614 Inzidenz und Prävention von Krankheiten
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The need for disinfection in ambulances is high as medical procedures are performed inside the cars and patients may have open wounds that pose a high risk of infection. The application of reactive products from air's oxygen and water vapor, brought to reaction through cold plasma, can be a solution to the discrepancy in surface hygiene. The cell membrane of the microorganisms is perforated by the charged particles of the cold plasma. This is impossible in human cells because proteins in the form of enzymes break down the cold plasma and protect the cells. An ambulance was contaminated in 8 places. Samples were taken at each site and two surfaces of approximately 8x8 cm were sealed and marked. Both surfaces were contaminated with an Enterococcus faecium suspension of 8.5x107CFU/mL by applying the suspension with a sterile cotton swab. Then, the disinfection process was applied. The PLASMOCAR® device was placed in the front work surface and operated for 30 minutes using the vehicle's onboard voltage. During operation, doors and windows were closed and the vehicle's air conditioning was active. The surfaces for bacterial counts were sampled after the disinfection process was completed. A reduction of 3.73 log levels in initial bacteria was achieved in the rescue vehicle for Enterococcus faecium, equivalent to a 10-4-fold reduction in bacteria, eliminating up to 99.99% of the initial microorganisms. This makes the process suitable as a continuously "background" procedure to support and relieve established disinfection procedures. The established disinfection procedures per hygiene plan should be recognized as soon as mechanical cleaning of surfaces is needed. The use of PLASMOCAR® provides additional security and significantly reduces the background risk of transmitting microorganisms through cross-contamination and aerosols, a relevant benefit for staff and patients.
Cold atmospheric plasma-aerosol (CAP-A) offers a promising alternative to conventional sterilisation and disinfection methods, which are often unsuitable for thermolabile medical devices due to high temperatures, toxic chemicals or radiation. CAP-A efficiently inactivates microorganisms and viruses without compromising the material integrity. Given the ongoing risk of infection associated with ultrasound probes and other delicate diagnostic instruments, this study investigates whether an indirect CAP-A method can meet all requirements for effective and safe disinfection of thermolabile medical devices. The disinfection of thermolabile medical devices was carried out in a container saturated with indirect CAP-A. A transvaginal ultrasound probe was used as a reference product. The study involved six test organisms, with five measurements taken at six different measurement points. The study showed that Enterococcus hirae (mean logarithmic reduction factor (LRF) 6.23), Staphylococcus aureus (mean LRF 6.51), and Enterococcus faecium (mean LRF 6.16) demonstrated a germ reduction of 99.9999%. For Pseudomonas aeruginosa (mean LRF 5.40) and Escherichia coli (mean LRF 5.29), a germ reduction of 99.999% was achieved, and for Candida albicans (mean LRF 4.95) and Clostridioides difficile (mean LRF 4.62), a germ reduction of 99.99% was demonstrated. The log reduction demonstrates a complete inactivation of the six tested microorganisms. The initially defined requirements for an effective disinfection process for thermolabile medical devices were met in the CAP-A method. Regarding highly tenacious microorganisms, such as Clostridioides difficile, the method of CAP-A proved effective, superior to alcohol-based methods, and with no resistance development observed. Its efficacy is otherwise only known in corrosive chemicals, such as hydrogen peroxide, chlorine, and chlorine dioxide. However, these chemicals have corrosive-oxidative effects on the surfaces to be disinfected and are critical in terms of market launch and hazardous material classification. Therefore, the method of CAP-A, provides an effective, material-friendly alternative.
The introduction of fundamental hygiene protocols within the healthcare sector during the nineteenth century led to a significant reduction in mortality rates. Contemporary advancements, such as alcohol-based sanitizers, have further enhanced hand hygiene practices. However, these measures are often overlooked in nursing facilities, resulting in low staff compliance rates and increased cross-infection rates. Novel approaches, such as cold plasma hand disinfection, present promising alternatives due to their minimal skin damage and economic benefits. This study aims to compare the disinfectant efficacy of cold plasma aerosol under practical application conditions with an alcoholic hand disinfectant listed by the Association for Applied Hygiene. The microbial count on participants’ hands was measured, with particular attention paid to the spontaneous occurrence of fecal indicators and the presence of potentially infectious bacteria. A t-test for independent samples was conducted to determine whether there was a significant difference between the two cohorts regarding the research question. Statistical analysis revealed that the mean log colony-forming unit (CFU) values were significantly lower in the test cohort using only the cold plasma method for hand disinfection compared to the cohort using conventional alcohol-based hand disinfection. Moreover, it was demonstrated that, unlike alcohol-based hand disinfection, cold plasma application ensures the effective elimination of Staphylococcus aureus. The findings indicate that staff utilizing plasma disinfection have an average bacterial count that is 0.65 log units lower than those who regularly use alcohol-based hand disinfection. In addition to the efficacy of cold plasma disinfection, its superiority over alcohol-based hand disinfection was also established. Beyond offering economic and logistical advantages, cold plasma disinfection provides additional health benefits as it does not induce skin damage, unlike alcohol-based hand disinfection.
