Vancomycin taper and pulse regimens are commonly used to treat recurrent infections, but the mechanism by which these regimens might reduce recurrences is unclear. Here, we used a mouse model to test the hypothesis that pulse dosing of vancomycin after a 10-day treatment course enhances clearance of from the intestinal tract. Mice with colonization received 10 days of once-daily oral vancomycin followed by 20 days of treatment with saline (controls), daily vancomycin, or pulse dosing of vancomycin every 2 or 3 days.
View Article and Find Full Text PDFInfect Control Hosp Epidemiol
January 2024
We tested the effectiveness of 23 disinfectants used in healthcare facilities against isolates from the 4 major clades of Sporicidal disinfectants were consistently effective, whereas quaternary-ammonium disinfectants had limited activity. Quaternary-ammonium-alcohol and hydrogen-peroxide-based disinfectants varied in effectiveness against .
View Article and Find Full Text PDFInfect Control Hosp Epidemiol
May 2023
A novel 1-step anionic surfactant disinfectant was effective against isolates from the 4 major phylogenetic clades as well as methicillin-resistant (MRSA) and the enveloped virus bacteriophage Phi6. This anionic surfactant disinfectant may be a useful addition to the disinfectant products available for use against .
View Article and Find Full Text PDFA novel 4% hydrogen peroxide disinfectant was effective against methicillin-resistant Staphylococcus aureus (MRSA), Clostridioides difficile spores, carbapenem-resistant Escherichia coli, and 2 strains of Candida auris. In laboratory testing, a sodium hypochlorite disinfectant caused fading and loss of pliability of a hospital mattress, but the hydrogen peroxide disinfectant did not. These findings suggest that the hydrogen peroxide-based disinfectant may be a useful addition to the sporicidal disinfectant products available for use in healthcare settings.
View Article and Find Full Text PDFInfect Control Hosp Epidemiol
August 2022
Objective: To investigate the frequency of environmental contamination in hospital areas outside patient rooms and in outpatient healthcare facilities.
Design: Culture survey.
Setting: This study was conducted across 4 hospitals, 4 outpatient clinics, and 1 surgery center.
Background: Ultraviolet-C (UV-C) light devices are effective in reducing contamination on N95 filtering facepiece respirators. However, limited information is available on whether UV-C devices meet the Food and Drug Administration's (FDA) microbiological requirements for Emergency Use Authorization (EUA) for respirator bioburden reduction.
Methods: We tested the ability of 2 UV-C light boxes to achieve the 3-log microorganism reductions required for EUA for reuse by single users.
A single spray application of a continuously active disinfectant on portable equipment resulted in significant reductions in aerobic colony counts over 7 days and in recovery of Staphylococcus aureus and enterococci: 3 of 93 cultures (3%) versus 11 of 97 (11%) and 20 of 97 (21%) in quaternary ammonium disinfectant and untreated control groups, respectively.
View Article and Find Full Text PDFInfect Control Hosp Epidemiol
June 2022
Background: Ultraviolet-C (UV-C) light devices could be useful to reduce environmental contamination with . However, variable susceptibility of strains to UV-C has been reported, and the high cost of many devices limits their use in resource-limited settings.
Objective: To evaluate the efficacy of relatively low-cost (<$15,000 purchase price) UV-C devices against strains from the 4 major phylogenetic clades.
Objective: To assess the potential for contamination of personnel, patients, and the environment during use of contaminated N95 respirators and to compare the effectiveness of interventions to reduce contamination.
Design: Simulation study of patient care interactions using N95 respirators contaminated with a higher and lower inocula of the benign virus bacteriophage MS2.
Methods: In total, 12 healthcare personnel performed 3 standardized examinations of mannequins including (1) control with suboptimal respirator handling technique, (2) improved technique with glove change after each N95 contact, and (3) control with 1-minute ultraviolet-C light (UV-C) treatment prior to donning.
Objective: To evaluate the use of colorimetric indicators for monitoring ultraviolet-C (UV-C) light delivery to sites in patient rooms.
Methods: In laboratory testing, we examined the correlation between changes in color of 2 commercial colorimetric indicators and log10 reductions in methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile spores with exposure to increasing doses of UV-C from a low-pressure mercury room decontamination device. In patient rooms, 1 of the colorimetric indicators was used to assess UV-C dose delivery to 27 sites in the room.
Infect Control Hosp Epidemiol
September 2021
Objective: To investigate the timing and routes of contamination of the rooms of patients newly admitted to the hospital.
Design: Observational cohort study and simulations of pathogen transfer.
Setting: A Veterans' Affairs hospital.
Background: Contaminated surfaces are a potential source for spread of respiratory viruses including SARS-CoV-2. Ultraviolet-C (UV-C) light is effective against RNA and DNA viruses and could be useful for decontamination of high-touch fomites that are shared by multiple users.
Methods: A modification of the American Society for Testing and Materials standard quantitative carrier disk test method (ASTM E-2197-11) was used to examine the effectiveness of UV-C light for rapid decontamination of plastic airport security bins inoculated at 3 sites with methicillin-resistant (MRSA) and bacteriophages MS2, PhiX174, and Phi6, an enveloped RNA virus used as a surrogate for coronaviruses.
In the setting of the coronavirus disease 2019 pandemic, efficient methods are needed to decontaminate shared portable devices and large open areas such as waiting rooms. We found that wheelchairs, portable equipment, and waiting room chairs were frequently contaminated with potential pathogens. After minimal manual precleaning of areas with visible soiling, application of a dilute sodium hypochlorite disinfectant using an electrostatic sprayer provided rapid and effective decontamination and eliminated the benign virus bacteriophage MS2 from inoculated surfaces.
View Article and Find Full Text PDFBackground: Shortages of personal protective equipment (PPE) including N95 respirators are an urgent concern in the setting of the global COVID-19 pandemic. Decontamination of PPE could be useful to maintain adequate supplies, but there is uncertainty regarding the efficacy of decontamination technologies.
Methods: A modification of the American Society for Testing and Materials standard quantitative carrier disk test method (ASTM E-2197-11) was used to examine the effectiveness of 3 methods, including ultraviolet-C (UV-C) light, a high-level disinfection cabinet that generates aerosolized peracetic acid and hydrogen peroxide, and dry heat at 70°C for 30 minutes.