APPLIED RESEARCH

Hospital-acquired infections (HAIs) pose a serious threat to patients, and hospitals spend billions of dollars each year to reduce and treat these infections. Many HAIs are due to contamination from workers’ hands and contact with high-touch surfaces. Therefore, we set out to test the efficacy of a new preventative technology, AIONX^® Antimicrobial Technologies, Inc’s cleanSURFACES^®, which is designed to complement daily chemical cleaning events by continuously preventing re-colonization of surfaces. To that end, we swabbed surfaces before (Baseline) and after (Post) application of the cleanSURFACES^® at various time points (Day 1, Day 7, Day 14, and Day 28). To circumvent limitations associated with culture-based and 16S rRNA gene amplicon sequencing methodologies, these surface swabs were processed using metatranscriptomic (RNA) analysis to allow for comprehensive taxonomic resolution and the detection of active microorganisms. Overall, there was a significant (P < 0.05) global reduction of microbial diversity in Post-intervention samples. Additionally, Post sample microbial communities clustered together much more closely than Baseline samples based on pairwise distances calculated with the weighted Jaccard distance metric, suggesting a defined shift after product application. This shift was characterized by a general depletion of several microbes among Post samples, with multiple phyla also being reduced over the duration of the study. Notably, specific clinically relevant microbes, including Staphylococcus aureus, Clostridioides difficile and Streptococcus spp., were depleted Post-intervention. Taken together, these findings suggest that chemical cleaning events used jointly with cleanSURFACES^® have the potential to reduce colonization of surfaces by a wide variety of microbes, including many clinically relevant pathogens.

Culture-based methods have been regarded as the gold standard of diagnosis for infectious diseases (Laupland and Valiquette, 2013) and used as an essential tool in determining treatment regimens. However, these methods can take up to 96 hours to identify a pathogen and determine its susceptibility to antibiotics (Afshari et al., 2012). Some organisms, such as the causal agent of Lyme disease, B. burgdorferi, require special media and may take much longer to grow to detectable levels, if they grow at all (Schutzer et al., 2019). Factors that decrease the efficacy of culture-based methods include previous antibiotic treatment, growth media requirements that can be difficult or impossible to replicate, poor sample quality or preprocessing, low microbial load, and minor infection severity (Fenollar et al., 2006; Mancini et al., 2010; Afshari et al., 2012; Blauwkamp et al., 2019). Such methods fail to identify a pathogen as often as 50% of the time (Srinivasan et al., 2015). Situations where culture- based methods fail to identify pathogenic organisms in cases involving infection (culture- negative infections), have been shown to increase the risk of further complications due to uncertainties involving identification of pathogen(s) and associated resistances, which can delay the proper treatment required.

Comprehensive Guide in Knee and Hip Arthroplasty: Asia-Pacific Arthroplasty Society—Delta Compendium.

Based on the current evidence, there is no diff erence in infection rates following IM fi xation of long bone fractures using a reamed or non-reamed technique. Using an IM fi xation technique has become the accepted standard in treating long bone fractures. Tibial fractures are the most common type of long bone fracture encountered and therefore are the most studied in the current literature.