Severe cases infected with the coronavirus disease 2019 (COVID-19), named by the World Health Organization (WHO) on Feb. 11, 2020, tend to present a hypercatabolic state because of severe systemic consumption, and are susceptible to stress ulcers and even life-threatening gastrointestinal bleeding. Endoscopic diagnosis and treatment constitute an irreplaceable part in the handling of severe COVID-19 cases. Endoscopes, as reusable precision instruments with complicated structures, require more techniques than other medical devices in cleaning, disinfection, sterilization, and other reprocessing procedures. From 2016 to 2019, health care-acquired infection caused by improper endoscope reprocessing has always been among the top 5 on the list of top 10 health technology hazards issued by the Emergency Care Research Institute. Considering the highly infective nature of COVID-19 and the potential aerosol contamination therefrom, it is of pivotal significance to ensure that endoscopes are strictly reprocessed between uses. In accordance with the national standard "Regulation for Cleaning and Disinfection Technique of Flexible Endoscope (WS507-2016)," we improved the workflow of endoscope reprocessing including the selection of chemicals in an effort to ensure quality control throughout the clinical management towards COVID-19 patients. Based on the experience we attained from the 12 severe COVID-19 cases in our hospital who underwent endoscopy 23 times in total, the article provides an improved version of endoscopic reprocessing guidelines for bedside endoscopic diagnosis and treatment on COVID-19 patients for reference.
Adult ; Aged ; Aged, 80 and over ; Betacoronavirus ; China ; Coronavirus Infections ; diagnosis ; therapy ; Cross Infection ; prevention & control ; Disinfection ; methods ; Endoscopes ; virology ; Equipment Contamination ; prevention & control ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Peracetic Acid ; Personal Protective Equipment ; Pneumonia, Viral ; diagnosis ; therapy ; Sterilization ; methods ; Workflow

Banking, Personal ; COVID-19/virology* ; Environmental Microbiology ; Equipment Contamination/statistics & numerical data* ; Humans ; Public Facilities/statistics & numerical data* ; Public Health ; SARS-CoV-2/physiology* ; Supermarkets

Water is an important component in liquid medical device products for human assisted reproductive technology. Water traits, conductivity, microbial limits, total organic carbon, easy oxides, heavy metal content, bacterial endotoxin and other indicators have an important impact on sperm, egg and embryo development in vitro, so for such products, the quality of water control is extremely important. The production water for producing such products is generally prepared by MilliQ purification system. In this research, we used four different types of water to fabricate the IVF liquids. It included deionized reverse osmosis water, ultra purified water and ultra purified water without endotoxin or nucleic acid, and compared with tap water. The in vitro rat embryo test system was used to study the embryotoxicity of this four different culture liquid production waters. From the result, the group of the super purified water without endotoxin and nucleic acid has the best result of the embryo formation rate, the number of total cell number and the inner cell number. This study proved the importance of removing endotoxin and nucleic acid from the water used for the preparation of the liquid products for assisted reproduction, and provided the basis for the selection of water quality for the liquid products for assisted reproduction.
Animals ; Embryonic Development ; Equipment Contamination ; Fertilization in Vitro/instrumentation* ; Humans ; Rats ; Reproductive Techniques, Assisted ; Research ; Technology ; Water

According to the national soft endoscope cleaning standard and the difference between the previous and latest version, the origin decontamination equipment is upgraded. Sensory control monitoring results in the last year shows that the average cleaning time for a single endoscope has been reduced from 20 min 55 s to 17 min 16 s. The number of bacterial colony has been reduced from 6.8 to 3.1. The pass rate of sensory control monitoring keeps steady. The upgraded decontamination equipment not only meets the requirements of the latest version of the standard,but also improves the efficiency and effectiveness of electronic endoscope disinfection.
Disinfection ; Endoscopes ; Equipment Contamination

BACKGROUND/AIMS: Due to a lack of scientific evidence and unstandardized protocols, the correct use of personal protective equipment (PPE) is not always easy for healthcare personnel (HCP). This study aimed to generate experimental evidence to reduce contaminations during PPE doffing. METHODS: With institutional review board approval, 4 standardized HCP were recruited to examine selected PPE protocols based on consultations with 10 invited Korean infection control leaders. Using fluorescent powder and ultraviolet light, each PPE protocol was evaluated for contaminations by comparing methods or steps. Pictures of contaminated areas and videos of HCP practice were evaluated for case analysis by linking all collected data using assigned study experiment codes. RESULTS: A total of 38 simulation experiments were conducted during December 14–20, 2016. No significant difference was found among minor variations in PPE protocols. Rather, after an intensive, 1-minute patient care simulation (e.g., physical assessment), severe powder contaminations on the front and under the sleeves of coveralls were found. Even after the outer-glove surface was wiped clean, partial contaminations still remained, especially between fingers and on fingertips. Moreover, after cleaning glove surface contaminations using wipes, each doffing step caused different contaminations. Among different types of N95 respirators, the foldable N95 type was the most stable during doffing processes, with less possibility of contamination. CONCLUSIONS: Based on this study's findings with visual evidence of contaminations during PPE doffing processes, some meaningful recommendations were feasible, such as the use of disposable long-sleeve aprons over coveralls. Further study is necessary to evaluate these recommendations.
Delivery of Health Care ; Equipment Contamination ; Ethics Committees, Research ; Fingers ; Health Personnel ; Humans ; Infection Control ; Patient Care ; Personal Protective Equipment ; Referral and Consultation ; Ultraviolet Rays ; Ventilators, Mechanical

We studied the disinfection effect of a new ultraviolet (UV) sterilizer and its utilization on ultrasound probe surfaces. Carrier quantitative germicidal tests, simulated on-the-spot trials, and organic substance influence tests were used to carry out experimental observation. Artificially infected probes were disinfected using the sterilizer or a germicidal lamp for comparison. The total number and types of bacteria were determined and identified. Our results demonstrated the sterilizer had the best disinfection effect among three different disinfection methods in hospital. The sterilizer has been used in a hospital setting for 2 years with no notable damage to the ultrasound probe instrument. It has the advantages of fast disinfection, high disinfection effect, and good compatibility with the ultrasound instrument, worthy of being a promoted application in medical institutions.
Bacterial Infections ; microbiology ; prevention & control ; Colony Count, Microbial ; Cross Infection ; microbiology ; prevention & control ; Disinfection ; instrumentation ; methods ; Equipment Contamination ; prevention & control ; Sterilization ; instrumentation ; Surface Properties ; Ultrasonography ; instrumentation ; Ultraviolet Rays

OBJECTIVES: To identify bacterial contamination rates of laryngoscope blades and handles stored in emergency crash carts by hospital and area according to the frequency of intubation attempts. METHODS: One hundred forty-eight handles and 71 blades deemed ready for patient use from two tertiary hospitals were sampled with sterile swabs using a standardized rolling technique. Samples were considered negative (not contaminated) if no colonies were present on the blood agar plate after an 18-hour incubation period. Samples were stratified by hospital and according to the frequency of intubation attempts (10 attempts per year) using the χ2-test and Fisher exact test. RESULTS: One or more species of bacteria were isolated from 4 (5.6%) handle tops, 20 (28.2%) handles with knurled surfaces, and 27 (18.2%) blades. No significant differences were found in microbial contamination levels on the handle tops and blades between the two hospitals and two areas according to the frequency of intubation attempts. However, significant differences were found between the two hospitals and two areas in the level of microbial contamination on the handles with knurled surfaces (p<0.05). CONCLUSIONS: Protocols and policies must be reviewed to standardize procedures to clean and disinfect laryngoscope blades and handles; handles should be re-designed to eliminate points of contact with the blade; and single-use, one-piece laryngoscopes should be introduced.
Agar ; Bacteria ; Disinfection* ; Emergencies* ; Equipment Contamination ; Humans ; Intubation ; Laryngoscopes* ; Tertiary Care Centers

To understand the potential causes of laboratory-acquired infections and to provide possible solutions that would protect laboratory personnel, samples from a viral laboratory were screened to determine the main sources of contamination with six subtypes of Rhinovirus. Rhinovirus contamination was found in the gloves, cuffs of protective wear, inner surface of biological safety cabinet (BSC) windows, and trash handles. Remarkably, high contamination was found on the inner walls of the centrifuge and the inner surface of centrifuge tube casing in the rotor. Spilling infectious medium on the surface of centrifuge tubes was found to contribute to contamination of centrifuge surfaces. Exposure to sodium hypochlorite containing no less than 0.2 g/L available chlorine decontaminated the surface of the centrifuge tubes from Rhinovirus after 2 min.
Equipment Contamination ; statistics & numerical data ; Humans ; Laboratories, Hospital ; manpower ; standards ; statistics & numerical data ; Occupational Exposure ; analysis ; statistics & numerical data ; Virus Diseases ; virology ; Viruses ; genetics ; growth & development ; isolation & purification

OBJECTIVE: To investigate the situation regarding the cleaning and sterilization of endonasal endoscopes in department of otolaryngology in Hunan Province, and to provide strategy for improving the level of sterilization and management of endonasal endoscopes.
 METHODS: A total of 100 medical institutions were investigated by spot assessment, check and sampling. Data was analyzed by multivariate analysis.
 RESULTS: The qualified rate of rules and regulations for endoscopy was 28.8% in the second-class hospitals and 45% in the top-class hospitals. The qualified rate of environment for endoscopy cleaning and sterilization was 36.3% in the second-class hospitals and 85% in the top-class hospitals. The main problems include lack of independent disinfection room, the space not large enough, and/or lack of ventilation system. The qualified rate of bacterial detection for post-sterilized endoscopes and biopsy forceps was 93.8% in the second-class hospitals and 95.0% in the top-class hospitals, and the main pathogenic bacteria was gram-positive cocci and gram-negative bacilli. The multivariate analysis showed that the influencial factors for endoscope cleaning and disinfection are as follows: staffs responsible for the cleaning and sterilization of otolaryngology endoscopes, the standard for cleaning and disinfection process, and the frequency of endoscope use.
 CONCLUSION The present situation of cleaning and sterilization for otolaryngology endoscopes is better in the top-class hospitals than that in the second-class hospitals. The sterilization and management of otolaryngology endoscopy are needed to be improved, and the staff training is needed, especially in the primary hospitals.
Disinfection ; statistics & numerical data ; Endoscopes ; Equipment Contamination ; statistics & numerical data ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Hospitals ; Humans ; Otolaryngology

Gordonia sputi causes rare bacterial infections resulting from a contaminated indwelling medical device. We report the case of a postoperative plastic expander abscess in a woman, with G. sputi identification by 16S ribosomal RNA sequencing. This report indicates that Gordonia spp. should be included in the list of organisms causing plastic implant infections.
Actinomycetales Infections ; etiology ; microbiology ; Adult ; Aged ; Breast Implants ; adverse effects ; microbiology ; Equipment Contamination ; statistics & numerical data ; Female ; Gordonia Bacterium ; isolation & purification ; physiology ; Humans ; Infant, Newborn ; Male ; Mammaplasty ; adverse effects ; Middle Aged ; Plastics