Hygiene, Volume 5, Issue 4 (December 2025) – 18 articles

Ensuring optimal food hygiene is essential for food safety and preventing foodborne illness, although the importance of food hygiene is often overlooked in the household kitchen setting. Adequate, good hygiene practices in the domestic environment are equally important as their implementation in any other food preparation environment, like in the food industry. The current review encompasses research data on the prevalence and isolation of major foodborne pathogenic bacteria (Campylobacter, Salmonella, Listeria monocytogenes, Staphylococcus aureus, Escherichia coli pathotypes, and Clostridium perfringens) from household kitchen equipment, as well as food cleaning utensils used in the kitchen, such as sponges, brushes, dishcloths, and hand towels. The most common bacterial pathogen present in the domestic environment is S. aureus. The latter can be transmitted orally, either via direct hand contact with contaminated kitchen surfaces and/or cleaning utensils, or indirectly through the consumption of contaminated food due to cross-contamination during food preparation (e.g., portioning prepared meat on the same cutting board surface and with the same knife previously used to cut fresh leafy vegetables). Moreover, research findings on the hygiene of food cleaning utensils demonstrate that (i) sponges have the highest microbial load compared to all other cleaning utensils, (ii) brushes are less contaminated and more hygienic than sponges, thus safer for cleaning cutlery and kitchen utensils, and (iii) kitchen dishcloths and hand towels positively contribute to cross-contamination since they are frequently used for multiple purposes at the same time (e.g., drying hands and wiping/removing excess moisture from dishes). Finally, the present review clearly addresses the emerging issue of antimicrobial resistance (AMR) in bacterial pathogens and the role of the domestic kitchen environment in AMR dissemination. These issues add complexity to foodborne risk management, linking household practices to broader AMR stewardship initiatives. Full article

The central venous catheter (CVC) is essential in the management of pediatric patients, allowing the administration of medications, parenteral nutrition, and other treatments. However, its use carries a high risk of central-line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI). Advanced chlorhexidine-impregnated dressings have been developed to reduce bacterial colonization, but their effectiveness in the pediatric population remains uncertain. The aim of this review is to evaluate the effectiveness of chlorhexidine-impregnated dressings compared to standard dressings in reducing CLABSI, CRBSI, and CVC colonization in pediatric patients. Randomized clinical trials published between 2005 and 2021 in PubMed, CINAHL, and Embase, in Italian or English, were selected. Methodological quality was assessed using the Joanna Briggs Institute (JBI) checklist. Relevant data were extracted and summarized in tables. Four studies, including a total of 733 pediatric patients (367 intervention, 366 control), were included. None reported a statistically significant reduction in CLABSI/CRBSI with the use of chlorhexidine-impregnated dressings. However, two studies showed a significant reduction in catheter colonization in the intervention group. Current evidence does not support a superior effect of chlorhexidine-impregnated dressings in preventing CLABSI/CRBSI in pediatric patients, although they may reduce catheter colonization. Randomized trials with larger samples and specific methodologies are needed to clarify the true clinical impact. Full article

Period poverty refers to the lack of access to or affordability of menstrual hygiene supplies such as sanitary products and the inaccessibility of washing facilities, waste disposal and educational materials. Period poverty can significantly affect menstruating individuals’ physical, mental, and reproductive health and emotional wellbeing; negatively impact educational outcomes; cause financial strain; result in absenteeism from work and school; create barriers to healthcare access; and perpetuate poor health outcomes for generations. Barriers to menstrual equity include lack of access to period support, cost, poor sanitary facilities, lack of education, social and cultural stigma, and legal restrictions. Therefore, it is crucial to actively advocate for initiatives to increase access to menstrual hygiene products, raise public awareness, and educate individuals on safe menstrual practices. Approximately 500 million girls and women worldwide and an estimated 16.9 million people in the United States experience period poverty, with the issue being particularly common among marginalized groups such as Black or Hispanic menstruating individuals and those who are homeless, living in poverty, of low income, or attending college. This article investigates the physical, psychological, educational and social impacts of inequitable access to menstrual products, menstrual education, and sanitation facilities among menstruating individuals who are Black, Hispanic or of low income within the United States. We examine the threat this poses to health equity and propose recommendations to address this pervasive issue. Full article

Background: In the Philippine basic education system, particularly in Technology and Livelihood Education (TLE) Cookery classes, teachers are at the forefront of promoting proper food hygiene. However, systemic challenges such as the absence of standardized policies, outdated training, and lack of resources hinder their effectiveness. To address this gap, this study aimed to assess the food hygiene knowledge and practices of cookery teachers and provides localized evidence to address the lack of division-level hygiene policies. Methods: A descriptive research design supported by qualitative interviews was employed. In total, 69 junior and senior high school cookery teachers from three school divisions in Ilocos Norte participated. A researcher-made survey questionnaire and an interview guide were used to gather data, which were analyzed using descriptive and inferential statistics. Participant testimonies were integrated to enrich the quantitative findings. Results showed high levels of food hygiene knowledge ($\overline{x}=$ 3.48; Highly Competent) and practices ($\overline{x}=$ 3.80; Highly Competent). Despite these strengths, notable gaps were identified in technical areas such as temperature control, cold storage, and specific aspects of personal hygiene. Conclusions: Interviews highlighted the need for a formal institutional hygiene policy to support teachers’ implementation of safe food-handling practices. All computed p-values were below 0.01, indicating significant correlations between demographic variables and both knowledge and practices. The correlation values ranged from r = 0.039 to r = 0.342, suggesting weak to moderate positive relationships and indicating that hygiene behaviors are influenced by multiple factors rather than demographics alone. Based on the findings, the study recommends institutionalizing the proposed policy brief, providing adequate resources, and implementing continuous professional development for Cookery teachers. The study’s scope is limited to Northern Philippines. Full article

Background: The use of computer-aided design and manufacturing (CAD/CAM) technology is rapidly expanding in modern dentistry. However, differences may exist in educational experiences and utilization competencies between dental hygiene and dental technology students. Objectives: This study aimed to assess CAD/CAM educational exposure and competencies by major and grade level. Methods: A cross-sectional online survey was conducted with 464 undergraduate students in Korea. The questionnaire covered general characteristics, CAD/CAM education experience, and competencies in scanning, CAD design, CAM operation, and post-processing. Data were analyzed using descriptive statistics, independent-samples t-tests, and correlation analysis. Results: A total of 464 valid responses were analyzed. Dental technology students reported significantly higher experience with CAD/CAM education compared with dental hygiene students (p < 0.001). Scanning, CAD design, CAM operation, and post-processing competency were all significantly higher among dental technology students and senior (3–4 year) students compared with dental hygiene and junior (1–2 year) students (p < 0.001). CAD/CAM competencies varied significantly by major and grade level. Conclusions: These findings emphasize the need to strengthen CAD/CAM training in dentistry curricula and to promote interdisciplinary digital dentistry education to prepare practice-ready graduates for a digitized clinical environment. Full article

Background: Environmental surfaces are key reservoirs for pathogen transmission, with the survival of bacteria on fomites influenced by factors such as temperature, humidity, and microbial interactions. This study aimed to determine microbial surface contamination and to determine the antimicrobial resistance profile of bacteria isolated from the indoor surface where the presence of cockroaches was observed in households of the Greater Letaba Municipality (GLM), South Africa. Methods: Swab samples were collected from kitchen countertops and food storage areas with visible cockroach activity. Bacteria were isolated and identified using standard microbiological methods, and antimicrobial susceptibility testing (AST) was conducted with the Vitek^® Automated 2 system. Results: Of the 120 samples collected, 82 (68%) showed bacterial growth, resulting in 190 isolates. The majority of isolates (93%) were Gram-negative, comprising Klebsiella, Pseudomonas, Enterobacter, Escherichia, Serratia, Stenotrophomonas, Pantoea, Raoultella, and Salmonella species, with 98% demonstrating multidrug resistance (MDR) to multiple antibiotics. Resistance was particularly high against gentamicin (94%), fluoroquinolones (88%) and amikacin (77%). Among Gram-positive isolates, all belonged to the Enterococcus species, with 22% being resistant to one or two of the tested antimicrobial agents and 78% exhibiting MDR. Conclusions: The study revealed a high prevalence of antibiotic resistance in both Gram-positive and Gram-negative bacteria isolated from household surfaces. The spread of antibiotic-resistant pathogens via environmental surfaces presents a significant risk to human health, safety, and well-being. Full article

Background: The cysts of the protozoan parasite Giardia duodenalis, which targets a broad spectrum of hosts including humans, can withstand environmental conditions for months, making effective disinfectant measures crucial for minimizing the infection burden. Previous investigations concerning disinfection efficacy were based on cysts from fecal/water samples or animal models, which are either unfit for standardized procedures or related to ethical concerns. Methods: To perform standardized in vitro disinfectant testing, four different encystation protocols were compared firstly. The protocol with the highest efficacy in our hands (1.7 × 10⁵ cysts per tube) was used for the production of cysts to establish a disinfectant assay. Therefore, it was used for the production of cysts to establish a dis-infectant efficacy assay. After incubation with a commercial disinfectant (ViPiBaX Giardien Ex^®) or 30% hydrogen peroxide solution (H₂O₂) at 10 °C and room temperature, parasite cyst viability was evaluated by the yield of trophozoites obtained by the applied excystation protocol. Results: Only untreated Giardia cysts, which were used as a negative con-trol, released trophozoites. The protocol established for the evaluation of cyst viability delivered reproducible results and appeared suitable for testing the inactivation of cysts by chemical disinfection. Conclusions: Under the given conditions, the disinfectant ViPiBaX Giardien Ex^® and H₂O₂ inactivated Giardia cysts. Full article

Introduction: The COVID-19 pandemic disrupted social interactions, family dynamics, and economic stability, disproportionately affecting vulnerable populations. Tuberculosis and leprosy perpetuate poverty and, once manifested, hinder socioeconomic development due to their high potential for disability. Methodology: This study analyzed the impact of the COVID-19 pandemic using DATASUS health data and assessed the influence of socioeconomic interventions (SAGICAD data) on tuberculosis and leprosy case notifications in Brazil. A correlation analysis was performed between regional diagnoses and variables such as Bolsa Família (a national social welfare program), BCG vaccination coverage, and COVID-19 immunization rates, applying Pearson’s correlation test. Results: No significant correlations were found between COVID-19 vaccination rates and tuberculosis/leprosy diagnoses. However, a strong negative correlation (p < 0.05) was observed between BCG (Bacillus Calmette–Guérin) vaccination coverage and leprosy incidence in the Northern region. The findings also suggest that social assistance programs such as Bolsa Família play a pivotal role in preventing infectious diseases in vulnerable areas. Conclusions: Understanding the complex interplay between socioeconomic determinants and public health outcomes is essential for guiding future research and informing health policies, including potential revisions to social programs and vaccination protocols. Full article

Medication non-adherence remains a major challenge in healthcare systems worldwide, with significant implications for patient outcomes and healthcare costs. This study explored the perceptions and practices of Key Opinion Creators (KOCs) in Kosovo regarding medication adherence. Using a qualitative approach, 15 participants representing hospitals, pharmacies, academia, pharmaceutical companies, insurance, and professional associations were surveyed through open-ended questionnaires. Findings reveal the absence of clear national policies or guidelines dedicated to adherence, limited monitoring systems, and insufficient institutional support. While KOCs recognize healthcare professionals’ (HPs) role in patient education, counseling, and monitoring, they also stressed that their engagement is often fragmented and lacks standardized reporting mechanisms. Technology and innovation were identified as promising tools to improve adherence, but their application is limited by inadequate infrastructure and resources. Key barriers include a lack of guidelines, financial and human resource constraints, low patient education, and disparities across demographic groups. The study highlights the urgent need for coordinated policies, stronger inter-professional collaboration, targeted interventions, and integration of digital health solutions to strengthen medication adherence practices in Kosovo. Full article

Sustainable aquaculture is increasingly vital to meet global protein demands while ensuring fish product safety and environmental stewardship from a One Health perspective. This review addresses fish hygiene as a comprehensive, multi-stage challenge encompassing water quality management, pathogen control, antimicrobial stewardship, feeding practices, humane slaughter, post-harvest handling, and monitoring systems. We examined current practices and technologies that promote hygienic standards and reduce contamination risks across production cycles. The integration of biosecurity measures and alternative health-promoting agents contributes to disease prevention and reduces reliance on antimicrobials. Responsible drug administration aligned with regulatory frameworks minimizes residues and antimicrobial resistance. Feeding strategies incorporating sustainable and safe ingredients further support fish health and product quality. Critical control points during slaughter and post-harvest processing ensure microbial safety and prolong shelf life. Advanced monitoring and traceability systems enable real-time oversight and enhance food safety assurance. Finally, certification programs and robust regulatory policies are essential to standardize practices and facilitate access to international markets. Collectively, these strategies foster sustainable aquaculture that safeguards public health, maintains ecological integrity, and supports economic viability. This holistic approach positions fish hygiene not as a final quality check, but as an integral, continuously managed component of responsible aquaculture production. Full article

Background: There is a need to develop comprehensive guidelines to encourage the promotion of oral hygiene care among older adults and to assist caregivers in this endeavor, taking into consideration the specific challenges that arise from aging, comorbidities and caregiving. Methods: This review was conducted by searching across relevant literature from meta-databases including Academic Google, PubMed, Scielo and Scopus for studies published from 2020 to 2024. PRISMA guidelines were followed. We included articles that described oral hygiene methods, caregiver education and mechanization status of older adults. Common themes, best practices, and gaps in current guidelines were tracked using extracted and analyzed data. Results: The review revealed multiple factors affecting the oral hygiene of older adults, with themes relating to physical impairment, cognitive dysfunction, and caregiver involvement. Highlighted between the approaches are individualized therapy for oral hygiene, caregiver education, and the use of technology to improve adherence to oral hygiene. Barriers like dental care access, underlying medical conditions complicating dental treatments, and cost considerations were identified. Conclusions: The findings emphasize the necessity of clear recommendations that can help caregivers and advance dental care for older adults. Full article

Background: Denture stomatitis (DS) represents an oral fungal infection induced by Candida albicans, impacting approximately 70% of the individuals who use removable acrylic dentures. Researchers suggest that the high level of the Candida species, particularly Candida albicans (C. albicans), is the predominant etiological factor of DS. Consequently, the development of a soft liner with antifungal activity might significantly enhance its therapeutic applicability. This in vitro study evaluates the impact of phosphate bioactive glass reinforced heat-cured acrylic-based soft liner on the candidal activity in this material. Method: Specimens (10 mm × 2 mm disc-like) were required for the selected test; PBG-Sr nano-powder was synthesized and added to the soft liner at percentages of 1 wt.%, 3 wt.%, 5 wt.%, and 7 wt.%. The candidal adherence test was investigated, and characterization was performed by X-ray diffraction analysis, field emission scanning electron microscopy, energy dispersive X-ray spectroscopy mapping, and particle size analysis. The resulting data were analyzed with one-way ANOVA followed by Dunnett’s test. Results: Candidal adherence in the 1 wt.%, 3 wt.%, 5 wt.%, and 7 wt.% PBG-Sr subgroups had decreased values in comparison to the control (0 wt.%), with the 7 wt.% subgroup demonstrating the lowest count of C. albicans (0.027), close to the nystatin group. Conclusions: PBG-Sr can diminish C. albicans adhesion in soft lining materials, and a soft liner containing PBG-Sr (7 wt.%) showed the most effective activity against C. albicans in the soft liner. Soft liners infused with bioactive glass may have the potential to assist those struggling with denture stomatitis, providing patients with enhanced therapeutic qualities. Full article

Healthcare workers, particularly those in training, face significant exposure to biological risks, including needlestick and sharps injuries, which remain a critical occupational hazard. This study examines the incidence and nature of such injuries among young healthcare trainees at the University of Campania “L.Vanvitelli,” with the aim of providing useful information for designing an effective preventive program. From 2014 to 2023, a study population of 14,908 health students was subject to health surveillance, of which 141 workers suffered an occupational injury. Needlestick injuries were most common (67.4%). Surgical residents were the most affected subgroup (24.8%). Injuries occurred more frequently after the first year of training (74.5%). Multivariate logistic regression showed significantly higher odds of injury for nursing students (OR = 8.673; 95% CI: 3.196–35.634) and residents (OR = 50.726; 95% CI: 17.789–214.279) compared to medical students. The findings underscore the urgent need for enhanced risk management strategies, targeted education programs, and stricter adherence to safety regulations to protect this vulnerable population. Full article

Background: With the increasing popularity and diversification of cosmetic products, an expanding number of retail stores are providing in-store testers to allow consumers to try products before purchasing. However, growing concerns have been raised about microbial contamination and the associated risk of infection due to the shared use of these testers. This study aimed to investigate consumer awareness and perceived susceptibility to microbial infection associated with the use of lip cosmetic testers, and to identify major pathogenic bacteria, thereby offering evidence to support the need for improved hygiene management practices. Methods: The survey examined the use of lip cosmetic testers and related side effects, as well as perceptions of product hygiene and microbial contamination. Awareness of microbial infection and consumer sensitivity to product safety were measured using a five-point Likert scale. Microorganisms were detected through PCR analysis of genomic DNA. Results: Among 134 respondents, 95% had previously used lip cosmetic testers, and 90% recognized the potential for microbial contamination. Sensitivity to product safety was not significantly associated with sociodemographic factors. However, susceptibility to microbial infection from tester use was significantly higher among participants of older age and with higher education levels. PCR analysis of lip cosmetic testers revealed frequent detection of Staphylococcus epidermidis and Pseudomonas aeruginosa. Other detected bacteria included Streptococcus oralis, Streptococcus salivarius, Streptococcus pneumoniae, and Escherichia coli, all of which are known to cause oral and respiratory infections. Conclusions: The analysis revealed that the majority of individuals who have used lip cosmetic testers expressed a high level of concern regarding product contamination and the potential for infection. Multiple pathogenic bacteria linked to oral and respiratory diseases were identified in the opened tester products. These findings underscore the necessity of establishing regulatory guidelines for the management of lip cosmetic testers and highlight the importance of enhancing consumer awareness regarding hygiene practices. Full article

Breastfeeding is a complex biological system and a bidirectional physiological dialogue in which the infant may contribute to maternal breast health. This review synthesizes current evidence, clearly separating established findings from emerging hypotheses, to examine the possible infant-driven mechanisms that influence hormonal and immune homeostasis in the mammary gland. We evaluate how neonatal suckling coordinates interconnected hormonal reflexes and immune activity, and we explore the hypothesis that the retrograde flow of infant saliva to the breast tissue could activate maternal enzymatic defenses, particularly the xanthine oxidase and lactoperoxidase systems. We also consider the activation of antimicrobial peptides through direct contact at the nipple and areola, including cathelicidin and defensins, as well as the potential roles of fetal microchimerism and microbial transfer from the infant’s mouth in strengthening breast resilience. Although much of the evidence remains indirect and based on in vitro and animal models, the convergence of data supports a reformulated conceptual model that presents the infant as an active physiological partner rather than a passive recipient of milk. Recognizing this shift has important clinical implications for the prevention of inflammatory conditions such as mastitis, the improvement of breastfeeding support strategies, and the optimization of maternal and infant health outcomes. The review also identifies significant gaps in current knowledge and cautiously proposes hypotheses to explore these mechanisms. While preliminary, this framework offers an original perspective that may guide future research and open new paths in the study of human lactation biology. Full article

Oral hygiene protocols and basic oral care (BOC) are paramount for patients undergoing cancer treatment, although based upon limited evidence from clinical trials. There are a range of oral care guidelines proposed in the literature mainly focusing on oral mucositis prevention. This systematic review aimed to define the best procedures and practices in the scope of oral hygiene protocols and BOC interventions for the prevention and/or treatment of oral complications in patients under cancer treatment. This systematic review was conducted according to the PRISMA guidelines, and the methods were previously established and registered in PROSPERO (CRD42022319455). A systematic search was completed in six databases (PubMed, Scopus, Web of Science, LILACS, and the Cochrane Library, and gray literature). Eleven studies were included in the qualitative analysis including non-randomized (n = 1) and randomized clinical trials (n = 6), and cohort studies (n = 4). The included studies showed the effectiveness of soft brushes for daily oral hygiene with topical fluoride, and the use of mouthwashes with 0.12% chlorhexidine, doxepin, and benzydamine and saline solutions, as well as dental scaling/prophylaxis in decreasing the severity of oral toxicities. Although not well-explored by well-designed clinical studies, BOC protocols may be effective in prevention oral toxicities from cancer therapy and are supported in multiple guidelines. This review synthesized available evidence on BOC in head and neck cancer patients, focusing on the effectiveness of hospital-based dental protocols during cancer treatment. Full article

Artificial intelligence (AI) is progressively being utilized in the healthcare sector to enhance efficiency, alleviate administrative burdens, and improve patient care outcomes. In the secondary healthcare sector, AI presents a range of opportunities as well as challenges. This study investigates the viewpoints of healthcare professionals regarding the adoption of AI in Greece, emphasizing the anticipated advantages and apprehensions associated with its integration. A cross-sectional descriptive study was carried out to collect responses from healthcare professionals at the General Hospital of “Evangelismos”, which is the largest hospital in Athens, Greece. A questionnaire was utilized and distributed over a period of four months, involving 513 registered healthcare professionals (comprising 136 physicians, 235 nursing staff, and 142 other healthcare personnel). Each participant had a minimum of one year of clinical experience and was selected using a convenience sampling method. The questionnaire comprised two parts: one focused on evaluating the AI knowledge and attitudes of healthcare professionals, and the other collected demographic data. The overall comprehension of knowledge pertaining to AI among healthcare professionals was evaluated as moderate, resulting in a mean score of 3.39. A distinction exists among different personnel categories, with physicians (M = 3.73) demonstrating a greater understanding of AI and a firm conviction that AI cannot supplant human positions. Conversely, nursing personnel appear to express apprehension regarding the implications of AI on the human experience, with a notable concern about potential replacement and job loss (M = 2.63), which was identified as the lowest-ranked issue. This latter concern is also echoed by other healthcare personnel (M = 2.90). Nevertheless, the majority of participants regard the prospective use of AI favorably, demonstrate confidence in its application, and contend that the benefits outweigh the possible risks. Sufficient training and ongoing updates would enhance employees’ comprehension of AI and their awareness of its potential benefits within the healthcare sector. Full article

This study aimed to explore psychosocial factors in a sample of Peruvian workers, examine their convergence with the PROPSIT model, and identify the emergence of new or idiosyncratic psychosocial dimensions. At the same time, the quality and efficiency of the categorization process were evaluated. n = 48 workers were contacted by a non-probabilistic sampling method and asked to fill out a form with open-ended questions that explored negative stressors and positive engaging factors. Some strategies were used to assess the quality and efficiency of the categorization process. The results showed that the quality, speed, and reliability of the categorization procedure were satisfactory, and several categories were aligned with the PROPSIT model and other literature, both in their negative aspects (workload and rhythm, working hours, shifts, etc.) and positive aspects (rewarding tasks, atmosphere of unity, etc.). The emerging new categories were confined to aspects of teamwork and conflict climate, as well as topics such as order, cleanliness, and recreation. These findings underline the need to adapt existing models and instruments to capture idiosyncratic aspects of the Peruvian work environment. In conclusion, this study validated an efficient mixed approach for categorizing psychosocial work factors in Peru, revealing both PROPSIT-aligned and novel context-specific categories, and highlighting the need for culturally adapted tools and broader validation. Full article