INFECTION PREVENTION


rooms the counts fell; by an average of 85.41% in the air cleaning room and an average of 99.64% in the room treated with the persistent disinfectant. The surface CFU counts fell in both rooms overnight, rising again only slightly during the day on day 2 (Fig 1). The overall average counts had reduced by an average of 98.17% in the air tech room and an average of 99.57% at 36 hours. Although it was possible to culture some bacterial species from the samples taken before any interventions were undertaken; CFU counts were so low, it was not possible to get any results after 36 hours. There were no unusual species identified on any agar plates. The air particle counts at all particle sizes in both rooms reduced at every test point over the 36 hours. Of particular note is the reduction of particles in the size range most likely to include airborne viruses (0.1 microns).6


Conclusion


Although this is a small-scale study, the results are compelling. There can be no doubt in the authors’ minds, that the introduction of either of these two new technologies will improve the overall bioburden in the air and on surfaces in an office environment. It is clear from the results that the air cleansing product required more time to have an effect on the surface CFU counts than the surface disinfectant, and that the surface disinfectant took longer to have an effect on the air quality than did the air cleansing units. Neither of these results should come as a surprise, based on their primary purposes. The surprising result is the amount of overall effect that each technology had on their secondary action. Whilst there can also be no doubt that individually these products are efficacious in both their primary and secondary purposes, based on the results from this study and the earlier cited study3


which


looked at the combined efficacy of both products, it is now possible to confirm that there is an element of ‘Holism theory’ (the whole is greater than the sum of its parts) when these products are used together.


Discussion Since the COVID pandemic office managers and staff have become more aware of the possibility of viral transmission in their places of work. It is not impossible to consider that ‘super spreader’ events could happen in these spaces, not just during pandemics, but during the annual flu season, or the lesser- known Norovirus season. Whilst working from home may be possible in some cases to reduce potential risks, there are other issues to consider, including the


44


It is now undeniable that disinfectant resistance can cause some pathogens to become antibiotic resistant. It is therefore clear that more research is required to determine if there is a potential for resistance to either of these products


mental health of staff working from home. Using both new technologies will give the public and private sectors the potential to create a much safer environment for staff to work in. These treated spaces allow the same flexibility of home/office working, but reduce some of the risks associated with this. Perhaps with the introduction of the WHO indoor air quality standards which are currently being defined, there will be a health and safety requirement made of building owners or the businesses renting those spaces that will include the bioburden in both the air and on surfaces? For now, it is likely that only the most diligent of companies will have the foresight to engage with cleaning services offering this new technology to produce safer workspaces for their staff, helping to encourage staff back into the office as their preferred place to work. It is now undeniable that disinfectant


resistance can cause some pathogens to become antibiotic resistant.13


It is


therefore clear that more research is required to determine if there is a potential for any pathogenic species to become resistant to either of these products. To date there is no evidence that they will.


References 1 Kemp A, Diggle M. How Do We Clean


Up This Mess? – A Review of The Testing Methodologies Used for Detection of Live Bacteria in Healthcare Environments. Am J Biomed Sci & Res. 2019;4(4):244-248 doi:10.34297/AJBSR.2019.04.000808.


2 Kemp A. A new era in bacterial detection in healthcare. Clinical Services Journal. 2018 Oct;17(9):38-39.


3 Kemp A, Hodgkinson V. Reducing infection risk: evaluating new disinfection technology in a busy office. Pathology in Practice. 2024 May;25(3):28-30.


4 Murray PR, Baron EJ, Jorgensen JH, Landry ML, Pfaller MA, Kilian M. 2007. Manual of clinical microbiology, 9th ed. ASM Press, Washington, DC.


5 Boone SA, Gerba CP. Significance of fomites in the spread of respiratory and enteric viral disease. Appl Environ Microbiol. 2007;73(6):1687-1696. doi:10.1128/AEM.02051-06


6 Pan M, Lednicky JA, Wu CY. Collection, DECEMBER 2024 WWW.PATHOLOGYINPRACTICE.COM


particle sizing and detection of airborne viruses. J Appl Microbiol. 2019;127(6):1596-1611. doi:10.1111/ jam.14278.


7 Leung NHL. Transmissibility and transmission of respiratory viruses. Nat Rev Microbiol. 2021;19(8):528-545. doi:10.1038/s41579-021-00535-6.


8 Stabile L, Pacitto A, Mikszewski A, Morawska L, Buonanno G. Ventilation procedures to minimize the airborne transmission of viruses in classrooms. Build Environ. 2021;202:108042. doi:10.1016/ j.buildenv.2021.108042


9 Kemp A, Laird K, Diggle M. Cleaning and Disinfection Quality. Guidance standards for establishing and assessing cleaning and disinfection in UK Hospitals and other healthcare facilities. British Institute of Cleaning Science, July 2017 (https://www. bics.org.uk/wp-content/uploads/2020/04/ V-3-Healthcare-Environmental-Cleaning- guide-and-standards-final.pdf)


10 Fennelly KP. Particle sizes of infectious aerosols: implications for infection control. Lancet Respir Med. 2020;8(9):914-924. doi:10.1016/S2213-2600(20)30323-4.


11 Bollmann A, Lewis K, Epstein SS. Incubation of environmental samples in a diffusion chamber increases the diversity of recovered isolates. Appl Environ Microbiol. 2007;73(20):6386-6390. doi:10.1128/ AEM.01309-07.


12 Kemp A, Hodgkinson V, Bugg A. Prevention is better than cure. Clinical Services Journal. 2017 Oct;16(9):61-63.


13 Kemp A. Antimicrobial Efficacy and Lack of Resistance to Silane Quaternary Compounds. Pathology in Practice 2020 April;21(2):23-28.


Andrew Kemp JP PhD, Independent research scientist, Head of Scientific Advisory Board at the British Institute of Cleaning Science, UK Antimicrobial Resistance Ambassador at AMR insights Amsterdam.


Dr Vanessa Hodgkinson MBBS BSc FRCA FFPMRCA, Consultant Anaesthetist, Nottingham University Hospitals, Nottingham, UK.


n This research study was funded entirely by the Birkin Cleaning Services (Grays UK). At the time of publication there are no conflicts of interest.


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