Journal of Hospital Infection最新文献

{"title":"Revisiting antimicrobial stewardship in the paediatric intensive care unit: insights from an unconventional approach","authors":"C. Liberati ,&nbsp;G. Brigadoi ,&nbsp;E. Gres ,&nbsp;E. Barbieri ,&nbsp;F. Cavagnero ,&nbsp;L. Maestri ,&nbsp;S. Trivellato ,&nbsp;A. Zenere ,&nbsp;M. De Pieri ,&nbsp;C. Di Chiara ,&nbsp;D. Mengato ,&nbsp;F. Venturini ,&nbsp;E. De Canale ,&nbsp;C. Del Vecchio ,&nbsp;A. Tessari ,&nbsp;A. Tosoni ,&nbsp;C. Zaggia ,&nbsp;C. Contessa ,&nbsp;C. Giaquinto ,&nbsp;E. Carrara ,&nbsp;D. Donà","doi":"10.1016/j.jhin.2025.02.010","DOIUrl":"10.1016/j.jhin.2025.02.010","url":null,"abstract":"<div><h3>Background</h3><div>Patients admitted to the paediatric intensive care unit (PICU) constitute a high-risk group with increased likelihood of receiving inappropriate antimicrobial prescriptions. This study describes an antimicrobial stewardship programme (ASP) in the PICU of a tertiary hospital in Italy.</div></div><div><h3>Method</h3><div>A pre–post quasi-experimental study was conducted between 1^st January 2019 and 31^st December 2022 in the PICU of the Department for Women's and Children's Health, University Hospital of Padova. The ASP intervention was implemented in February 2021 by a multi-disciplinary team using the ‘handshake’ approach. The population included all patients admitted to the PICU. The primary outcome was antibiotic consumption measured as days of therapy administered (DOTs)/1000 patient-days. An interrupted time series analysis was used to assess trends in antibiotic prescribing before and after the intervention.</div></div><div><h3>Results</h3><div>In total, 616 patients (episodes) were admitted in the pre-intervention phase (January 2019–January 2021) and 602 patients were admitted in the post-intervention phase (February 2021–December 2022). Implementation of the ASP resulted in a significant decrease in overall antibiotic consumption by 3.0% every month (<em>P</em>&lt;0.0001). Monthly reductions in higher consumption antibiotics were: meropenem, 4.9% (<em>P</em>=0.009); glycopeptides, 3.8% (<em>P</em>=0.014); and piperacillin-tazobactam 4.8% (<em>P</em>=0.034). The consumption of third-generation cephalosporins and amikacin did not change significantly.</div></div><div><h3>Conclusions</h3><div>The ASP intervention was effective in reducing the consumption of antimicrobials in this complex setting. These results show the importance of antimicrobial stewardship in the scenario of critically ill children.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"160 ","pages":"Pages 53-59"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating decontamination interventions to control carbapenemase-producing Enterobacterales transmission from sinks: a retrospective analysis","authors":"A. Arbel ,&nbsp;R. Abdo ,&nbsp;M. Amar ,&nbsp;R. Yasin ,&nbsp;M. Feldman ,&nbsp;O. Salah ,&nbsp;G. Weber ,&nbsp;R. Najjar-Debbiny","doi":"10.1016/j.jhin.2025.02.011","DOIUrl":"10.1016/j.jhin.2025.02.011","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"160 ","pages":"Pages 118-120"},"PeriodicalIF":3.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the risk of Clostridioides difficile infection from toilet flushing: a quantitative microbial risk assessment and implications for infection control","authors":"E.N. Paddy,&nbsp;M. Sohail,&nbsp;O.O.D. Afolabi","doi":"10.1016/j.jhin.2025.02.012","DOIUrl":"10.1016/j.jhin.2025.02.012","url":null,"abstract":"<div><h3>Background</h3><div>Despite stringent infection control measures, <em>Clostridioides difficile</em> infection (CDI) remains a challenge in healthcare settings, partly due to overlooked transmission vectors such as toilet plume bioaerosols.</div></div><div><h3>Aim</h3><div>To systematically quantify the risks associated with CDI transmission via toilet flushing and provide critical insights to inform CDI preventive strategies.</div></div><div><h3>Methods</h3><div>Impaction sampling was used to quantify airborne <em>C. difficile</em> post-flush and high-contact surfaces were swabbed to assess contamination levels, in a controlled toilet environment. A quantitative microbial risk assessment (QMRA) approach was then used to estimate the risk to subsequent users from contamination by a previously colonized individual.</div></div><div><h3>Findings</h3><div>A single flush can release <em>C. difficile</em> into the air, with bioaerosol concentrations up to 29.50 ± 10.52 cfu/m³ and deposit about 8–11 cfu on immediate surfaces. Despite a 4.4 log reduction in bacterial concentration within the toilet bowl post-flush, bacteria persist on its inner walls. Relative humidity increases by approximately 31.28% within the first 10 min post-flush, potentially enhancing the viability and transmission of aerosolized <em>C. difficile</em>. The flush button contact and inhalation-followed-by-ingestion in frequent-use hospital settings present the highest risks and exceed US EPA and WHO acceptable infection risk thresholds.</div></div><div><h3>Conclusion</h3><div>The findings of this study necessitate a review of current toilet designs, public health policies and facility management practices to mitigate the overlooked risks of CDI transmission through toilet plume bioaerosols in healthcare settings. Additionally, this study lays a foundation for developing evidence-based interventions aimed at achieving substantial behavioural and infrastructural changes in infection control practices.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"159 ","pages":"Pages 92-99"},"PeriodicalIF":3.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outbreak investigations of contact patients and the hospital environment after detection of carbapenemase-producing Pseudomonas aeruginosa on general hospital wards","authors":"A.C. Büchler,&nbsp;C.H.W. Klaassen,&nbsp;I. de Goeij,&nbsp;M.C. Vos,&nbsp;A.F. Voor in ’t holt,&nbsp;J.A. Severin","doi":"10.1016/j.jhin.2025.02.009","DOIUrl":"10.1016/j.jhin.2025.02.009","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenemase-producing <em>Pseudomonas aeruginosa</em> (CPPA) is known to cause outbreaks in healthcare settings. Outbreak investigations, including screening of contact patients and the environment, are key in infection prevention and control (IPC) management to contain them.</div></div><div><h3>Aim</h3><div>The aim of this study was to determine the yield of outbreak investigations performed after unexpected detections of CPPA in clinical or screening cultures of patients hospitalized on a general ward.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, we included all adult patients newly detected with CPPA (‘index patients’) while hospitalized on a general ward from June 2011 to December 2021. We evaluated the outbreak investigations performed, i.e., screening of epidemiologically linked patients (‘contact patients’) and the environment. Isolates were analysed by whole-genome sequencing (WGS).</div></div><div><h3>Findings</h3><div>Outbreak investigations of 34 of 38 (89.5%) index patients were evaluated, with screening of contact patients performed in 34 (100%) and the environment in 18 (52.9%). CPPA was detected in eight (44.4%) of the environmental screenings, and WGS confirmed relatedness to the index in four (22.2%). A total of 1707 of 1982 (86.1%) identified contact patients were screened, of which eight carried CPPA (0.5%). WGS confirmed transmission from index patient to contact patient in five of these (0.3%).</div></div><div><h3>Conclusion</h3><div>Environmental screening should be part of outbreak investigations for CPPA, as it identifies sources which enables timely installation of targeted IPC measures. Identification of index-to-contact patient transmission was rare in our setting, thus implying reconsideration of the definition of contact patients at high risk is needed.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"159 ","pages":"Pages 11-19"},"PeriodicalIF":3.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to the use of personal protective equipment in long-term care: a qualitative study.","authors":"Christian C Tsang, Jayna M Holroyd-Leduc, Vivian Ewa, John M Conly, Myles M Leslie, Jenine R Leal","doi":"10.1016/j.jhin.2025.02.008","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.02.008","url":null,"abstract":"<p><strong>Background: </strong>Long-term Care (LTC) residents are vulnerable to invasive infection. Appropriate use and training on personal protective equipment (PPE) is important for protecting residents and healthcare workers (HCWs). Studies on the barriers and facilitators to PPE use are limited in LTC settings.</p><p><strong>Objective: </strong>Characterize HCWs' perceptions of barriers and facilitators to the uptake and appropriate use of PPE in LTC facilities Calgary, Alberta.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with HCWs from April to October 2022. Interview transcripts were analyzed deductively to identify themes from the Theoretical Domains Framework.</p><p><strong>Results: </strong>Seven HCWs were interviewed. Barriers and facilitators fell within six overarching themes including: availability and quality of PPE; knowing how to use PPE; familial obligations; convenience and comfort; sense of professional duty; and social influences and identity. Additional factors such as understaffing and the need for more training sessions were highlighted. Strategies to improve PPE use were identified by HCWs, including the use of PPE champions, regular audits, and constructive feedback.</p><p><strong>Conclusion: </strong>Identification of unique barriers and facilitators regarding PPE use by HCWs in LTC will facilitate targeted interventions to improve PPE use in this setting.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety outcomes of a mobile laminar airflow device to perform intravitreal injections: a 3-year retrospective study","authors":"M.M. Carlà ,&nbsp;A. Scampoli ,&nbsp;L. Governatori ,&nbsp;G. Grieco ,&nbsp;R. Catalani ,&nbsp;W. Calcatelli ,&nbsp;T. Caporossi","doi":"10.1016/j.jhin.2025.02.007","DOIUrl":"10.1016/j.jhin.2025.02.007","url":null,"abstract":"<div><h3>Background</h3><div>The increasing demand for intravitreal injections (IVIs) necessitates exploring efficient and safe alternatives to traditional operating rooms (ORs). The use of mobile laminar airflow (LAF) devices has emerged as a potential solution to create a sterile environment for IVIs outside the OR. This study investigated the safety outcomes of the Operio mobile LAF device to perform IVIs in a non-OR setting.</div></div><div><h3>Methods</h3><div>This retrospective study included 1420 patients who received a total of 6638 IVIs between January 2021 and December 2024 at Ospedale Fatebenefratelli Isola Tiberina – Gemelli Isola in Rome, Italy. The Operio mobile LAF device was positioned beside the operating table, directing air flow towards the surgical area. A standardized protocol was followed for patient preparation, anaesthesia, IVI administration and post-injection care. The primary outcome was the incidence of endophthalmitis.</div></div><div><h3>Results</h3><div>Antivascular endothelial growth factor agents constituted 96% (6369/6638) of all IVIs. Corticosteroids accounted for the remaining 4% (269/6638) of IVIs. One case of endophthalmitis following an IVI with Mvasi was observed among the 6638 IVIs administered during the study period, a rate of 0.015%. Other complications, such as subconjunctival haemorrhage (386 eyes) and transient ocular hypertension (57 eyes), were not linked with use of the Operio mobile LAF device.</div></div><div><h3>Conclusion</h3><div>Using a portable LAF device, such as the Operio mobile LAF device, for IVIs in a non-OR setting is a safe and effective alternative to traditional ORs.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"159 ","pages":"Pages 88-91"},"PeriodicalIF":3.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Staphylococcus aureus nasal decolonization at hospital admission on reduction of any infections within 90 days – a systematic review and meta-analysis","authors":"T.C. Scheier ,&nbsp;P.W. Schreiber ,&nbsp;X. Yao ,&nbsp;J.W. Eikelboom ,&nbsp;S.D. Brugger ,&nbsp;D. Mertz","doi":"10.1016/j.jhin.2025.01.017","DOIUrl":"10.1016/j.jhin.2025.01.017","url":null,"abstract":"<div><div>Infections with <em>Staphylococcus aureu</em>s are associated with excess mortality and costs. Simple interventions, such as decolonization protocols, might help to reduce subsequent infections, especially in settings in which <em>S. aureus</em> is of major clinical relevance, such as healthcare-associated infections. The aim of this research was to determine whether <em>S. aureus</em> decolonization protocols, using a nasal ointment and applied at hospital admission, reduce the risk of infection. MEDLINE, EMBASE and <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> were searched for all randomized controlled trials investigating the use of nasal ointments for decolonization for patients at hospital admission and reporting on infections within 90 days. Data were pooled as risk ratios using a random-effects model. The Cochrane RoB 2 tool and GRADE were used to assess the risk of bias and quality of evidence. Four (0.5%) of 833 screened studies with a total of 4150 patients met eligibility criteria. The overall certainty of evidence ranged from low to moderate across outcomes. Nasal <em>S. aureus</em> decolonization probably reduces infections (6.9% vs 9.5%; rate ratio (RR): 0.73 (95% confidence interval (CI) 0.57; 0.93)) and may increase microbiological eradication (82.7% vs 55.2%; RR: 1.80 (95% CI 0.73; 4.44)) compared with placebo. It may not reduce mortality (2.5 vs 2.4; RR: 1.02 (95% CI 0.67; 1.54)) but also not lead to increased adverse effects (0.7% vs 0.6%; RR: 1.01 (95% CI 0.45; 2.30)). Results were consistent across subgroups and sensitivity analyses. In conclusion, nasal decolonization at acute-care hospital admission probably reduces the risk of infections and may result in a large increase in microbiological eradication. It may not reduce mortality and also not result in an increased number of adverse events.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"159 ","pages":"Pages 1-10"},"PeriodicalIF":3.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidrug resistance assessment of indoor air in Portuguese long-term and acute healthcare settings","authors":"C. Santos-Marques ,&nbsp;C. Teixeira ,&nbsp;R. Pinheiro ,&nbsp;W.M. Brück ,&nbsp;S. Gonçalves Pereira","doi":"10.1016/j.jhin.2025.02.005","DOIUrl":"10.1016/j.jhin.2025.02.005","url":null,"abstract":"<div><h3>Background</h3><div>Knowledge about air as a pool of pathogens and multidrug resistance (MDR) in healthcare units apart from hospitals is scarce.</div></div><div><h3>Aim</h3><div>To investigate these features in a Portuguese long-term healthcare unit (LTHU) and a central hospital (CH).</div></div><div><h3>Methods</h3><div>Air samples were collected and their microbial load (bacteria and fungi) determined. Bacterial isolates were randomly selected for further characterization, particularly identification by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry, antimicrobial susceptibility testing, and polymerase chain reaction screening of extended-spectrum β-lactamases, carbapenemase genes and <em>mecA</em> gene, with RAPD profile assessment of positive results of the latter.</div></div><div><h3>Findings</h3><div>A total of 192 samples were collected (LTHU: 86; CH: 106). LTHU showed a statistically significantly higher bacterial load. CH bacteria and fungi loads in inpatient sites were statistically significantly lower than in outpatients or non-patient sites. A total of 164 bacterial isolates were identified (MALDI-TOF: 78; presumptively: 86), the majority belonging to <em>Staphylococcus</em> genus (LTHU: 42; CH: 57). The highest antimicrobial resistance rate was to erythromycin and vancomycin the least, in both settings. Eighteen isolates (11%) were classified as MDR (LTHU: 9; CH: 9), with 7 MDR <em>Staphylococcus</em> isolates (LTHU: 4; CH: 3) presenting <em>mecA</em>. Nine non-MDR <em>Staphylococcus</em> (LTHU: 5; CH: 4) also presented <em>mecA</em>.</div></div><div><h3>Conclusion</h3><div>The current study highlights that healthcare unit indoor air can be an important pool of MDR pathogens and antimicrobial resistance genes. Also, LTHUs appear to have poorer air quality than hospitals, as well as supportive areas compared to curative care areas. This may suggest possible yet unknown routes of infection that need to be explored.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"159 ","pages":"Pages 115-123"},"PeriodicalIF":3.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal operating positions of two air purifiers for improving indoor air quality in hospital wards","authors":"I.H. An ,&nbsp;D.B. Kwak ,&nbsp;J. Lee ,&nbsp;S.H. Park ,&nbsp;S.J. Yook","doi":"10.1016/j.jhin.2025.02.006","DOIUrl":"10.1016/j.jhin.2025.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Maintaining high indoor air quality (IAQ) in hospital wards is crucial, particularly in settings lacking proper ventilation. This study investigates the effectiveness of air purifiers in enhancing IAQ under varying conditions, including ventilation systems and curtains.</div></div><div><h3>Aim</h3><div>This study aims to evaluate the optimal operating positions of two air purifiers to enhance IAQ in hospital wards under varying ventilation and curtain use conditions.</div></div><div><h3>Methods</h3><div>This study employed a combination of experiments and computational fluid dynamics (CFD) simulations across 20 scenarios, analysing the impact of air purifier placement on the age of air, a key IAQ metric.</div></div><div><h3>Findings</h3><div>This study found that the positioning of air purifiers greatly influenced IAQ, with reductions in the age of air ranging from 19% to 44% depending on the configuration. The most effective placement involved active ventilation systems and unfolded curtains, leading to a significant decrease in the volume-averaged age of air.</div></div><div><h3>Conclusion</h3><div>This study concludes that optimal placement of air purifiers in hospital wards can significantly improve IAQ, with reductions in the age of air by up to 44%. Specifically, when ventilation systems were active and curtains were unfolded, the age of air was reduced to as low as 318 s, representing a 27–44% improvement over less-effective configurations. These findings emphasize the critical role of strategic air purifier placement in reducing airborne infection risks and enhancing patient safety in healthcare environments.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"159 ","pages":"Pages 42-51"},"PeriodicalIF":3.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drain decontamination using in-situ-generated ozone","authors":"M.Z. Pajak-Zajac ,&nbsp;A. Dowdell ,&nbsp;H.E. Potts ,&nbsp;A. Smith ,&nbsp;D.A. Diver","doi":"10.1016/j.jhin.2025.02.001","DOIUrl":"10.1016/j.jhin.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Sink drains can be a significant source of microbial contamination in healthcare settings due to aerosolization and splashback of pathogens caused by flowing water.</div></div><div><h3>Aim</h3><div>To demonstrate a method of ozone disinfection of drains using a novel generation process that suppresses pathogen growth in the drain sump, whether planktonic or dwelling in biofilms.</div></div><div><h3>Methods and results</h3><div>Highly biocidal ozone was generated <em>in situ</em> in the drain using the ambient air sealed between the water trap and a portable cold plasma device. Safety mechanisms in the device ensured that the operator was not exposed to ozone. Subsequent bacterial recovery illustrated an approximate bioburden reduction of 5 log₁₀ for biofilms in the drain itself, and 6 log₁₀ for biofilms located in the sink.</div></div><div><h3>Conclusions</h3><div>Plasma-generated ozone is a safe and effective method for controlling bioburden in periodically wetted, otherwise inaccessible pipework and drains.</div></div><div><h3>Significance and impact of study</h3><div>The portable ozone disinfection system described has demonstrated potential for controlling the escape of pathogens from drains. Compared with conventional liquid-based disinfection techniques, the portable ozone disinfection system has the following advantages: (i) a gaseous biocide can reach all surfaces inside the treatment target, without any restriction from orientation or surface tension; (b) ozone is effective in reducing planktonic and biofilm bacterial counts; and (c) ozone is generated at the point of use from air, using minimal electrical power, requiring no chemical delivery or storage, and producing no toxic residues.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"159 ","pages":"Pages 100-105"},"PeriodicalIF":3.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}