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BACKGROUND: The effect of the periurethral cleansing range on catheter-associated urinary tract infection (CAUTI) occurrence remains unknown. The purpose of this study was to evaluate the efficacy of expanded periurethral cleansing for reducing CAUTI in comatose patients. METHODS: In this randomized controlled trial, eligible patients in our hospital were enrolled and allocated randomly to the experimental group (expanded periurethral cleansing protocol; n = 225) or the control group (usual periurethral cleansing protocol; n = 221). The incidence of CAUTI on days 3, 7, and 10 after catheter insertion were compared, and the pathogen results and influencing factors were analyzed. RESULTS: The incidences of CAUTI in the experimental and control groups on days 3, 7, and 10 were (5/225, 2.22% vs. 7/221, 3.17%, P = 0.54), (12/225, 5.33% vs. 18/221, 8.14%, P = 0.24), and (23/225, 10.22% vs. 47/221, 21.27%, P = 0.001), respectively; Escherichia coli and Candida albicans were the most common species in the two groups. The incidences of bacterial CAUTI and fungal CAUTI in the two groups were 11/225, 4.89% vs. 24/221, 10.86%, P = 0.02) and (10/225, 4.44% vs. 14/221, 6.33%, P = 0.38), respectively. The incidences of polymicrobial CAUTI in the two groups were 2/225 (0.89%) and 9/221 (4.07%), respectively (P = 0.03). The percentages of CAUTI-positive females in the two groups were 9.85% (13/132) and 29.52% (31/105), respectively (P < 0.05). The proportion of CAUTI-positive patients with diabetes in the experimental and control groups was 17.72% (14/79), which was lower than the 40.85% (29/71) in the control group (P < 0.05). CONCLUSION: Expanded periurethral cleansing could reduce the incidence of CAUTI, especially those caused by bacteria and multiple pathogens, in comatose patients with short-term catheterization (≤ 10 days). Female patients and patients with diabetes benefit more from the expanded periurethral cleansing protocol for reducing CAUTI.

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BACKGROUND: Environmental cleaning and disinfection is the basis of the prevention of healthcare-acquired infections (HAIs). AIM: This study aimed to describe photon disinfection technologies (PDTs), report their impact on inactivating micro-organisms and preventing HAIs and to create recommendations for their implementation in hospital settings. METHODS: An integrated literature review was completed to evaluate and report the impact of PDTs in hospital settings. The quality of 23 articles were assessed, their contents analysed and results reported according to the PICOT model. FINDINGS: The microbiological impact of the PDT varied by micro-organism, settings and according to the used devices. It was crucial that environmental cleaning was completed before the disinfection. CONCLUSION: The implementation of PDT in the hospital setting requires inquiry from the viewpoints of microbiological, environmental, occupational, technical and human safety. To enhance the safe implementation of PDTs, the construction and use of evidence-based global standards for PDT are crucial.

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The current pandemic crisis caused by SARS-CoV-2 has also pushed researchers to work on LEDs, especially in the range of 220-240 nm, for the purpose of disinfecting the environment, but the efficiency of such deep UV-LEDs is highly demanding for mass adoption. Over the last two decades, several research groups have worked out that the optical power of GaN-based LEDs significantly decreases during operation, and with the passage of time, many mechanisms responsible for the degradation of such devices start playing their roles. Only a few attempts, to explore the reliability of these LEDs, have been presented so far which provide very little information on the output power degradation of these LEDs with the passage of time. Therefore, the aim of this review is to summarize the degradation factors of AlGaN-based near UV-LEDs emitting in the range of 200-350 nm by means of combined optical and electrical characterization so that work groups may have an idea of the issues raised to date and to achieve a wavelength range needed for disinfecting the environment from SARS-CoV-2. The performance of devices submitted to different stress conditions has been reviewed for the reliability of AlGaN-based UV-LEDs based on the work of different research groups so far, according to our knowledge. In particular, we review: (1) fabrication strategies to improve the efficiency of UV-LEDs; (2) the intensity of variation under constant current stress for different durations; (3) creation of the defects that cause the degradation of LED performance; (4) effect of degradation on C-V characteristics of such LEDs; (5) I-V behavior variation under stress; (6) different structural schemes to enhance the reliability of LEDs; (7) reliability of LEDs ranging from 220-240 nm; and (8) degradation measurement strategies. Finally, concluding remarks for future research to enhance the reliability of near UV-LEDs is presented. This draft presents a comprehensive review for industry and academic research on the physical properties of an AlGaN near UV-LEDs that are affected by aging to help LED manufacturers and end users to construct and utilize such LEDs effectively and provide the community a better life standard.

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Harmful microorganism (e.g., new coronavirus) based infection is the most important security concern in life sciences and healthcare. This article aims to provide a state-of-the-art review on the development of advanced technology based on nanomaterial disinfection/sterilization techniques (NDST) for the first time including the nanomaterial types, disinfection techniques, bactericidal devices, sterilization products, and application scenarios (i.e., water, air, medical healthcare), with particular brief account of bactericidal behaviors referring to varied systems. In this emerging research area spanning the years from 1998 to 2021, total of ~200 publications selected for the type of review paper and research articles were reviewed. Four typical functional materials (namely type of metal/metal oxides, S-based, C-based, and N-based) with their development progresses in disinfection/sterilization are summarized with a list of synthesis and design. Among them, the widely used silver nanoparticles (AgNPs) are considered as the most effective bacterial agents in the type of nanomaterials at present and has been reported for inactivation of viruses, fungi, protozoa. Some methodologies against (1) disinfection by-products (DBPs) in traditional sterilization, (2) noble metal nanoparticles (NPs) agglomeration and release, (3) toxic metal leaching, (4) solar spectral response broadening, and (5) photogenerated e-/h+ pairs recombination are reviewed and discussed in this field, namely (1) alternative techniques and nanomaterials, (2) supporter anchoring effect, (3) nonmetal functional nanomaterials, (4) element doping, and (5) heterojunction constructing. The feasible strategies in the perspective of NDST are proposed to involve (1) non-noble metal disinfectors, (2) multi-functional nanomaterials, (3) multi-component nanocomposite innovation, and (4) hybrid techniques for disinfection/sterilization system. It is promising to achieve 100% bactericidal efficiency for 108 CFU/mL within a short time of less than 30 min.

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The ever-increasing need for access to safe water has meant that alternative water sources and innovative water reclamation approaches are often required to meet the global water demand. As a result, many wastewater treatment facilities have faced regulatory pressure to seek alternative disinfection methods that ensure public health safety, while adhering to regulations that set limits on carcinogenic disinfection by-products (DBPs). Peracetic acid (PAA) is an emerging wastewater disinfectant in the United States that has been widely used in other industries such as food sanitization and does not produce carcinogenic DBPs. However, several factors such as transport, storage, and physical and chemical effects have stymied its widespread use in wastewater markets. Therefore, the purpose of this study was to examine the antimicrobial efficacy of an on-site generated PAA compared against a commercially available PAA. Antimicrobial efficacy was assessed using standard fecal contamination indicators (i.e., total coliforms and Escherichia coli) in six urban wastewater treatment facilities ranging in size and treatment processes. Overall, few statistical differences were found between the antimicrobial efficacies of on-site generated PAA and commercially available PAA; however, before becoming more widely utilized, the on-site PAA should be tested against emerging fecal contamination indicators (e.g., human norovirus and enterovirus) and be assessed in terms of economic and sustainability impacts. PRACTITIONER POINTS: Alternative Ct approaches should be considered when using disinfectants like PAA. On-site generated PAA can achieve the same level of disinfection as commercial PAA. On-site generation of PAA may help further its use as a wastewater disinfectant.

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Zinc has been widely utilized as an antimicrobial material, often in the form of complexes or zinc oxide nanoparticles. The efficacy of zinc complexes are often due to the synergistic effect of both the zinc ions and the attached organic ligands. In contrast, the nanoparticle effect of ZnO, and the photocatalytic generation of reactive oxygen species (ROS) has been postulated to be the effective mechanism of ZnO as a biocide. Recently, new forms of zinc-based biocidal materials have been reported with distinct antimicrobial mechanisms. This minireview summarizes these recent advances, including zinc-based nano-arrays, MOF-based ROS release and zinc composites that can self-generate ROS.

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The isolation wards, institutional quarantine centers, and home quarantine are generating a huge amount of bio-medical waste (BMW) worldwide since the outbreak of novel coronavirus disease-2019 (COVID-19). The personal protective equipment, testing kits, surgical facemasks, and nitrile gloves are the major contributors to waste volume. Discharge of a new category of BMW (COVID-waste) is of great global concern to public health and environmental sustainability if handled inappropriately. It may cause exponential spreading of this fatal disease as waste acts as a vector for SARS-CoV-2, which survives up to 7 days on COVID-waste (like facemasks). Proper disposal of COVID-waste is therefore immediately requires to lower the threat of pandemic spread and for sustainable management of the environmental hazards. Henceforth, in the present article, disinfection technologies for handling COVID-waste from its separate collection to various physical and chemical treatment steps have been reviewed. Furthermore, policy briefs on the global initiatives for COVID-waste management including the applications of different disinfection techniques have also been discussed with some potential examples effectively applied to reduce both health and environmental risks. This article can be of great significance to the strategy development for preventing/controlling the pandemic of similar episodes in the future.

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BACKGROUND: The reduction in microbial bioburden achieved by terminal disinfection in a hospital may vary considerably by type of disinfectant or cleaner and by environmental service (EVS) personnel. This study estimated whether supplemental ultraviolet (UV) irradiation after disinfection or cleaning reduced bioburden and whether the supplemental effect persisted after adjusting for disinfectant or cleaner type and EVS personnel. METHODS: Environmental samples for aerobic bacterial colonies (ABC) and methicillin-resistant Staphylococcus aureus (MRSA) were obtained from 5 high-touch surfaces in patient rooms at 3 time points: before manual cleaning, after manual cleaning using 1 of 3 disinfectants or 1 cleaner, and after UV irradiation. RESULTS: For ABC, the model-estimated mean (95% uncertainty interval) counts were 56% (48%-63%) lower for postmanual + UV compared with manual clean alone, and for MRSA they were 93% (62%-99%) lower for postmanual + UV vs manual clean alone. CONCLUSIONS: Although UV supplementation provides incremental benefit in bioburden reduction across all cleaners or disinfectants tested, it provides the greatest benefit when supplementing cleaners or disinfectants with the lowest disinfection properties. UV irradiation provides additional bioburden reduction to manual cleaning or disinfection, even when accounting for variability introduced by different disinfectants and EVS personnel.