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.

Thursday, August 29, 2013

School Absenteeism Due to Illness - Fact or Fiction?

For many, September 3rd marks the first day of school.  Some parents will be celebrating the fact that life can again get back to some semblance of a routine while other parents may be dreading the juggling of extracurricular activities.  For me, it signifies the potential start of a 10-month cycle of sickness. 

School absenteeism due to illness is not fiction.  In the United States, there are approximately 164 MILLION lost school days each year among students in kindergarten to grade 12 which averages out to 4.5 sick days per student per year.   In fact, some studies have shown that kindergarteners on average have 12 colds a year, while older kids develop about seven.  In a society where school reimbursement is directly related to attendance this can mean the loss of a significant portion of the schools funding.  Reimbursement numbers vary from district to district, but generally average $30 - $50 per student.  To a school district with a student population of 50,000 that receives a $30/student reimbursement, a daily absenteeism rate of 1% can mean a loss of $15,000/day.  Assuming that same district of 50,000 students averages 4.5 sick days each, by the end of the school year we are talking big bucks - $6.75 MILLION to be exact!

The effect of implementing a hand hygiene program in schools to reduce infections has been well documented by a number of studies.  In our back-to-school blog last year, URGENTLY NEEDED - 1 Angry Bird Knapsack, I highlighted a study that reported after a hand hygiene program was implemented where student's used hand sanitizer 3 times per day that the number of students who missed four or more days due to illness dropped by 66%!

A study published in 2009 in the Journal of School Nursing by Gerba et al titled "Occurrence of bacteria and viruses on elementary classroom surfaces and the potential role of classroom hygiene in the spread of infectious diseases" explored the survival of bacteria and viruses on surfaces in classrooms in an attempt to determine if an environmental hygiene program using disinfecting wipes could reduce infections.  In the study, disinfecting wipes were used daily (each morning before students arrived) to clean surfaces within classrooms.  The study found that the water fountain handle and the manual pencil sharpener, both of which are used by numerous students throughout the day were two of the most bacterially contaminated classroom surfaces.  The sink faucet handle, the paper towel dispenser and the student desktops were most often contaminated by Influenza A virus and Norovirus was frequently found on these surfaces as well.

As with the hand hygiene study, Gerba et al found that the classrooms that were cleaned and disinfected each morning with a disinfectant wipe had a statistically significant reduction in student absenteeism due to illness suggesting that proper classroom environmental hygiene program could reduce the transfer of bacteria and viruses from environmental surfaces to students hands.

As you prepare to send your kids back to school ask yourself one of two questions: how much sick time did I save over the summer to use this fall as bacteria or viruses invade my home and what can I do to prepare my children to battle these vicious little bugs?  The truth is keeping them healthy throughout the entire school year may be unrealistic.  However; if you take some time to teach your child to keep their hands clean by washing before eating and after EACH time they use the bathroom, teach them the importance of not sharing hats, makeup, towels etc and teach them to keep their area clean you may significantly improve your odds of not having to miss work to look after your sick child.   At the very least if you pack hand sanitizer and disinfecting wipes in their lunch box and instill the importance of sanitizing their hands and cleaning their desk before eating you'll still be a step ahead.

I wonder, instead of grounding a child for bad marks, what would happen if we grounded them for each day they were sick....do you think they would start washing their hands and cleaning their desks then?

Bugging Off!


Friday, August 23, 2013

Disinfectant Chemistry Report Card #16 - Iodophors

Iodine-based formulations have been widely used by a number of markets both as antiseptics and disinfectants.  It was first used for the treatment of wounds about 140 years ago. An iodophor is a mixture of iodine and a solubilizing agent or carrier which produces a solution that provides a sustained-release reservoir of iodine and releases small amounts of free iodine in aqueous solution. Iodine solutions or tinctures have been used primarily as antiseptics on skin or tissue.  The best-known and most widely used iodophor is povidone-iodine, a compound of polyvinylpyrrolidone with iodine. This product and other iodophors retain the germicidal efficacy of iodine but unlike iodine generally are non-staining and relatively free of toxicity and irritancy.

Iodine imposes broad spectrum antimicrobial activity due to its ability to penetrate the cell wall of microorganisms which results in disruption of protein and nucleic acid structure and synthesis.  Povidone-Iodine prevents viruses from anchoring to host cells by incorporating the free iodine to the viral capsid surface.  In bacteria, povidone-iodine releases the iodine ion to react with membrane proteins’ amino acid side chains and thus disrupt cellular vitality. Published reports demonstrate that iodophors are bactericidal, mycobactericidal, and virucidal but can require prolonged contact times to kill certain fungi and bacterial spores. 

Mutagenic properties of Iodophors have been identified against bacterial and yeast cells; however not tested on human tissue. Allergic reaction (and in some cases anaphylactic shock) to iodine appear in several cases of diagnostics upon use of povidone-iodine.  From an environmental perspective, aquatic concentrations of povidone-iodine and/or its degraded by-products are considered toxic to certain aquatic creatures.
Here’s how we would score Iodophors on the key decision making criteria:

• Speed of Disinfection – B

o Contact times will be dependent upon concentration and formulation
o Hand Sanitizing formulations generally carry a  30 second sanitizing claims

• Spectrum of Kill – B to C

o Efficacy against bacteria, viruses and fungi has been shown but is dependent upon formulation and concentration

• Cleaning Effectiveness – C to D

o Iodine itself widely stains surfaces
o Any cleaning efficacy that may be present in Iodophors solutions would be as a result of surfactants included in the formulation

• Safety Profile – B

o Allergic reactions to iodine have been well documented
o Mutagenic properties of Iodophors have been identified against bacterial and yeast cells; but not verified on human tissue

• Environmental Profile – D

o Povidone-iodine and/or its degraded by-products are considered toxic to certain aquatic creatures

• Cost Effectiveness – B to C

o Products are available from a number of suppliers

**For more in-depth scientific information about Alcohol and other disinfectant chemistries, stay tuned to www.infectionpreventionresource.com.

Bugging Off!


Monday, August 19, 2013

Book Review: Infections and Their Cause, A Historical Review

The past weekend I was astounded yet again, by a group of friends who were spouting off lines from movies dating back to the mid-1980's.  I categorically admit, I suck at trivia - especially pop trivia naming off movies and TV shows or the like.  When picking teams for trivia games, I'm that "unpopular" kid who always gets picked last.  I do however, have an uncanny knack for locking away information about science-based topics.  Do you know what rabbits eat their droppings?  I do...and that was from high school biology class...

It was for that reason that Infections and Their Cause, a Historical Review by Bill Newsom is so fascinating.  Dr. Newsom is a medical microbiologist interested in the history of bacteriology and infection.  The compilation of articles originally published in the British Journal of Infection Control interspersed with diagrams, illustrations and descriptions of his personal experiences make for a most enjoyable read.

Prior to our ability to identify living organisms in the late 19th century, infection was considered to be due to malevolence of evils spirits, witchcraft, or the wrath of god.  Eventually more "scientific" theories emerged such as miasmas consisting of putrid air from decaying animal or vegetable matter, stagnant water or cesspools.  Eventually, it began to be understood that disease was somehow spread from infected patients.

The series of articles found in the book provides a wealth of information and history on the life and work of the founders of the field of infection control and the similarly to Semmelweiss, conclusions drawn by these icons were not initially accepted - even if good evidence was provided.  Where would we be today if Louis Pasteur had not disproved the theory of spontaneous generation with proof that infections were caused by living organisms or Robert Koch and his colleagues identifying the causative organisms of most bacterial diseases by laboratory methods, many of which are still in use today!

Where would we be if John Snow had not recognized that sewage in rivers and streets were a source of contaminating drinking water?  His removal of the Broad Street pump handle from the well that supplied drinking water to residents of Broad Street helped reduced the cholera rates of users of that pump!  Of course the discovery of penicillin by Alexander Fleming in 1929 and its development into a clinical agent by Florey and colleagues was the tipping point if you will for the discovery of a number of antibiotics in the  1940s to the 1960s.

This collection of articles is chalk filled with tidbits of science that will be forever locked away in my grey matter and would make a welcome addition to the bookshelf of microbiologists, infection preventionists and geeks like me who are interested in the history of infection and infection prevention.

Bugging Off!


Friday, August 9, 2013

Cyclospora....the new salad topping?

I would hazard a guess that prior to July 28th, most people had never heard of Cyclospora....unless you've travelled to a tropical or subtropical destination and gotten "traveller's diarrhea"!   A quick Google search this morning resulted in 53 000 hits with news articles, blogs and updates from all the major media outlets, and of course the appropriate governmental agencies such as the CDC, FDA, etc. Of particular interest is how the use of electronic messaging and media attention in the early stages of this outbreak investigation helped public health agencies identify cases which might not otherwise have been considered by health care providers or their patients.

The outbreak has spread through 16 states with a case count of 466 as of Aug 5th, at least 24 of which have hospitalized in five of the affected states.  Iowa has the most reported Cyclospora infections with 146 cases, followed by Texas with 113 cases and Nebraska with 81 cases.  Nebraska and Iowa have concluded that the cause of the outbreak was due to the supply of pre-packaged salad mix to restaurants in those states by Taylor Farms de Mexico, a processor of foodservice salads.   The FDA investigation found that illness clusters at restaurants including Olive Garden and Red Lobster, both of which are owned by Darden Restaurants, were traced to a common supplier. It has been confirmed that the salad mix linked to the outbreak is no longer available.

Cyclospora cayetanensis is a parasite composed of one cell and is too small to be seen without a microscope.  Cyclosporiasis occurs in many countries, but is most commonly found in tropical and subtropical regions.  The risk for infection is seasonal; however no consistent pattern has been identified regarding the time of year or the environmental conditions, such as temperature or rainfall.  In the United States, foodborne outbreaks of Cyclosporiasis since the mid-1990s have been linked to various types of imported fresh produce, including raspberries, basil, snow peas, and mesclun lettuce.  No commercially frozen or canned produce has been implicated.
People become infected with Cyclospora by ingesting fecal matter contaminated with sporulated oocysts, which are the infective form of the parasite. This most commonly occurs when food or water contaminated with feces is consumed.  An infected person sheds unsporulated (non-infective) Cyclospora oocysts in the feces. The oocysts are thought to require days to weeks in favorable environmental conditions to become infective; therefore direct person-to-person transmission and transmission via ingestion of newly contaminated food or water is unlikely.

The time between becoming infected and becoming sick is usually about 1 week.  Cyclospora infects the small intestine causing watery diarrhea with frequent, sometimes explosive, bowel movements.  Other common symptoms include loss of appetite, weight loss, stomach cramps/pain, bloating, nausea, and fatigue.  Vomiting, body aches, headache, fever, and other flu-like symptoms have also been noted as associated symptoms.

As Cyclospora is transmitted only by ingesting contaminated food, avoiding food or water that may have been contaminated with feces is the best way to prevent Cyclosporiasis.   Although it is prudent to thoroughly wash produce that will be eaten raw, this practice may not eliminate the risk of transmission of Cyclospora as treatment with chlorine or iodine is unlikely to kill the Cyclospora oocysts.

It's summer - our traditional salad season.  I can't say I'll stop eating salads over concern about becoming infected with Cyclospora, but I definitely will try to buy from local farms and avoid any packaged salad mix from countries with endemic Cyclospora and poor sanitation programs, THANKFULLY Ohio has only had one case of Cyclospora, so I should be pretty safe on my trip to Cincinnati this week!

Bugging Off!


Friday, August 2, 2013

iPads, iPhones and Blackberrys...oh my!!

When was the last time you observed a healthcare worker (HCW) making notes in a patient’s chart using good old pen and paper on a clipboard?  Personally, I can’t remember the last time I encountered this.  However, if I were to ask when was the last time that you observed a HCW utilizing a smart phone, tablet PC or portable computer workstation at a patient’s bedside, I’m certain most of you would indicate that this is something much more common in today’s healthcare environment.  Fact is, electronic devices such as smart phones, tablets and portable computers have become increasingly important tools for the delivery of healthcare services.  Not surprisingly, many of these items are subsequently at risk of becoming contaminated and acting as a source for the transmission of microorganisms. 

Infection prevention and control related associations such as CHICA-CANADA (Community and Hospital Infection Control Association) have recognized the proliferation of electronic device use and have done their part to establish guidelines and publish their recommendations for electronic devices in healthcare settings.  Needless to say, hand hygiene continues to be the most important factor for preventing the transmission of microorganisms and contamination of the device itself.  Patrick Boshell of Deb spoke to this in his recent blog titled, “Your Mobile Phone is Dirtier Than You Think”.  By diligently following the WHO’s 5 Moments of Hand Hygiene a HCW is most likely to prevent the contamination of the device and reduce the potential transmission of any microorganisms that may be lurking on the shiny touchscreen.

Taking into account that most HCWs are not 100% compliant with hand hygiene, the remainder of CHICA-Canada’s recommendations are centered around the act of effectively cleaning and disinfecting the device itself and ensuring that the device is accompanied by clear instructions on how to do so.  Which brings us to some of the questions that have inundated my email inbox over the past 18-24 months, “How do we clean our iPads?”, “Is this disinfectant approved for use on iPhone or Blackberry?”...etc.  In fact, in the course of writing this blog I have received just such an inquiry from an Infection Preventionist at a prominent Boston area facility.  Boy, do I wish I had an easy answer for her and everyone else that poses these questions.  Unfortunately, many of these devices were simply not developed with their healthcare use in mind and therefore they are not accompanied with cleaning and disinfection directions nor a list of approved disinfectants.  Until the manufacturers of these commonly used electronic devices recognize the importance of validating cleaning and disinfection procedures and the chemical solutions utilized, healthcare end-users will be required to perform their own risk assessments to determine a solution for the situation.  In other words, are there means to mitigate the risk of transmission without having to clean the device?  Or, can the healthcare facility make a simple judgement call that the risk of not cleaning the device far out-weighs the risk of damaging the device with long-term use of cleaning and disinfectant solutions?

Hasta la vista!