Search Results (27)

Pseudomonas aeruginosa is a highly adaptable opportunistic pathogen with significant clinical relevance in both human and veterinary medicine. Despite its well-documented role in hospital-acquired infections in human healthcare settings, its persistence and transmission within veterinary clinics remain underexplored. This review highlights the overlooked status of veterinary facilities as environmental reservoirs and amplification points for multidrug-resistant (MDR) P. aeruginosa, emphasizing their relevance to One Health surveillance. We examine the bacterium’s environmental survival strategies, including biofilm formation, resistance to disinfectants, and tolerance to nutrient-poor conditions that facilitate the long-term colonization of moist surfaces, drains, medical equipment, and plumbing systems. Common transmission vectors are identified, including asymptomatic animal carriers, contaminated instruments, and the hands of veterinary staff. The review synthesizes current data on antimicrobial resistance in environmental isolates, revealing frequent expression of efflux pumps and mobile resistance genes, and documents the potential for zoonotic transmission to staff and pet owners. Key gaps in environmental monitoring, infection control protocols, and genomic surveillance are identified, with a call for standardized approaches tailored to the veterinary context. Control strategies, including mechanical biofilm disruption, disinfectant cycling, effluent monitoring, and staff hygiene training, are evaluated for feasibility and impact. The article concludes with a One Health framework outlining cross-species and environmental transmission pathways. It advocates for harmonized surveillance, infrastructure improvements, and intersectoral collaboration to reduce the risk posed by MDR P. aeruginosa within veterinary clinical environments and beyond. By addressing these blind spots, veterinary facilities can become proactive partners in antimicrobial stewardship and global resistance mitigation. Full article

Objective: Current good manufacturing practice (cGMP) guidance for positron emission tomography (PET) drugs has been established in Europe and the United States. In Japan, the Pharmaceuticals and Medical Devices Agency (PMDA) approved the use of radiosynthesizers as medical devices for the in-house manufacturing of PET drugs in hospitals and clinics, regardless of the cGMP environment. Without adequate facilities, equipment, and personnel required by cGMP regulations, the quality assurance (QA) and clinical effectiveness of PET drugs largely depend on the radiosynthesizers themselves. To bridge the gap between radiochemistry standardization and site qualification, the Japanese Society of Nuclear Medicine (JSNM) has issued guidance for the in-house manufacturing of small-scale PET drugs under academic GMP (a-GMP) environments. The goals of cGMP and a-GMP are different: cGMP focuses on process optimization, certification, and commercialization, while a-GMP facilitates the small-scale, in-house production of PET drugs for clinical trials and patient-specific standard of care. Among PET isotopes, N-13 has a short half-life (10 min) and must be synthesized on site. [¹³N]Ammonia ([¹³N]NH₃) is used for myocardial perfusion imaging under the Japan Health Insurance System (JHIS) and was thus selected as a working example for the manufacturing of PET drugs in an a-GMP environment. Methods: A [¹³N]NH₃-radiosynthesizer was installed in a hot cell within an a-GMP-compliant radiopharmacy unit. To comply with a-GMP regulations, the air flow was adjusted through HEPA filters. All cabinets and cells were disinfected to ensure sterility once a month. Standard operating procedures (SOPs) were applied, including analytical methods. Batch records, QA data, and radiation exposure to staff in the synthesis of [¹³N]NH₃ were measured and documented. Results: 2.52 GBq of [¹³N]NH₃ end-of-synthesis (EOS) was obtained in an average of 13.5 min in 15 production runs. The radiochemical purity was more than 99%. Exposure doses were 11 µSv for one production run and 22 µSv for two production runs. The pre-irradiation background dose rate was 0.12 µSv/h. After irradiation, the exposed dosage in the front of the hot cell was 0.15 µSv/h. The leakage dosage measured at the bench was 0.16 µSv/h. The exposure and leakage dosages in the manufacturing of [¹³N]NH₃ were similar to the background level as measured by radiation monitoring systems in an a-GMP environments. All QAs, environmental data, bacteria assays, and particulates met a-GMP compliance standards. Conclusions: In-house a-GMP environments require dedicated radiosynthesizers, documentation for batch records, validation schedules, radiation protection monitoring, air and particulate systems, and accountable personnel. In this study, the in-house manufacturing of [¹³N]NH₃ under a-GMP conditions was successfully demonstrated. These findings support the international harmonization of small-scale PET drug manufacturing in hospitals and clinics for future multi-center clinical trials and the development of a standard of care. Full article

Introduction: Healthcare-associated infections (HAIs) pose a significant global challenge, resulting in prolonged hospital stays, higher healthcare costs, and increased morbidity and mortality rates. Reusable medical equipment, such as tourniquets, represents a potential vector for infection transmission. Despite frequent use and close contact with patients’ skin, infection control protocols often overlook these devices. This study examines microbial contamination on the surface of reusable tourniquets in both emergency department and operating theatre settings. Methods: A cross-sectional study was conducted between March and September 2024 in Gdansk, Poland. Samples from tourniquets used in the emergency department and the operating theatre were collected after an indefinite period, 14 days, and 28 days. Bacterial contamination on the surfaces of the tourniquets was measured using Columbia agar blood medium and expressed as colony-forming units (CFUs) per cm². Results: Significant bacterial loads were detected on reusable tourniquets, with contamination levels varying by location and duration of use. The average number of CFU/cm² across all stages of this study was 545 CFU/cm² for the emergency department and 101 CFU/cm² for the operating theatre. Tourniquets used in the emergency department exhibited higher bacterial counts compared to those from the operating theatre, which showed a greater diversity of bacterial species. These findings underscore the need to revise infection control protocols for reusable tourniquets. Conclusion: This study provides critical data that may influence future policy changes aimed at reducing the risk of HAIs through the improved management of reusable medical devices. Full article

Spore-forming bacterial species pose a serious threat to food plants and healthcare facilities that use high-temperature processing and sterilizing techniques to sanitize medical equipment and food items. These severe processing conditions trigger sporulation, which is the process by which spore-forming bacteria, such as those of the Bacillus and Clostridium species, begin to produce spores, which are extremely resilient entities capable of withstanding adverse environmental circumstances. Additionally, these spores are resistant to a wide range of disinfectants and antibacterial therapies, such as hydrolytic enzymes, radiation, chemicals, and antibiotics. Because of their ability to combat bacteria through several biological pathways, selenium nanoparticles (SeNPs) have emerged as an effective method for either eliminating or preventing the formation of spore-forming bacteria. This review aims to investigate every potential pathway of entry and mechanism by which SeNPs impact bacterial species that produce spores. Additionally, SeNPs’ antibacterial efficacy against several infections is reviewed. To precisely explain the antibacterial mechanism of SeNPs and the various factors that can affect their effectiveness, more research is necessary. Full article

Dental students are frequently exposed to percutaneous injuries (PCIs) due to the nature of their clinical work, which involves sharp instruments and close patient contact. The COVID-19 pandemic further emphasized the need for stringent biosafety measures and the use of personal protective equipment (PPE). Despite these precautions, injuries remain prevalent, highlighting the need for comprehensive education and training in biosafety and infection control. This study investigates the incidence and causes of injuries among undergraduate dental students during clinical sessions. This study was conducted at the Department of Dentistry, National and Kapodistrian University of Athens, focusing on injuries reported from 2021 to 2024. Data were collected through self-reported clinical records. The primary variables assessed included the type of injury, the instrument involved, the clinical procedure performed, and the immediate actions taken post-injury. Serological testing was conducted on students and patients to assess the risk of the transmission of bloodborne pathogens. The findings reveal a high prevalence of injuries, with needles being the most common cause (51.4%), followed by other tools such as dental probes (25.7%) and burs (8.6%). The most frequent injury type is piercing (74.2%), primarily affecting the fingers (88.6%). Periodontal treatments, restorative procedures, and endodontic treatments are the main activities leading to injuries, with 17.1% of injuries being caused by each. No statistically significant results are recorded. Despite regular medical records for most patients treated by injured students, serological testing shows significant positivity rates for HCV and HBV. Notably, most injured students demonstrate their commitment to safety by adhering to recommended post-exposure protocols, including wound cleaning, disinfecting, and serological testing. Furthermore, the impact of COVID-19 heightened the importance of personal protective equipment (PPE) and reinforced occupational health standards. Our study highlights the critical need for enhanced biosafety awareness and training among undergraduate dental students to reduce injury risks. Full article

This study aimed to characterize Pseudomonas aeruginosa strains isolated from hospitalized patients during the COVID-19 pandemic. This was achieved using phenotypic and molecular techniques, including their antimicrobial resistance profile and biofilm formation. Eighteen strains were isolated from a hospital in Rio de Janeiro, Brazil, and identified by VITEK^®2, MALDI-TOF/MS (VITEK MS^® and MALDI Biotyper^®), and 16S rRNA sequencing. Fourier-transform infrared (FTIR) spectroscopy, antimicrobial susceptibility testing, and biofilm formation and disinfectant tolerance tests were applied to evaluate the virulence characteristics of the strains. VITEK^®2 (≥99%), VITEK MS^® (≥82.7%), and MALDI Biotyper^® (score ≥ 2.01) accurately identified the P. aeruginosa strains, but 16S rRNA sequencing did not differentiate the species P. aeruginosa from P. paraeruginosa. FTIR typing identified three different clusters, but no correlation between the phenotypical or antimicrobial susceptibility testing patterns was found. Most strains exhibited resistance to various antimicrobials. The exceptions were sensitivity to amikacin and norfloxacin, and consequently, these could be considered potential treatment options. Most strains (n = 15, 83.3%) produced biofilms on polystyrene. Sodium hypochlorite treatment (0.5%/15 min) was shown to be the most effective disinfectant for biofilm elimination. P. aeruginosa biofilm formation and tolerance to disinfectants demonstrate the need for effective cleaning protocols to eliminate contamination by this organism in the hospital environment and medical equipment. Full article

This study explores the progression of global healthcare and medical waste (HMW) disposal technologies and emerging practices in China including the COVID-19 pandemic period through patent technology innovation analysis. Trends were identified through both the Derwent Innovation Index database and bibliometric methods. Based on the bibliometric analysis of 4128 patents issued from 2002 to 2021, the development status and research trends of HMW disposal technology were revealed. Regarding patents, China significantly advanced post-2011. However, a large number of applications are filed only in China and are more focused on domestic rather than overseas markets. As the pandemic remains a threat, and increasing amounts of medical waste are generated, new technologies are being sought in China that will be safer for humans and the environment, and will also be in line with the zero waste technology trend. Incineration and waste crushing are core methodologies in medical waste disposal. Future directions pivot towards innovations in large-scale and distributed processing equipment, automation and unmanned systems and high-temperature steam disinfection collaborative disposal methods—including the “High temperature steam–municipal solid waste incineration collaborative technology” and the “High temperature steam–thermal magnetic gasification collaborative technology”. This patent analysis enhances our understanding of the impact of COVID-19 on HMW disposal practices, guiding improved policymaking and research in the HMW sector. Full article

Despite the significant consequences for medical practice and public health, burnout in healthcare workers remains underestimated. Pandemic periods have increased the reactivity to stress by favoring some changes whose influence are still felt. Purpose: This study aims to identify opportune factors during pandemic periods that predispose medical personnel to burnout and the differences between medical staff which worked with COVID-19 patients and those who did not work with COVID-19 patients. Material and Methods: This is a prospective study on 199 subjects, medical staff and auxiliary staff from national health units, COVID-19 and non-COVID-19, who answered questions using the Google Forms platform about the level of stress related to the workplace and the changes produced there. All statistical analyses were conducted using IBM SPSS Statistics (Version 28). Results: The limited equipment and disinfectant solutions from the lack of medical resources category, the fear of contracting or transmitting the infection from the fears in relation to the COVID-19 pandemic category and the lack of personal and system-level experience in combating the infection due to the lack of information on and experience with COVID-19 were the most predisposing factors for burnout. No significant differences were recorded between those on the front line and the other healthcare representatives. Conclusions: The results of this study identify the stressors generated in the pandemic context with prognostic value in the development of burnout among medical personnel. At the same time, our data draw attention to the cynicism or false-optimism stage of burnout, which can mask a real decline. Full article

Given the growing ecological footprint of anthropomorphic activities, considering the environmental impacts of any process is becoming increasingly important. This is especially true for the healthcare industry, whose objective of maintaining human health standards is impeded by its own unsustainable practices. To this end, life cycle analysis is particularly helpful. There have not been many life cycle analyses performed on a healthcare device or on medical procedures. Many medical devices are single use, which leads to a significant waste management problem, particularly as plastic is widely used in their composition. The objective of this study is to present a life-cycle-thinking-based approach to compare the environmental impacts associated with single-use electrophysiological catheters with the sterilization of reusable electrophysiological catheters using hydrogen peroxide, ethylene oxide, and peracetic acid. A life cycle assessment was conducted considering different use, disinfection, and disposal scenarios for electrophysiological catheters, using ReCiPe midpoint and endpoint analysis with the SimaPro software. The findings indicate that using single-use disposable electrophysiological catheters, instead of sterilizing a single catheter using either ETO or hydrogen peroxide and reusing multiple times, is preferable from a purely environmental perspective. However, the costs reduce drastically when equipment is sterilized and reused instead of disposing them after using one time. This in turn illustrates that depending on the process, sanitizing and reusing medical devices may not always be more resource-efficient than single device usage. From a cost perspective, ETO sterilization has the lowest costs, and yet it leads to an aggregate environmental impact of over 20 times compared to the single-use scenario, mainly due to the required detoxification process. The outcomes of this research will assist the health care industry in identifying the most suitable operational procedures considering patient safety, economics, and environmental stewardship, and in developing policies and guidelines for a more sustainable healthcare sector. Full article

We propose the use of an n-doped periodic AlN/GaN quantum cascade structure for the optical up-conversion of multiple near-infrared (near-IR) photons into deep-ultraviolet (deep-UV) radiation. Without applying an external bias voltage, the active region of such a device will (similar to an un-biased quantum cascade laser) resemble a sawtooth-shaped inter-subband structure. A carefully adjusted bias voltage then converts this sawtooth pattern into a ‘quantum-stair’. Illumination with λ = 1.55 µm radiation results in photon absorption thereby lifting electrons from the ground state of each main well into the first excited state. Three additional GaN quantum wells per period then provide by LO-phonon-assisted tunneling a diagonal transfer of these electrons towards the ground level of the neighboring period. From there, the next near-infrared (near-IR) photon absorption, electron excitation, and partial relaxation takes place. After 12 such absorption, transfer, and relaxation processes, the excited electrons have gained a sufficiently high amount of energy to undergo in the final AlN-based p-type contact layer an electron-hole band-to-band recombination. By employing this procedure, multiple near-IR photons will be up-converted to produce deep-UV radiation. Since for a wavelength of 1.55 µm very powerful near-IR pump lasers are readily available, such an up-conversion device will (even at a moderate overall conversion efficiency) potentially result in an equal or even higher output power than the one of an AlN-based p-n-junction light-emitting diode. The proposed structures are therefore very interesting for applications such as ultra-high-resolution photolithography or printing, water purification, medical equipment disinfection, white light generation, or the automotive industry. Full article

COVID-19, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), placed health systems worldwide under immense pressure, and healthcare workers (HCWs) were at the front lines. The Puerto Rico Department of Health confirmed the first case of COVID-19 in March 2020. We aimed to assess whether COVID-19 preventive measures implemented by HCWs were effective in a work scenario before vaccine availability. We conducted a descriptive cross-sectional study from July to December 2020 to evaluate the use of personal protective equipment (PPE), hygiene guidelines, and other measures taken by HCWs to prevent the spread of SARS-CoV-2. We collected nasopharyngeal specimens for molecular testing at the beginning of the study and follow-up. We recruited 62 participants aged 30–59 (79% women). Participants recruited from hospitals, clinical laboratories, and private practice included medical technologists (33%), nurses (28%), respiratory therapists (2%), physicians (11%), and others (26%). Among our participants, nurses were at higher risk (p < 0.05) of infection. We identified that 87% of participants followed the hygiene recommendation guidelines. In addition, all participants practiced handwashing or disinfection before or after caring for each patient. All participants tested negative for SARS-CoV-2 during the study period. On follow-up, all study participants reported being vaccinated against COVID-19. The implementation of PPE and hygiene measures showed high efficacy as a prevention method against SARS-CoV-2 infection when vaccines and treatment were not widely available in Puerto Rico. Full article

Pathogenic bacteria and viruses in medical environments can lead to treatment complications and hospital-acquired infections. Current disinfection protocols do not address hard-to-access areas or may be beyond line-of-sight treatment, such as with ultraviolet radiation. The COVID-19 pandemic further underscores the demand for reliable and effective disinfection methods to sterilize a wide array of surfaces and to keep up with the supply of personal protective equipment (PPE). We tested the efficacy of Sani Sport ozone devices to treat hospital equipment and surfaces for killing Escherichia coli, Enterococcus faecalis, Bacillus subtilis, and Deinococcus radiodurans by assessing Colony Forming Units (CFUs) after 30 min, 1 h, and 2 h of ozone treatment. Further gene expression analysis was conducted on live E. coli K12 immediately post treatment to understand the oxidative damage stress response transcriptome profile. Ozone treatment was also used to degrade synthetic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA as assessed by qPCR CT values. We observed significant and rapid killing of medically relevant and environmental bacteria across four surfaces (blankets, catheter, remotes, and syringes) within 30 min, and up to a 99% reduction in viable bacteria at the end of 2 h treatment cycles. RNA-seq analysis of E. coli K12 revealed 447 differentially expressed genes in response to ozone treatment and an enrichment for oxidative stress response and related pathways. RNA degradation of synthetic SARS-CoV-2 RNA was seen an hour into ozone treatment as compared to non-treated controls, and a non-replicative form of the virus was shown to have significant RNA degradation at 30 min. These results show the strong promise of ozone treatment of surfaces for reducing the risk of hospital-acquired infections and as a method for degradation of SARS-CoV-2 RNA. Full article

Global society has been highly pressured by the COVID-19 pandemic, which has exposed vulnerabilities in supply chains for disinfection products, personal protective equipment, and medical resources worldwide. It is critically necessary to find effective treatments and medications for these viral infections. This review summarizes and emphasizes critical features of recent breakthroughs in vaccines, inhibitors, radiations, and innovative nonthermal atmospheric plasma (NTAP) technologies to inactivate COVID-19. NTAP has emerged as an effective, efficient, and safe method of viral inactivation. NTAP can be used to inactivate viruses in an environmentally friendly manner, as well as activate animal and plant viruses in a variety of matrices. Researchers and engineers desire to help the medical world deal with the ongoing COVID-19 epidemic by establishing techniques that make use of widely available NTAP technologies. NTAP technology is not dependent on viral strain, and it does not necessitate months or years of research to develop specific vaccines for each novel or arising viral disease. We believe the NTAP is a highly promising technique for combating COVID-19 and other viruses. Thus, NTAP technology could be a significant breakthrough in the near future in assisting humans in combating COVID-19 infections. We hope that this review provides a platform for readers to examine the progress made in the fight against COVID-19 through the use of vaccines, inhibitors, radiation, and NTAP. Full article

Lung ultrasound images have shown great promise to be an operative point-of-care test for the diagnosis of COVID-19 because of the ease of procedure with negligible individual protection equipment, together with relaxed disinfection. Deep learning (DL) is a robust tool for modeling infection patterns from medical images; however, the existing COVID-19 detection models are complex and thereby are hard to deploy in frequently used mobile platforms in point-of-care testing. Moreover, most of the COVID-19 detection models in the existing literature on DL are implemented as a black box, hence, they are hard to be interpreted or trusted by the healthcare community. This paper presents a novel interpretable DL framework discriminating COVID-19 infection from other cases of pneumonia and normal cases using ultrasound data of patients. In the proposed framework, novel transformer modules are introduced to model the pathological information from ultrasound frames using an improved window-based multi-head self-attention layer. A convolutional patching module is introduced to transform input frames into latent space rather than partitioning input into patches. A weighted pooling module is presented to score the embeddings of the disease representations obtained from the transformer modules to attend to information that is most valuable for the screening decision. Experimental analysis of the public three-class lung ultrasound dataset (PCUS dataset) demonstrates the discriminative power (Accuracy: 93.4%, F1-score: 93.1%, AUC: 97.5%) of the proposed solution overcoming the competing approaches while maintaining low complexity. The proposed model obtained very promising results in comparison with the rival models. More importantly, it gives explainable outputs therefore, it can serve as a candidate tool for empowering the sustainable diagnosis of COVID-19-like diseases in smart healthcare. Full article

Glutaraldehyde (GA) has been cleared by the Center for Devices and Radiological Health (CDRH) of the Food and Drug Administration (FDA) as a high-level disinfectant for disinfecting heat-sensitive medical equipment in hospitals and healthcare facilities. Inhalation exposure to GA is known to cause respiratory irritation and sensitization in animals and humans. To reproduce some of the known in vivo effects elicited by GA, we used a liquid aerosol exposure system and evaluated the tissue responses in a human in vitro airway epithelial tissue model. The cultures were treated at the air interface with various concentrations of GA aerosols on five consecutive days and changes in tissue function and structure were evaluated at select timepoints during the treatment phase and after a 7-day recovery period. Exposure to GA aerosols caused oxidative stress, inhibition of ciliary beating frequency, aberrant mucin production, and disturbance of cytokine and matrix metalloproteinase secretion, as well as morphological transformation. Some effects, such as those on goblet cells and ciliated cells, persisted following the 7-day recovery period. Of note, the functional and structural disturbances observed in GA-treated cultures resemble those found in ortho-phthaldehyde (OPA)-treated cultures. Furthermore, our in vitro findings on GA toxicity partially and qualitatively mimicked those reported in the animal and human survey studies. Taken together, observations from this study demonstrate that the human air-liquid-interface (ALI) airway tissue model, integrated with an in vitro exposure system that simulates human inhalation exposure, could be used for in vitro-based human hazard identification and the risk characterization of aerosolized chemicals. Full article