INFECTION PREVENTION
Fig 5. Day 1, control room pm.
onto the surfaces, they were then allowed to dry fully. The ActivePure Beyond Guardian, was placed at the back of the room and activated at level three, once the surfaces were visibly dry.
Results/data Day 1: In the control room, live CFU counts were higher at the front of the room than at the back. On the tabletop at the front of the room, live CFU counts increased during day 1 from 59.06 CFU pcm2
to 316.10 CFU pcm2 , to 253.91 CFU Conclusion
Although this is a small-scale study, the results are so compelling, there can be no doubt that the combination of these two new technologies reduce the live CFU counts and therefore reduce risk of cross infection from surfaces in an office environment. Unfortunately, due to study limitations,
, an
increase of 536%. On the tabletop at the rear of the room live CFU counts increased from 49.71 CFU pcm2 pcm2
, an increase of 511%. In the trial room, live CFU counts at the
front of the room reduced from 64.81 CFU pcm2
, to 0.94 CFU pcm2 to 0.56 CFU pcm2 , a reduction of
98.55%. At the back of the room, CFU counts were reduced from 43.87 CFU pcm2
, a reduction of
98.73%. Day 2: In the control room, CFU counts were similar at all data points to those on day 1. At the front of the room live bacterial levels rose from 68.17 CFU pcm2 to 440.81 CFU pcm2
(646%) and at the
back of the room from 34.07 CFU pcm2 278.25 CFU pcm2
(816%).
In the trial room, CFU counts started the day at less than those of the start on the previous day, and whilst they doubled during the day, they remined at below 1 CFU pcm2
were
similar in both rooms on day 1 (front of room 59.06 to 64.81 and back of room 49.71 and 43.87). By the end of day 2 it is clear that the results from day 1 were not anomalous, P= >0.5. Culture plates from both rooms (Figs 5 and 6) showed growth of the following bacterial species (sub species identification was not always possible); Staphylococcus, Pseudomonas, Streptococcus, Klebsiella, Haemophilus influenzae, Shigella, Escherichia coli, Clostridium perfringens and Campylobacter.
30 to
we were unable to determine which of the two technologies is most efficacious. It is the authors’ view that as the air- handling system is primarily designed to remove or kill pathogens circulating the air, and that the system’s secondary action has an effect on surfaces, the authors’ index of suspicion is that the Invisiguard product will be showing the most efficacy on surface contamination. It is equally possible that due to the ‘Holism theory’ or entourage theory8
both products have
equal efficacy, or that their individual efficacy is increased by the combined use with the other product.
with no culture growth possible. The starting CFU counts per cm2
Further research It is clear there is more research required if we are to determine which of the new technologies is most efficacious on surface contamination levels. It is also unclear as to how much effect the reduction in live CFU surface counts will have on staff sickness. As yet unpublished US studies have shown a direct two- way relationship between surface contamination and air contamination, it is therefore the intention of the researchers to undertake a second study looking at both air microbial contamination and air quality, combined with live surface CFU counts, separating the two new technologies to try to determine the individual efficacy of both.
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
Fig 6. Day 1, treated room pm.
2 Kemp A. A new era in bacterial detection in healthcare. Clinical Services Journal. 2018 Oct;17(9):38-39.
3 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
4 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
5 Murray PR, Baron EJ, Jorgensen JH , Landry ML , Pfaller MA, Kilian M 2007. Manual of clinical microbiology, 9th ed. ASM Press, Washington, DC.
6 Kemp A, Hodgkinson V, Bugg A. Prevention is better than cure. Clinical Services Journal 2017 Oct;16(9):61-63.
7 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)
8 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.
MAY 2024
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