge to store your lunch or leftovers after going out to lunch? Do any of you have that one (or two) colleagues who believe there is a magical fairy or elf that comes in and cleans up the mess in the fridge – you know the stuff that horror stories are made of? How many times have you opened the door of the fridge only to have your nose recoil in disgust because it smells like something curled up and died in there? Tell the truth – how many of you have had that happen at home? It happened to me about a week ago after being away on a business trip for a few days. It took me a couple of days, but I found the culprit. It was a piece of steak that even when enclosed in Tupperware managed to smell like….well I don’t want to think about it anymore. Let’s just say a skunk would have smelled far more pleasant.
According to a recent survey, “Office fridges are an interesting social experiment on people’s warring definitions of cleanliness, hygiene, and manners.” The survey asked 1000 adults when the last time their office fridge was cleaned. The average was 93 days! Of the 1000 people surveyed almost half of them lacked even basic food hygiene knowledge! If you’re unsure what your food hygiene knowledge is, check out the FDA Refrigeration and Food Safety website. Cold temperatures will help slow the growth of many potential pathogens, but it does not stop them all! The website also includes the length of time you should leave cooked or uncooked food in the fridge. Did you know an open package of hot dogs should be tossed after a week? Who is able to eat an entire package of hot dogs in a week unless you have a small army to feed!
If you’re unsure how to clean the office fridge, here’s a few tips:
- First, draw straws. The short straw gets to clean the fridge or you could just have the person who made the biggest mistake that week clean the fridge.
- Grab some reusable latex cleaning gloves or disposable vinyl gloves. Don’t be afraid to double glove!
- Find a N95 respirator to put a mental & physical “barrier” between you and the gross stuff
- Make sure you have HEAVY DUTY Garbage Bags. Don’t chintz on the cheap bags, if they rip or tear you’ll have to touch everything twice!
- Be sure to have a disinfectant that will kill even the nastiest of bugs
- Stock up on Paper Towels
- Have Coffee (beans or grounds) out and ready to sniff after cleaning up to get the remnants of any nasty odors out of your nose!
The long and the short is, be an adult. Unless you work in an office with a magical fairy or elf, clean up after yourself and for the love of Pete, do NOT leave your food in the fridge! If you don’t eat it, take it home or throw it out!
Thursday, September 21, 2017
I’ve been known to imbibe now and again. I like to have fun. Those that know me well may have been involved in one or two of my escapades and a few of you may have heard some stories. I am happy to say I have never been arrested and never been hospitalized. Being grounded while a teenager…..well that’s another story!
Why the discussion of alcohol? Alcohol is one of those “magical” chemicals – you can drink it, you can cook with it, you can wash your hands with it, you can clean with it, you can kill with it and you can use it for fuel (it’s also lights nicely with a match!). In the chemical world, there are a number of different types of alcohols that can be used as a solvent (helps to dissolve things) mixed in with other chemistries (e.g. Quats) that can be used as a disinfectant. On its own (aka 70% IPA), we use it as a disinfectant for skin prep and in microbiology, use it as a fixative agent. Here in lies the catch.
Alcohol is a fixative. It’s well known to be one, but generally speaking most do not realize what that means or how its ability to adhere organic matter to a surface can impede cleaning and disinfection. In fact, a study published in AJIC recently looked at just that. The researchers found that treating contaminated surgical instruments with alcohol and allowing them to dry, increased difficulty in cleaning and could lead to sterilization inefficiency. The rationale of using alcohol in this way is of course for its killing properties to reduce pathogen load prior to cleaning and disinfection or sterilization. The researchers found that yes, the bacterial load was reduced when instruments were wiped or sprayed, but this practice significantly increased the attachment of soil to the instruments which made cleaning these same instruments significantly harder. The long and the short was that the benefit associated with the decreased microbial load was overshadowed by the increased difficulty in cleaning and should be discouraged.
While the study looked at surgical instruments, we need to contemplate that alcohol used for surface disinfection will do the same thing. In surface products, alcohol (IPA, ethanol etc) is often added to boost the efficacy of quats and other disinfectant actives to either enhance efficacy (such as achieve a TB claim) or help to reduce the contact time. Similar to the effect of sticking soils to instruments, the same will happen when using alcohols on surfaces, highlighting the importance of removing soils prior to wiping with an alcohol containing surface disinfectant.
In the end, it’s about finding the balance of what you are looking for in your facility and knowing the advantages and disadvantages of the disinfectant you are looking at. If you know what you’re dealing with, you can implement practices to try and minimize the negative side effects of the product. When it comes to surgical equipment, as cleaning is so vital to ensuring that disinfection or sterilization can occur, I hope you’ll stop the practice of using alcohol to wipe down the instruments prior to cleaning. When it comes to surface products, I hope you also do your research, particularly if you work in a high soil environment!
Friday, September 15, 2017
As I’ve mentioned before, I grew up on a farm. We raised beef cows, capons (neutered male chickens) and grew cash crops (wheat, corn, soya beans, etc). As any good animal loving country girl can probably attest, you can make a pet out of virtually any animal. Some of my favorites were Joy our Jersey who, while a cow, we rode like a horse; there was also Cookie the Capon, Miss Piggy, Herman and Hersey (also cows), Rainbow my thoroughbred horse, Pursey my albino rabbit, Mr. Boots my Dutch belted rabbit, Sparky a very vocal guinea pig and of course we always had a dog or two and lots and lots of cats. I played in our barns, I’ve mucked my fair share of stalls and yes, I’ve been known to get into manure fights while mucking stalls. I’m pretty sure at some point in my life I’ve eaten poop – unknowingly of course, but I’m sure it’s had to have happened.
While acknowledging in a public forum that I’ve eaten poop, what I can say is that when coming in from the barn I always washed my hands. I washed my hands after playing with our pets, before eating, and I NEVER let any of our animals lick my face or kiss them in any close vicinity to their tongues. How many of you can say the same? Not to shame you if you have, but GROSS!!!! Do you know where those mouths and those tongues have been?
We often talk about Swine or Avian Influenza and Salmonella as common zoonotic diseases. Certainly, we need only go back a few weeks to my “Fall Fair Fun” blog to read about transmission of pathogens from animals to humans. Only a few weeks ago there was yet another Salmonella outbreak associated with pet turtles (I talked about that in my “Pet Turtles Pose Health Problems” blog back in 2015). I think we’ve come to understand that farm animals (and pet turtles) can spread disease but what about adorable, cute, cuddly and wet tongued puppies?
Well….those darn adorable puppies can also be the cause of outbreaks. In fact, the CDC is currently investigating a multi-state Campylobacter outbreak in people that have been linked to puppies purchased from a chain of pet stores. At least 39 people across 7 states have been identified and the cause has been linked to puppies sold by a chain of pet stores based in Ohio. Of the 39 people, 12 are employees while the remaining 27 have been directly linked to either purchasing a puppy from the store or visited the store. The CDC does not yet know the exact cause of the outbreak and it may be difficult to ever pinpoint the exact cause.
Campylobacter itself is a bacterium that can infect dogs, cats and humans. There are a number of different strains of Campylobacter that can be found in many of our food production animals so it is most frequently linked to eating raw or undercooked meat. Typical symptoms include diarrhea, abdominal pains and fever that can last for about a week. Person to person transmission is rare, but transmission from exposure to dog feces is possible. Washing your hands after handling poop and after touching your dog is recommended – I would hazard a guess that’s not realistic for many dog lovers! While the CDC does not call it out, letting your dog lick you or kissing on the mouth should also be avoided….dogs do clean themselves down there you know!
P.S. Next week it will be a toss-up between a study about how alcohol fixes soil to medical devices or a study on bleach causing COPD. If you have a preference tweet and let me know!
Friday, September 8, 2017
Tell the truth…you all started humming John Denver’s famous song “Leaving on a Jet Plane”. In case didn’t know, the reason he wrote the song was that he loved to travel, but he hated leaving people (friends, family, loved ones) behind while out on the road. I too hate leaving my loved ones behind when out on the road. For most, September signifies back to school and back to routine after an enjoyable summer. For some of us, it also means back to the travel grind of attending tradeshows and events. While my fall does not look as bad as my winter and spring travel, I can say that I’m still on track to keep my travel status and in fact will come in at fewer flights than last year. As I write this blog I have already looked at the weather in Vegas where I am off to on Monday for the ISSA Interclean Tradeshow and started to “virtually” pack my bag.
As many of you are probably well aware, while travelling can be fun and in this case educational, it can also come with myriad of problems such as delayed flights, lost luggage and the very real threat of picking up something infectious. If you’re lucky, it may be just the common cold; and while it’s irritating, you’ll generally recover without much to show for it (unless it’s a man cold of course). If your luck is not so good you may pick up norovirus and take a bit longer to feel back to normal, but happy that you’ve lost any weight you gained over the summer. If you’re really unlucky, well you might pick up the next superbug or emerging viral pathogen. It’s the give and take we have to partake in when it comes to travel. We have the luxury of globetrotting to far away destinations, but so do bugs!
I think we can all agree there have been several studies and articles about how “germy” planes are and what the “germiest” surface is…. The obvious solution is to ensure the plane arrives with enough time to properly turn it around which includes cleaning and disinfecting all of the surfaces the people on the last flight touched. The reality of course is that to avoid delaying the next flight, corners get cut to get the next set of passengers on board. I was extremely interested to see a study out of Arizona State University that looked at ways of decreasing the chance of contamination or spread of germs. They found that if you split up how the plane was boarded you could decrease the risk!
The researchers realized that if you could reduce the clustering and crowding of people in the isles during the boarding process you could significantly reduce the risk of infecting travelers. Using a model looking at transmission of Ebola, they found that under the current boarding process there was a 67% chance of reaching 20 or more cases of air travel-related cases of Ebola per month. However, if they modified how people boarded to reduce crowding, they found the risk of infecting 20 people per month dropped to 40%. They also found that smaller planes (e.g. 150 seats or less) also reduced the risk of transmission. I wouldn’t call that rocket science. With fewer people on a plane there would be less crowding and therefore, the risk of spreading disease would (should) be lower.
Basically, next week I’m doomed. A hot spot like Vegas means a large plane and lots of people. The upside is that my status allows me to be one of the first to board the plane and one of the first to get off the plane. As long as everyone keeps their hands to themselves I should be good! Of course, it doesn’t hurt that I always have a supply of disinfectant wipes!
Friday, September 1, 2017
Like me, I am sure many of you are following the situation in Texas. It’s heartbreaking. I cannot fathom the devastation and the toll on the lives of those who live in the area – human or animal. Hurricane Harvey can only be described as catastrophic not just due to the vehemence with how it hit land, but because of the continued rainfall after the fact. The flooding that has occurred is truly an example of how we are no match for Mother Nature.
In light of the recent events in Charlottesville, it’s refreshing to see the country pulling together to help those in need. From news clips of “The Cajun Navy” pulling boats heading to Houston to help with rescue efforts, to a boat filled with 21 dogs that a group of good Samaritans helped rescue, to donations made by celebrities and us “regular” folk, I think it’s fair to say that those affected by Hurricane Harvey know people everywhere are doing what they can to help out.
While people rush to help, it’s important to realize that flood water is not just dangerous in terms of drowning its victims. Flood water can also be dangerous because of what it contains. It can be full of a myriad of contaminants from pesticides and other chemicals to animal or human waste. The bacterial count in flood water is extremely high and can cause health issues from ingestion such as vomiting and diarrhea to skin infections and even chemical poisoning. Even after the flood waters subside, the worry is not over. The silt and mud left behind from the water will likely be contaminated, so care in handling during clean-up efforts will be needed. Then of course we move from moving water to potential standing water and the probable infestation of mosquitoes carrying arboviruses such as Zika and West Nile Virus.
If that’s not enough, biosecurity measures need to be put in place to manage potential transmission of diseases between animals that may not normally come in contact with each other. For example, there is a cattle fever tick eradication program in South Texas with the quarantine area extending more than 500 miles from Del Rio to the Gulf of Mexico. While anticipated rain and flooding have not yet occurred in the quarantine area, government officials are working to issue permits to allow for the relocation of livestock to safer grounds should it be necessary in the days ahead.
Needless to say, Texas needs our help. If you’re interested in lending a hand or donating items or money, the following are some organizations that are looking for help:
- Texas Board of Veterinary Medical Examiners – Temporary Emergency License Application
- Red Cross – Hurricane Harvey Support
- Houston Food Bank or Corpus Christi Food Bank
- Houston Humane Society
In the words of John Bunyan “You have not lived today until you have done something for someone who can never repay you.”
Friday, August 25, 2017
I’m not sure what exactly is going on in the world of cleaning, disinfection, and infection prevention, but I am LOVING all of the new studies being published and news bulletins being sent by a whole host of regulatory bodies! I have topics galore for upcoming blogs!
Last week, I was in the Sacramento area visiting the UC Davis Veterinary Medicine campus. I was meeting with two influential veterinarians who focus on Shelter Medicine. Animals, cleaning and disinfection, infection prevention and biosecurity were of course our key topics of discussion. I’m not sure if it was serendipity or just coincidence that after being on campus, a new publication came rolling across my desk published by researchers at UC Davis. The study investigated the number of compounds and drugs found in household and pharmaceutical use. The study discovered that Quaternary Ammonium Compounds (Quats) were found in many different types of household products including disinfectants, hand wipes, shampoos, nasal sprays and even mouthwash could inhibit mitochondria (the powerhouse of the cell) as well as estrogenic functions in cells.
Before we start to panic, it’s important to understand that the testing conducted was done using in-vitro testing using cells. There is already some evidence to support that Quats can disrupt fertility in mice, therefore the fact that this study shows that Quats can impact the estrogen signalling process that is important for human fertility is something that should not be ignored. While it’s true we do not yet know what levels these chemicals reach within the human body when exposed to Quats, the data certainly warrants further investigation including moving to investigation using animal models.
With the ban on Triclosan and need to remove it from consumer products, some companies have been looking to utilize Quats in their place. The thought of course was they were choosing a safer alternative. This study demonstrates that this may not be a safer alternative. This research is yet another to add to the growing pile of findings that Quats may not be as safe as previously believed. As this study showed, six out of the ten most potent mitochondrial inhibitors were Quats. The fact that almost everyone is exposed to Quats on a regular, if not daily basis, is certainly cause for concern.
I’m not crying wolf or inferring the sky is falling. I do however, think this is yet another example of not considering what the wide spread use of antibacterial agents in our homes can lead to. We know there is no need to use antibacterial hand soaps or antibacterial dish soaps because plain soap and water will do. Do we really need to use antibacterial agents in our tooth paste? If we’re concerned with bad breath why not brush more frequently or chew gum between brushings?
Regardless, this is going to be an interesting topic to follow and see what unfolds as more testing and research is conducted. I’ll be sure to keep you posted if I learn anything further!
Friday, August 18, 2017
The end of August is bitter sweet. On the sweet side, it marks the anniversary my husband and I started dating and got married and it marks the month we moved from a high-risk pregnancy to a “you’re good to go” pregnancy. On the bitter side, it marks the end of summer, the return of cool nights and for children the return to school. It also marks the start of Fall Fair season!
Growing up on a farm, Fall Fairs were where you got to show off your prized animal (in my case a purebred Hereford named Patience). She was aptly named as it took all my patience to teach her to lead on a line, stand quietly to be judged and to stop dragging me through the manure pile. I was a horse girl, so Fall Fairs were also high season for competition – hunter, equitation and jumping were my events. My boy Wally, known in the show world as “The Other Man” was a bit fickle. We had our good days and our bad days. In hindsight, I should have named him “The Only Man” seeing as he was the reason for much of my teenage drama and losses of boyfriends. If I had a show, you could be sure that I would cancel a date to go ride and groom my horse.
Fall Fairs are a great time for people to learn where our food comes from and to get to touch and feel different animals, learn their sounds and their smells, and for some unsuspecting child or adult it may also mark the first time you got nipped, bit or kicked it because you wrongly thought that all animals were pets. Fall Fairs are also a time of food poisoning and catching a zoonotic disease such as Salmonella or influenza. Because Fall Fairs result in the mixing of humans and animals, it is important that we all take steps to protect ourselves from picking up a zoonotic disease. Whenever there is a human and animal interface, we need to recognize the risks that come with it. Promoting simple things like good hand hygiene habits and ensuring there is adequate access to hand washing stations or hand sanitizers can go a long way to protecting people. But it’s not just about our protection, animals can be susceptible as well, so we need biosecurity measures in place to prevent animals getting sick because we traipsed something in to their area on our shoes.
In fact, a study recently published in Emerging Infectious Disease looked at how novel viruses can evolve in an agricultural fair setting highlighting how quickly influenza and other potential diseases can spread from pigs to humans. The study looked at samples from 161 pigs from 7 different fairs. They found that for 6 of the 7 fairs, 77.5% of the pigs were infected with Influenza A. Interestingly only 2 of the fairs showed extensive influenza-like illness among the pigs meaning subclinical infections with influenza pose a potential public health threat. Influenza viruses can jump from humans to pigs and back to humans. Biosecurity measures at Fall Fairs and the need to conduct surveillance within the pig population is an important method for detecting novel influenza A viruses that threaten swine and human health alike.
Don’t let this stop you from attending these fun events. There is much to see and do, and of course eat! If you happen to attend any in Southwestern Ontario you may come across my niece! She’s gone the “western” route meaning she runs barrels, poles and flags, but I still love her even if she picked the wrong events!
Friday, August 11, 2017
If you ever read or watched the Sherlock Holmes books, movies or the TV series you will recall the line “Elementary, my dear Watson”. It was the explanation that Sherlock Holmes gave to his assistant, Dr. Watson, when explaining deductions he had made. Science, like solving murders, is all about deduction and solving mysteries and puzzles.
The same can certainly be said with infection prevention and trying to find out who or what are transmitting infections and how. In recent years, there has been a huge push on improving hand hygiene rates. There has also been a focus on improving cleaning and disinfection processes, particularly when it comes in environmental surfaces. Studies have looked at different types of disinfectant actives, different cleaning processes, changing frequency of disinfection, increasing staff (or decreasing staff), and implementing verification methods to ensure that cleaning and disinfection has in fact occurred. Several studies have shown that changing products, processes and including a validation program could in fact improve cleaning and disinfection showing a direct link to reducing HAIs.
Regardless of the implementation of hand hygiene programs or improving environmental surface disinfection, HAIs were not eliminated. Improved hand hygiene and enhanced cleaning certainly showed a reduction in HAIs, but HAIs still occurred. Several years ago after conducting a cleaning audit at a facility that was in the midst of an outbreak one of the observations I made was that I never saw any cleaning and disinfection of patient care equipment by nursing staff.
Don’t jump to conclusions. I’m not saying that nurses are to blame for outbreaks, but the thought came back in flash after reading a study that hoped to improve both hand hygiene and stethoscope hygiene. The researchers’ intervention sought to educate staff regarding the importance of stethoscope hygiene. Expectations were set that stethoscopes needed to be disinfected between each patient encounter due to the fact that they are repeatedly used throughout the day and can become contaminated after contact with patients. This repeated use throughout the day and between multiple patients make stethoscopes a key fomite that can transmit pathogens from patient to patient. Unfortunately for the researchers (and maybe the patients) of the 128 initial observations disinfection of the stethoscopes never occurred. Post-intervention, an additional 41 observations found that even with an education intervention to discuss the importance of disinfection of the stethoscopes, no stethoscope hygiene was performed.
Do I hear crickets chirping?
I wonder just how wide spread the lack of stethoscope hygiene is? I know the next time I’m at my doctor’s I’m going to ask when the last time she disinfected her stethoscope was and may just offer to clean it for her myself!
Friday, August 4, 2017
My dad is a prostate cancer survivor. We were lucky. He had a doctor who was on top of things and through my contacts, we were able to find him an excellent specialist. The best news of all was in June when the oncologist said my dad no longer needs to visit him and passed him back to his GP. It was an awesome day.
Why am I sharing this? Well each November since my dad was diagnosed with prostate cancer I have supported “Movember”. Rest assured, I am not growing facial hair. I do, however, donate to friends or family members who decide to grow a beard, a mustache or a goatee. I’m giving to a worthy cause – prostate cancer research. I’m hoping that sometime in the future someone else’s dad won’t have to tell his baby girl that he has cancer.
Without a doubt there is no shortage of worthy causes – cancer research, food banks, clothing and even hair donations – we can become almost numb to the requests for money to support cause after cause. So I will apologize as this is another cause, but one I hope the infection control community can get behind – infection control education. In particular, funding for infection control education in Africa.
Why is education in Africa so important? Because there is a shortage of skills particularly in infection prevention and related topics like engineering and infrastructure maintenance. Education and understanding of the local conditions is pivotal to good infection control practices in both healthcare facilities and in the communities. Similar to the National Infection Prevention Associations we see in industrialized countries like Canada, the US, the UK, etc, an association was started by a group of visionaries in Africa. The Infection Control African Network (ICAN) was established in 2012 and has grown include 500 members from 34 countries across Africa. It has an extensive Education programme – Cape to Cairo. Since 2005 ICAN in partnership with Stellenbosch University has graduated over 120 students in the Postgraduate diploma program in IPC, 300 in fundamentals in IPC, 1200 in the Basic course in IPC, 94 managers in cost effective IPC practices. These are just a few of the many courses that are offered. There is also an ICAN conference where bursaries and scholarships are given to African scientists to present their research. Further, ICAN has been a member of the WHO committees on IPC and related topics with a view to carry forward the view of low to middle income countries. There is no question that ICAN has had a very positive impact on African lives.
But all of this comes with a cost. In a country the size of Africa where resources and money is scarce, support is needed to continue and expand the education efforts. By using teleclass education systems like Webber Training, ICAN can take their infection control education into some of the more rural and remote parts of the African continent. To ensure that as many people as possible can receive the training, all of the course lectures will be made available on teleclassafrica.org in English, and eventually, in French, Portuguese, Arabic, and Swahili. This will mean that virtually every healthcare worker on the continent will be taught in at least one language that is understandable to them.
In the spirit of “sharing is caring” I am hoping that some of you may be willing to support this worthy cause. If you’re not able to support, I am hoping that you would consider sharing the Go Fund Me link. It’s amazing how far $15,000 can go. Where else on earth can an infection control education program be brought to healthcare workers from 54 countries?
Friday, July 28, 2017
I generally start each blog with a little story. Often times the story may be personal and something that can lead nicely into the main topic of the blog. This week after reading the article that is serving as the basis for the blog topic and deciding upon the title, I knew if I shared a personal story I would really have tipped the scales of TOO much information. I’m sure each of you can think of a situation where you’ve been hit by diarrhea. You may even recall from childhood a certain song dedicated to the topic of diarrhea. There are a few different renditions and I think in an attempt to be mature I’ll let you google “Diarrhea Song” on your own.
So why the talk of diarrhea? Well an investigation report was released by the CDC last week about a Salmonella outbreak linked to microbiology laboratories which infected a total of 24 people in 16 states between March and June this year. Of the 24 confirmed cases, 6 people were hospitalized, but no deaths have been reported. The infections occurred in clinical, commercial, college and university microbiology laboratories where the investigation revealed that several of the people infected in the outbreak reported risky behaviors, such as not wearing gloves, not washing hands and using writing utensils or notebooks outside the laboratory.
As a result of this latest outbreak, the CDC has released a new set of guidelines to be used when working in laboratories. Some of the key recommendations include not bringing home items used in the lab; following proper biosafety training; wearing gloves, a lab coat or other protective garments; actively washing your hands; and avoiding touching your face or body while in the lab. Having worked in a lab setting and being responsible for the technical service team and sample reception, I would also say a key recommendation should be not to store your lunch, snacks or drinks in the same fridge that samples are stored…..
The Salmonella typhimurium strain identified in this outbreak was also linked to infections in microbiology labs in 2011 where 109 people infected including 2 children of an infected student and 2014 where 41 people infected. The long and the short, is it seems to take about 3 years for lab staff to forget that outbreaks and diarrhea associated with Salmonella can be an occupational risk. This goes to show that biosecurity measures cannot be underestimated. In a lab setting, once the crisis is over we cannot simply fall back into our old habits over time. Biosecurity measures were designed for one very specific reason – to protect us as we work with potentially infectious pathogens. This is our health we are talking about. Sure an infection with Salmonella and the associated diarrhea is a nuisance and some may just shrug it off as a fact of life. Would we’d be so cavalier if we were talking about Ebola?
Check back with me in 2020 and let’s see if we can find another outbreak!
Saturday, July 22, 2017
I was in SoCal this week. It was lovely. It had been a while since I’ve been to California and was able to enjoy a drive down the coast from LA to Dana Point. If you’ve not been there, it’s the home of the Doheny Beach – you know the one mentioned in the Beach Boy’s song “Surfin’ USA”? If you love sand and surf it’s worth the trip, as is a visit to Salt Creek Beach. I say “if you like sand” because I #hatesand! It gets all over you, and I may have had a bit of a tantrum while trying to get sand out of my sandal and then locking the keys to my rental car in the trunk…… The car wasn’t locked and while there was no trunk button in the cabin of the car we did manage to unlock the car by putting down the back seats and crawling into the trunk that way. If you don’t believe me check out my Twitter or Instagram for hilarious picture evidence @nicolecronkenny.
As is the case with the picture that inspired this week’s blog, I may also have followed the local way and walked bare foot in public on sidewalks and stairs. Why would I risk contracting Plantar Warts or Athlete’s foot (Tinea pedis) by walking bare foot in a public place? I had #Ihatesand on my feet. I had to walk back to the car without shoes so that I could use a bottle of water to wash the sand off. Don’t you agree it’s ridiculous they did not have showers readily available as you came off the beach? I’m sure I’m not the only #Ihatesand person out there! At the very least, I am sure that most people hate bringing sand home with them!
Aside from enjoying days at the beach accumulating sand in areas it does not belong, summer is also known as high season for pedicures, because who does not want to make sure your feet look good while walking in public?! Back in 2012, I wrote a blog “Be Spa Safe” where I gave 7 things to look for when going to a spa or nail salon:
1. Is the facility clean and organized?
2. Are the tools and work surfaces in good repair?
3. Did I see the personal service worker wash their hands?
4. Are the tools and supplies stored in a clean area?
5. Are creams, lotions, wax etc used in a way that does not contaminate them?
6. Are clean sheets, towels, etc used for each client and paper liners thrown out after each use?
7. Most importantly, ask yourself if you feel comfortable with getting whatever treatment you are looking forward to done. If what you see or hear is making you uncomfortable…RUN!!!!!
I hope that you’ll consider these the next time you go for a mani or pedi! If you’re off to the beach this weekend enjoy, but I hope it’s a beach that has showers and you’ll wear sandals! You can be sure this weekend I will not be spending time at the beach. #Ihatesand you know!
PS – I’ll let you know if I caught anything infectious walking in public!
Friday, July 14, 2017
As much as I hate to date myself, I’m hoping that when many of you read the title for this week’s blog you started humming, singing or at least thought of the 1972 song by Alice Cooper “Schools out for Summer”! Let me be clear, I was still a baby when it first debuted, but I dare say many of us probably sang the song on the last day of school as we ran out the school doors whether it was to catch the bus, to jump in your car or simply run all the way home. While many kids hope to completely avoid anything that may resemble learning in any form this summer, there are some of us who take the opportunity to catch up on reading or learning during the couple months that we anticipate having a bit more time to slow down and relax.
As I do each quarter I wanted to share the Webber Training teleclasses coming up for the next three months. As noted in past blogs, the Teleclass Education by Webber Training is an international lecture series on topics related to infection prevention and control. The objective is to bring the best possible education to the widest possible audience with the fewest possible barriers when trying to access it. Here's the list of teleclasses for the third quarter of 2017.
psychology of hand hygiene: How to improve hand hygiene using behaviour
Jocelyn Srigley, Canada
The impact of
catheter associated urinary tract infection
infection control via games
Anne-Gaëlle Venier, France
Biofilms in the
hospital environment: Infection control implications
Prof. Karen Vickery,
Media: Useless or useful in infection prevention
patient safety climate and adherence to standard precautions
Dr. Amanda Hessels,
passion, sparking improvement
How to publish in
the journals and why it matters
Prof. Elaine Larson,
For more information on Webber Training, including a full list of the upcoming Infection Prevention and Control Teleclasses, please visit www.webbertraining.com. If you’re a Twitter follower you can also be part of the conversation during the sessions by following #WebberTraining.
I hope many of you will take the opportunity to listen to these teleclasses and share them with your colleagues!