Journal Description
Hygiene
Hygiene
is an international, peer-reviewed, open access journal on healthcare epidemiology, public health and environmentally-related hygiene, published quarterly online by MDPI. We also welcome submissions with a focus on best practices that help maintain health and prevent the spread of diseases.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 21.1 days after submission; acceptance to publication is undertaken in 7.6 days (median values for papers published in this journal in the first half of 2024).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
Latest Articles
Assessment of the Demographic Burden of Epidemics and Diseases within the African Sub-Region: A Review of Recent Epidemiological Data, Responses, and Resultant Psychosocial Risk Tendencies
Hygiene 2024, 4(3), 346-360; https://doi.org/10.3390/hygiene4030027 - 22 Aug 2024
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Background: Over the past few decades, epidemic outbreaks and disease occurrences have become more frequent and widespread in Africa, posing challenges for poor countries in the region and impacting vulnerable populations. Limited resources, inadequate healthcare infrastructure, socioeconomic inequalities, malnutrition, mass gatherings, and lack
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Background: Over the past few decades, epidemic outbreaks and disease occurrences have become more frequent and widespread in Africa, posing challenges for poor countries in the region and impacting vulnerable populations. Limited resources, inadequate healthcare infrastructure, socioeconomic inequalities, malnutrition, mass gatherings, and lack of proper sanitation and hygiene contribute to Africa’s high burden of epidemics and infectious diseases such as cholera, measles, monkeypox, Ebola viral disease, and COVID-19. This paper reviewed epidemic outbreaks and diseases transmitted through intimate contact in Africa and their impacts on vulnerable populations. Methods: A narrative review approach was adopted to gather and analyze the relevant literature on epidemic outbreaks in African sub-regions. The review encompassed causes, transmission patterns, demographic impact, community susceptibility, preventive measures, and psychosocial risk-taking behaviors. Results: This study emphasizes the importance of addressing the causes of response lapses and the resulting human, material, and economic losses in the region. Effective preventive measures include disease surveillance, early mitigation strategies, contact tracing, personal protective measures, improved political and public health leadership, and socioeconomic equity. However, the review highlights challenges in implementing these measures effectively due to limited resources, delayed detection, and difficulties in scaling up response solutions. Conclusions: There is a need for a comprehensive approach involving health departments, infrastructure development, and addressing socioeconomic factors.
Full article
Open AccessArticle
Unveiling the Mechanisms for Campylobacter jejuni Biofilm Formation Using a Stochastic Mathematical Model
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Paulina A. Dzianach, Gary A. Dykes, Norval J. C. Strachan, Ken J. Forbes and Francisco J. Pérez-Reche
Hygiene 2024, 4(3), 326-345; https://doi.org/10.3390/hygiene4030026 - 8 Aug 2024
Abstract
Campylobacter jejuni plays a significant role in human health, food production, and veterinary practice. Biofilm formation is a likely mechanism explaining the survival of C. jejuni in seemingly unfavourable environments, but the underlying mechanisms are poorly understood. We propose a mathematical model to
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Campylobacter jejuni plays a significant role in human health, food production, and veterinary practice. Biofilm formation is a likely mechanism explaining the survival of C. jejuni in seemingly unfavourable environments, but the underlying mechanisms are poorly understood. We propose a mathematical model to unify various observations regarding C. jejuni biofilm formation. Specifically, we present a cellular automaton with stochastic dynamics that describes both the probability of biofilm initiation and its subsequent growth. Our model incorporates fundamental processes such as cell rearrangement, diffusion of chemical compounds, accumulation of extracellular material, cell growth, lysis, and deactivation due to nutrient scarcity. The model predicts an optimal nutrient concentration that enhances population survival, revealing a trade-off where higher nutrient levels may harm individual cells but benefit the overall population. Our results suggest that the lower biofilm accumulation observed experimentally in aerobic conditions compared to microaerobic conditions may be due to a reduced surface invasion probability of individual cells. However, cells that do manage to invade can generate microcolonies of a similar size under both aerobic and microaerobic conditions. These findings provide new insights into the survival probability and size of C. jejuni biofilms, suggesting potential targets for controlling its biofilm formation in various environments.
Full article
(This article belongs to the Special Issue The Challenge of Disinfection and Sterilization in Veterinary Practice)
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Open AccessArticle
Relationship between Tooth Brushing and Hand Washing by Family Type among Adolescents: A 2020 Nationally Representative Korean Survey
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Eun-Jeong Kim, Gyeong-Won Ko, Eun-Ji Seong, Su-Jin Lee, Ye-Seo Lee, Chae-Rim Lee and Hye-Ju Lee
Hygiene 2024, 4(3), 317-325; https://doi.org/10.3390/hygiene4030025 - 5 Aug 2024
Abstract
Habits formed during adolescence tend to persist into adulthood, and correcting poor habits or behaviors during this time is more effective than at other times. Particularly, parents and caregivers should encourage good hygiene habits in their adolescent children by setting a positive example
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Habits formed during adolescence tend to persist into adulthood, and correcting poor habits or behaviors during this time is more effective than at other times. Particularly, parents and caregivers should encourage good hygiene habits in their adolescent children by setting a positive example themselves. Using logistic regression, we analyzed the association between brushing teeth after lunch and washing hands before lunch by family type among 54,848 adolescents from the 17th Youth Health Behavior Survey raw data in 2021. Four logistic regression models were used to adjust for confounders hierarchically. In all models, adolescents who practiced tooth brushing after lunch were 2.09 times more likely to practice hand washing before lunch than those who did not. With and without adjustment, we found that the association between adolescents’ tooth brushing and hand washing practices in two-parent households was stronger than the association between adolescents’ tooth brushing and hand washing practices in single-parent households. Associations were found between tooth brushing and hand washing practices, and these associations were higher among adolescents in two-parent households than among adolescents in single-parent households. The finding of a significant link between family type and personal hygiene habits indicates the need for interventions to enhance the oral health of children and adolescents. Such interventions should be customized to reflect the specific characteristics of the child’s household.
Full article
Open AccessReview
The Antimicrobial Resistance Pandemic Is Here: Implementation Challenges and the Need for the One Health Approach
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Elena Ponzo, Silvia De Gaetano, Angelina Midiri, Giuseppe Mancuso, Presti Giovanna, Danna Giuliana, Sebastiana Zummo and Carmelo Biondo
Hygiene 2024, 4(3), 297-316; https://doi.org/10.3390/hygiene4030024 - 1 Aug 2024
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The issue of antibiotic resistance represents a significant threat that extends beyond human health, encompassing animal welfare and the sustainability of the natural environment. The inappropriate use of antibiotics, poor sanitation and inadequate control measures have contributed to the emergence of drug-resistant bacteria,
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The issue of antibiotic resistance represents a significant threat that extends beyond human health, encompassing animal welfare and the sustainability of the natural environment. The inappropriate use of antibiotics, poor sanitation and inadequate control measures have contributed to the emergence of drug-resistant bacteria, which can spread at the human–animal–environment interface. The documented presence of antimicrobials in agriculture, veterinary medicine and human medicine has convinced all stakeholders of the need to contribute to the development of a “One Health” approach, which recognises the interrelationships between animals, humans and their environment and the need to adopt a common strategy encompassing these sectors to limit the spread of bacterial antimicrobial resistance (AMR). Although a number of countries have implemented integrated surveillance systems to monitor antibiotic use and antimicrobial resistance, available data suggest that the use of antibiotics in humans, animals and the environment is increasing worldwide. Consequently, the emergence of antibiotic-resistant pathogens is becoming a recurring concern. This review provides a comprehensive overview of the measures that are necessary to be taken and implemented in order to guarantee global health security.
Full article
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Open AccessArticle
Comprehensive Analysis of Environmental Monitoring Data from the Department of Nuclear Medicine and Molecular Imaging (NMMI) of the University Medical Center Groningen (UMCG)
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Hendrikus H. Boersma, Mirte M. Woerdenbag, Sascha Mulder, Tirza W. T. Poiesz, Lucas B. S. Bekhof, Hein T. Tholen, Gert Luurtsema, Marjolijn N. Lub-de Hooge, Danique Giesen and Herman J. Woerdenbag
Hygiene 2024, 4(3), 282-296; https://doi.org/10.3390/hygiene4030023 - 27 Jul 2024
Abstract
Environmental monitoring (EM) is the cornerstone for the assurance of sterility during aseptic manufacturing. In this study, the EM quality aspects in the radiopharmaceutical cleanrooms of the University Medical Center Groningen (UMCG), The Netherlands, were evaluated. Hereto, data obtained from EM over the
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Environmental monitoring (EM) is the cornerstone for the assurance of sterility during aseptic manufacturing. In this study, the EM quality aspects in the radiopharmaceutical cleanrooms of the University Medical Center Groningen (UMCG), The Netherlands, were evaluated. Hereto, data obtained from EM over the period 2010–2022 were analyzed. The data were sorted according to the Good Manufacturing Practice (GMP) classification of the respective premises with their corresponding limits, and frequencies of excursions were determined per location. The frequency of conducted measurements gradually increased between the start and end of the assessed period. There was a trend of increased action limit excursions observed between 2010–2022. We found that EM in grade A areas appeared to be significantly less compliant with GMP specifications than the combined data from all sampled premises at the facility (p < 0.00001; two-sided Fisher’s exact test). A trend was found for reduced action limit excursions for passive air sampling and particle counting, suggesting improved GMP compliance over time for this specific type of EM. The contamination recovery rate (CRR) found for cleanroom conditions, around 10%, was considered sufficient. From this comprehensive data analysis, we learn that, in order to be fully compliant with the requirements set in the recent revision of EU (European Union)-GMP Annex 1 ‘Manufacture of sterile medicinal products’ (in force as of 25 August 2023), strategies to further improve product protection are justified. For example, improved cleaning and disinfection procedures, more efficient working methods as well as optimization of the conditions under which aseptic manufacturing is performed are to be considered.
Full article
(This article belongs to the Section Hygiene in Healthcare Facilities)
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Open AccessArticle
A Combined Cleaning and Disinfection Measure to Decontaminate Tire Treads from Tomato Brown Rugose Fruit Virus
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Martina Bandte, Jens Ehlers, Shaheen Nourinejhad Zarghani and Carmen Büttner
Hygiene 2024, 4(3), 269-281; https://doi.org/10.3390/hygiene4030022 - 23 Jul 2024
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Mechanically transmissible and stable viruses such as tobamoviruses, which include Tobamovirus fructirugosum (syn. tomato brown rugose fruit virus (ToBRFV), will continue to pose major challenges for farmers. Consequently, holistic hygiene concepts are being implemented to prevent the introduction and spread of these viruses.
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Mechanically transmissible and stable viruses such as tobamoviruses, which include Tobamovirus fructirugosum (syn. tomato brown rugose fruit virus (ToBRFV), will continue to pose major challenges for farmers. Consequently, holistic hygiene concepts are being implemented to prevent the introduction and spread of these viruses. The decontamination of tires and castors was previously a weak point in many industrial hygiene concepts. For this reason, the ProfilGate clean-off zone was tested in combination with the disinfectant MENNO Florades for the decontamination of ToBRFV-contaminated tires. In total, 478 tire segments were sampled to evaluate the contamination of ToBRFV and the following decontamination of the tires. This treatment reliably removed high (4.5 µg/cm2), medium (0.45 µg/cm2), and low concentrations (0.045 µg/cm2) of ToBRFV from the tires, as shown by a bioassay. The reduction in necrotic local lesions on susceptible indicator plants N. tabacum cv. Xanthi NN was between 91.9 and 97.6%. The reduction in ToBRFV contamination largely depended on the length of the rollover distance, i.e., the number of tire rotations. For transport trolleys with polyamide and rubber tires, depletions of 97.4 and 97.6%, respectively, was determined after 16 rotations. For transport wagons with tires twice the size and polyurethane tread, the depletion was still at least 91% after eight wheel turns. Even in the case of gross soiling of the tires, the mean reduction from the different tread materials was 80.9 to 98.9%. Subsequent analysis of the clean-off zone revealed that ToBRFV did not accumulate, even when the contaminated tires were driven over several times, but was safely inactivated completely in the disinfectant solution. This provides growers with an effective tool for preventing the introduction and spread of ToBRFV.
Full article
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Open AccessArticle
Contamination of High-Touch Surfaces in the Ophthalmic Clinical Environment—A Pilot Study
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Berdjette Y. Y. Lau, Cassandra X. C. Chan, Xin Le Ng, Dawn K. A. Lim, Blanche X. H. Lim and Chris H. L. Lim
Hygiene 2024, 4(3), 258-268; https://doi.org/10.3390/hygiene4030021 - 22 Jul 2024
Abstract
In light of the close contact between patient and clinician during ophthalmic examinations and the multiple opportunities for pathogen transmission, we identified and evaluated potential pathogen transmission routes through high-touch surfaces in an outpatient ophthalmology clinic. A circuit simulation was performed to replicate
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In light of the close contact between patient and clinician during ophthalmic examinations and the multiple opportunities for pathogen transmission, we identified and evaluated potential pathogen transmission routes through high-touch surfaces in an outpatient ophthalmology clinic. A circuit simulation was performed to replicate a patient’s journey through an ophthalmology clinic with various stations. Fluorescent oil and powder were applied to the hands of Simulated Patient A who went through the circuit. Routine disinfection of surfaces in the slit lamp environment and hand hygiene by the ophthalmologist were conducted prior to Simulated Patient B going through the same circuit with untagged hands. Ultraviolet black light was used to identify fluorescent marker contamination after Simulated Patient B completed the circuit. Fluorescent marker contamination was found on the hands of all the simulated patients and staff, various items of the simulated patients, multiple equipment surfaces—particularly the ophthalmologist’s working table and slit lamp environment—and miscellaneous objects like appointment cards and files. Fluorescent marker contamination on Simulated Patient B’s untagged hands despite proper hand hygiene being performed prior suggests suboptimal surface disinfection following Simulated Patient A’s circuit. Through this pilot study, we recognised the key role that ophthalmic high-touch surfaces play in fomite transmission and that thorough disinfection of high-touch surfaces is essential on top of proper hand hygiene. With the contact sequences delineated in this pilot study, specific cues for hand hygiene and surface disinfection may be implemented at suitable intervals during contact with high-touch surfaces. Environmental decontamination adjuncts could also be considered to reinforce surface disinfection.
Full article
(This article belongs to the Section Hygiene in Healthcare Facilities)
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Open AccessArticle
Comparison of the Proteome of Staphylococcus aureus Planktonic Culture and 3-Day Biofilm Reveals Potential Role of Key Proteins in Biofilm
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Md. Arifur Rahman, Ardeshir Amirkhani, Durdana Chowdhury, Karen Vickery and Honghua Hu
Hygiene 2024, 4(3), 238-257; https://doi.org/10.3390/hygiene4030020 - 3 Jul 2024
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Staphylococcus aureus and coagulase-negative staphylococci account for about 80% of infections associated with medical devices and are associated with increased virulence due to their ability to form biofilm. In this study, we aimed to construct a comprehensive reference map followed by significant pathway
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Staphylococcus aureus and coagulase-negative staphylococci account for about 80% of infections associated with medical devices and are associated with increased virulence due to their ability to form biofilm. In this study, we aimed to construct a comprehensive reference map followed by significant pathway analysis in the proteome of S. aureus biofilm grown for 3 days compared with 24 h of planktonic culture using a high-resolution Tandem Mass Tag (TMT)-based MS. We identified proteins associated with secondary metabolites, ABC transporters, biosynthesis of amino acids, and response to stress, and amino sugar and nucleotide sugar metabolism were significantly upregulated in 3-day biofilm. In contrast, proteins associated with virulence factors, microbial metabolism in diverse environments, secondary metabolites, translation, and energy metabolism were significantly downregulated. GO functional annotation indicated that more proteins are involved in metabolic processes, catalytic activity, and binding in biofilm, respectively. Among the significantly dysregulated proteins, hyaluronidase (hysA) in conjunction with chitinase may play a significant role in the elimination and/or prevention of biofilm development. This study advances the understanding of the S. aureus subproteome, identifying potential pathways significant to biofilm biology. The insights gained may aid in developing new therapeutic strategies, including antibiofilm agents, for treating biofilm-related infections associated with implantable medical devices.
Full article
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Open AccessArticle
Compliance of the Dryness of Dental Handpieces for Their Sterilization under Various Treatment Conditions
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Axel Fruhauf, Gabriel Fernandez de Grado, Julie Scholler and Damien Offner
Hygiene 2024, 4(2), 231-237; https://doi.org/10.3390/hygiene4020019 - 18 Jun 2024
Abstract
Objectives: In the protocol for cleaning and sterilizing dental handpieces (DHs), water retention within the instrument poses a challenge and may compromise the sterilization process. This study aimed to assess the reliability and reproducibility of the sterilization protocol regarding the dryness of DHs.
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Objectives: In the protocol for cleaning and sterilizing dental handpieces (DHs), water retention within the instrument poses a challenge and may compromise the sterilization process. This study aimed to assess the reliability and reproducibility of the sterilization protocol regarding the dryness of DHs. It evaluated the presence of residual water in these instruments after various conditions of treatment through multiple dryness tests. Methods: This comparative study examined the dryness of seven different DHs following five washing–disinfection and/or sterilization protocols. Dabbing tests, shaking by hand, or compressed air tests through DHs and over absorbent paper were employed to ascertain the thorough dryness of DHs after treatment. As soon as the first sign of water appeared on the absorbent paper, the DH was deemed to be not dry. Results: Upon completion of the washing–disinfection protocol without sterilization, five out of seven DHs were deemed dry using the dabbing test, yet none were fully dry when subjected to shaking or compressed air. However, in the four protocols incorporating final sterilization, all DHs were dry according to the three drying tests. Conclusion: This study underscores the essential role of the sterilization step in eliminating residual water from DHs, thereby ensuring optimal conditions for effective sterilization in terms of dryness. Furthermore, the study recommends against relying solely on the dabbing drying test, emphasizing the importance of shaking or using compressed air to confirm instrument dryness.
Full article
(This article belongs to the Section Oral and Dental Hygiene)
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Open AccessArticle
Oral Hygiene Practices and Oral Health Knowledge among Adult Orthodontic Patients: A Best Practice Implementation Project
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Antonija Tadin, Marija Badrov, Branimira Mikelic Vitasovic and Tina Poklepovic Pericic
Hygiene 2024, 4(2), 221-230; https://doi.org/10.3390/hygiene4020018 - 3 Jun 2024
Cited by 1
Abstract
Orthodontic therapy is associated with a more significant accumulation of dentobacterial plaque and impaired oral hygiene, which increase the risk of developing dental caries and periodontal disease. Therefore, it is crucial to educate orthodontic patients about proper oral hygiene maintenance and oral health
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Orthodontic therapy is associated with a more significant accumulation of dentobacterial plaque and impaired oral hygiene, which increase the risk of developing dental caries and periodontal disease. Therefore, it is crucial to educate orthodontic patients about proper oral hygiene maintenance and oral health before and during treatment. The aim of this pilot study was to implement evidence-based best practices related to oral hygiene in adult orthodontic patients and improve compliance. In addition to evaluating oral hygiene practices, another goal of the project was to assess the knowledge of orthodontic patients regarding oral health. Questionnaires with seven pre- (before) and post-test criteria (90 day after implementation) were developed based on the best evidence available. This project was conducted in a private dental clinic in Split, Croatia, and included 45 patients. The baseline audit showed a gap between clinical practice and the best evidence. Three criteria achieved a high compliance baseline, while after implementation, there were substantial improvements in compliance for all. The everyday use of mouthwash improved from 17.8% at baseline to 66.7% at follow-up, as did the use of interdental aids, which increased from 55.6% to 91.1%. Statistically significant differences were found in the total score for oral health knowledge between the baseline (6.67 ± 1.74) and the follow-up audit (7.78 ± 0.56, p ≤ 0.001). The strategies developed in this project were effective in providing essential information to adult orthodontic patients and improving compliance with evidence. Guidelines on this topic should be designed to assist orthodontists and patients in maintaining oral health and oral hygiene.
Full article
(This article belongs to the Section Oral and Dental Hygiene)
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Open AccessArticle
Specific Personal Hygiene Procedures and Practices in Food Handlers—A Cross-Sectional Study in Butcher and Fishmonger Shops in Almada
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Inês Oliveira, Miguel Almeida, João J. Ferreira Gomes and Ana Rita Henriques
Hygiene 2024, 4(2), 207-220; https://doi.org/10.3390/hygiene4020017 - 31 May 2024
Cited by 1
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Good manufacturing practices play an important role in obtaining safe food and preventing foodborne diseases. To achieve this goal, food handlers must receive appropriate training to be aware of their responsibilities. In this work, compliance with specific personal hygiene requirements by food handlers
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Good manufacturing practices play an important role in obtaining safe food and preventing foodborne diseases. To achieve this goal, food handlers must receive appropriate training to be aware of their responsibilities. In this work, compliance with specific personal hygiene requirements by food handlers was assessed in a cross-sectional study of traditional small retail establishments, namely butcher (n = 56) and fishmonger (n = 17) shops in Almada, Portugal. Food handlers (n = 140, of which 113 worked in butcher shops, and 27 worked in fishmonger shops) were interviewed for data collection, and retail establishments were audited considering specific hygiene requisites. In fishmonger shops, most food handlers are women (89%), aged 18 to 45 years (70%), with a high school degree, having worked for less than 5 years in this activity, while in butcher shops most food handlers are men (90%) over 45 years old (58%), with a basic education level, and more than 26 years of experience. Most food handlers (>95%) attended recent food safety and hygiene training courses and were able to recognize that hand sanitizers cannot replace a proper hand wash, and to identify Staphylococcus aureus transmission routes to food. However, approximately 23% of retail establishments failed to provide hot water in the handwashing basin and exhibited improper placement of handwashing instructions. Furthermore, these establishments did not implement corrective actions following non-conforming microbiological results of hand hygiene monitoring. These findings reinforce the need for consistent management commitment, and for providing food handlers with regular training, which is crucial for maintaining a strong food safety and hygiene culture in these traditional small retail establishments.
Full article
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Open AccessArticle
Hygienic Practices and Level of Contamination in Toothbrushes at Mexican Homes in Guadalajara, Jalisco
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Luz Eduviges Garay-Martínez, Andrés Octavio Betancourt-Cortés, Alondra Lizeth Reyes-Castellanos, Sara Gabriela Ulloa-Pérez, Carlos Arnulfo Velázquez-Carriles, Beatriz Venegas-Ruiz and Jorge Manuel Silva-Jara
Hygiene 2024, 4(2), 197-206; https://doi.org/10.3390/hygiene4020016 - 25 May 2024
Abstract
In the present study, a Google Forms survey open questionnaire was applied to identify variables in hygiene habits that influence the contamination of toothbrushes in Mexican homes. A total of 275 questionnaires were validated, and 18 samples were analyzed to determine microbiology indicator
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In the present study, a Google Forms survey open questionnaire was applied to identify variables in hygiene habits that influence the contamination of toothbrushes in Mexican homes. A total of 275 questionnaires were validated, and 18 samples were analyzed to determine microbiology indicator groups (Mesophilic Aerobic Bacteria [MAB], Coliform Organisms [CO], and Yeast and Molds [Y/M]) with dilution and plate casting methods. Results were compared with data obtained from surveys, which were encoded to construct conglomerates. Interestingly, a higher microbial count was found in toothbrushes stored in cases (4.9 × 109 CFU/mL for MAB, 4.43 × 109 CFU/mL for CO, and 4.38 × 109 CFU/mL for Y/M), while the use and disposal of toothbrushes following recommendations of life expectancy limited bacterial growth (<10 CFU/mL for CO and Y/M), reducing the possible growth of pathogens such as Klebsiella pneumoniae, Streptococcus pyogenes, and Pseudomonas, among others. Finally, most people do not have the habit of disinfecting their toothbrushes periodically. Further, the survey revealed that disinfection techniques applied by a limited group (14% of the respondents) are improvised and are not standardized with the objective of disinfection.
Full article
(This article belongs to the Section Oral and Dental Hygiene)
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Open AccessArticle
Visualization of Effectiveness: The Use of a Set of Colored Cleaning Wipes for Visible Disinfection of Ultrasound Probes
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Christian Kühnel and Falk Gühne
Hygiene 2024, 4(2), 189-196; https://doi.org/10.3390/hygiene4020015 - 15 May 2024
Abstract
The German health authorities’ guidelines for medical devices in 2012 highlighted the importance of cleaning ultrasound probes, emphasizing their validation and reliability. In addition to automated and validated options, alternative manual methods such as wipe disinfection have gained traction due to their independence
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The German health authorities’ guidelines for medical devices in 2012 highlighted the importance of cleaning ultrasound probes, emphasizing their validation and reliability. In addition to automated and validated options, alternative manual methods such as wipe disinfection have gained traction due to their independence from additional hardware. The study examines the effectiveness of a manual cleaning process using wipes, addressing concerns raised by the Robert Koch Institute regarding the lack of validation for wipe disinfection of semi-critical devices. The EQUINOS colored wipe disinfection kit identified wetting gaps in all cleanings across four probes tested. The results indicate significant challenges in ensuring complete surface wetting, particularly in complex device parts such as clip-on areas and fixtures for additional biopsy attachments, suggesting that manual methods alone may not adequately mitigate the risk of infection transmission (p value < 0.0001). The study concludes that while manual disinfection methods are a commonly used alternative to automated reprocessing, there is a critical need for enhanced training and potentially the development of more effective manual disinfection techniques or colored wipes to ensure patient safety and compliance with healthcare hygiene standards.
Full article
(This article belongs to the Section Hygiene in Healthcare Facilities)
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Open AccessArticle
Effectiveness of Nudge Tools to Promote Hand Disinfection among Healthcare Professionals and Visitors in Health Institution: The Slovenian Pilot Study
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Neža Podvratnik, Andrej Ovca and Mojca Jevšnik
Hygiene 2024, 4(2), 178-188; https://doi.org/10.3390/hygiene4020014 - 6 May 2024
Abstract
Healthcare-associated infections (HAIs) are considered to be one of the biggest health problems as they continue to be an important cause of morbidity and mortality worldwide. They cannot be completely prevented, but their incidence can be significantly limited. Preventive action is the most
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Healthcare-associated infections (HAIs) are considered to be one of the biggest health problems as they continue to be an important cause of morbidity and mortality worldwide. They cannot be completely prevented, but their incidence can be significantly limited. Preventive action is the most important measure in this case. Due to the frequent interaction between healthcare professionals and patients, the crucial importance of hand hygiene is therefore emphasised. Adherence to good disinfection and hand washing practices remains around 40%, which can be improved by using a variety of nudge tools to promote desired hygienic behaviour. We conducted an open observation of employees and visitors with participation. The aim of this study was to determine the actual status of hand disinfection in a selected healthcare facility amongst doctors, registered nurses, medical technicians, cleaners, and visitors or parents of children; then, we selected and introduced three nudge tools of desired hygiene behaviour and analysed their effectiveness; finally, we provided suggestions for the use of nudge tools of desired hygiene behaviour with the aim of influencing doctors, registered nurses, medical technicians, cleaners, and visitors or parents of children so that they disinfect their hands properly. The actual state of hand disinfection was determined on the basis of observation without introducing any changes; then, we separately introduced three nudge tools, posters with an inscription and picture, the scent of citrus, and flashing lights. The obtained results were analysed with the help of the SpeedyAudit Lite application, and the effectiveness of each nudge tool and the adequacy of hand disinfection by categories of people were compared. In general, posters with a picture and an inscription contributed the most to more consistent disinfection of employees’ hands, while the scent of citrus and flashing lights contributed slightly less.
Full article
(This article belongs to the Section Hygiene in Healthcare Facilities)
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Open AccessArticle
Evaluating the Ergonomic Performance of a Novel Periodontal Curette with Adaptive Handle Design
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Cherie Wink, Kairong Lin, Benjamin E. Dolan, Kathryn Osann, Ali A. Habib and Petra Wilder-Smith
Hygiene 2024, 4(2), 164-177; https://doi.org/10.3390/hygiene4020013 - 22 Apr 2024
Abstract
(1) Background: Periodontal instrumentation with dental curettes is associated with discomfort, fatigue, and musculoskeletal diseases. The goal of this study was to compare comfort, fatigue, and muscle work using three different curettes. (2) Methods: Eight hygienists each scaled three typodonts using the three
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(1) Background: Periodontal instrumentation with dental curettes is associated with discomfort, fatigue, and musculoskeletal diseases. The goal of this study was to compare comfort, fatigue, and muscle work using three different curettes. (2) Methods: Eight hygienists each scaled three typodonts using the three different curettes. Curette A was a prototype with a novel adaptive design, Curette B had a conventional stainless-steel design, and Curette C featured a conventional silicon-covered handle. Time-based work in four muscles, comfort, fatigue, tactile feedback, grip and blade position, and pinch and grasp strength were recorded. Statistical analysis was performed using a General Linear Model (GLIM) and Tukey’s post hoc test. The level of significance was set at p < 0.05. (3) Results: Comfort, correct grasp, fingertip placement, and blade-to-tooth adaptation were significantly better with Curette A (p < 0.05). While pinch and grasp strength were significantly reduced post-instrumentation for Curettes B and C (p < 0.05), they remained unchanged for Curette A. Curette A required significantly less total muscle work and work in individual muscles, resulting in significantly less post-instrumentation fatigue than for Curettes B and C, but similar levels of tactile feedback (p < 0.05). (4) Conclusions: The ergonomic performance of a prototype adaptive periodontal curette was significantly better than that of two conventional instruments with rigid handle designs.
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(This article belongs to the Section Oral and Dental Hygiene)
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Open AccessBrief Report
Ralstonia insidiosa Bacteremia in Patients with Solid Cancer Treated by Means of a Central Venous Catheter
by
Lorenzo Ruggieri, Anna Lisa Ridolfo, Sara Giordana Rimoldi, Maria Silvia Cona, Davide Dalu, Pietro Olivieri, Giuliano Rizzardini, Spinello Antinori, Anna Gambaro, Sabrina Ferrario, Cinzia Fasola, Maria Antista, Carmen Giusy Rea and Nicla La Verde
Hygiene 2024, 4(2), 157-163; https://doi.org/10.3390/hygiene4020012 - 17 Apr 2024
Abstract
Ralstonia spp. are low-virulent environmental Gram-negative bacteria that can cause serious nosocomial infections in immunocompromised patients. We report the characteristics of a cluster of R. insidiosa bacteremia cases occurring in our oncology day ward in Milan, Italy, between January and March 2022. A
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Ralstonia spp. are low-virulent environmental Gram-negative bacteria that can cause serious nosocomial infections in immunocompromised patients. We report the characteristics of a cluster of R. insidiosa bacteremia cases occurring in our oncology day ward in Milan, Italy, between January and March 2022. A case was defined as a cancer patient attending our day ward and whose blood culture (performed because of bacteremia symptoms) led to the isolation of Ralstonia insidiosa. An epidemiological investigation was conducted in order to seek the possible source of infection. Seven adult patients received curative or palliative treatment via infusion through a Port-a-Cath (PAC). All developed symptoms within 24 h of the infusion (three during the infusion itself). Ralstonia insidiosa was isolated in the blood drawn from the PAC in all patients. All of the isolates were susceptible to carbapenems, fluoroquinolones, and piperacillin/tazobactam but resistant to aminoglycosides and cephalosporins. Systemic and/or lock antibiotic therapy led to stable symptom resolution and negative blood cultures in five patients, whereas bacteremia recurred in two patients. An epidemiological investigation suggested that extrinsic contamination of antiseptic solutions was the possible cause of the R. insidiosa infections. Although R. insidiosa is not considered a virulent pathogen, clinicians, microbiologists, and infection control teams should be aware about its potential to cause outbreaks of nosocomial bloodstream infections, especially in immunocompromised patients bearing central venous catheters.
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(This article belongs to the Section Infectious Disease Epidemiology, Prevention and Control)
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Open AccessArticle
Formation/Removal of Biofilms on/from Coupons of Selected Food-Grade Elastomeric Polymers vs. Plexiglass Used for the Fruit-Catching Plates of OTR Blueberry Machine Harvesters
by
Peien Wang, Minji Hur, Lisa Wasko DeVetter, Fumiomi Takeda and Jinru Chen
Hygiene 2024, 4(2), 146-156; https://doi.org/10.3390/hygiene4020011 - 11 Apr 2024
Abstract
To reduce the bruising potential of machine-harvested fresh blueberries, manufacturers of over-the-row (OTR) machine harvesters are replacing the hard, plexiglass fruit-catching plates with soft, elastomeric polymers. This study assessed whether selected soft, food-grade elastomeric polymers, with the potential to be used in OTR
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To reduce the bruising potential of machine-harvested fresh blueberries, manufacturers of over-the-row (OTR) machine harvesters are replacing the hard, plexiglass fruit-catching plates with soft, elastomeric polymers. This study assessed whether selected soft, food-grade elastomeric polymers, with the potential to be used in OTR harvesters, have a greater likelihood to encourage more microbial buildups, making cleaning/sanitation a greater challenge. Coupons of plexiglass, silicone, neoprene, and ethylene propylene diene monomer (EPDM) were exposed to fecal coliforms from various sources for biofilm development. The coupons with developed biofilms were treated with sodium hypochlorite, peracetic acid, isopropyl alcohol-based quaternary ammonium compounds (Alpet D2), or commercial dish soap. Biofilms and their residuals after the sanitizer treatments were quantified. The fecal coliforms isolated from the surface of OTR harvesters developed significantly (p ≤ 0.05) more biofilms than those from other sources. EPDM coupons had significantly more, while neoprene and silicone coupons had insignificantly different (p > 0.05) amounts of biofilms from plexiglass coupons. After sanitizer treatments, EPDM coupons had significantly more, while neoprene and certain silicon coupons had significantly fewer residues than plexiglass coupons. Study suggests that compared to plexiglass, neoprene and silicon did not support more microbial buildups or retain more biofilms after sanitizing treatments.
Full article
(This article belongs to the Section Food Hygiene and Safety)
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Open AccessArticle
Antimicrobial Properties of Basil (Ocimum basilicum L.), Sage (Salvia officinalis L.), Lavender (Lavandula officinalis L.), Immortelle (Helichrysum italicum (Roth) G. Don), and Savory (Satureja montana L.) and Their Application in Hard Cheese Production
by
Nevijo Zdolec, Marijana Franičević, Lucija Klanac, Ivana Kavain, Josip Batinić, Manuela Zadravec, Jelka Pleadin, Darko Čobanov and Marta Kiš
Hygiene 2024, 4(2), 135-145; https://doi.org/10.3390/hygiene4020010 - 29 Mar 2024
Abstract
The aim of the study was to evaluate the antimicrobial activity of the extracted plants basil (Ocimum basilicum L.), sage (Salvia officinalis L.), lavender (Lavandula officinalis L.), immortelle (Helichrysum italicum (Roth) G. Don), savory (Satureja montana L.), and
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The aim of the study was to evaluate the antimicrobial activity of the extracted plants basil (Ocimum basilicum L.), sage (Salvia officinalis L.), lavender (Lavandula officinalis L.), immortelle (Helichrysum italicum (Roth) G. Don), savory (Satureja montana L.), and rosemary (Salvia rosmarinus Spenn.) against foodborne and clinical pathogens. Dried plants were used in the production of Dalmatian cow’s milk hard cheese at concentrations of 0.5, 1.0, 1.5, and 2% to evaluate the microbiological safety and sensory properties of novel cheeses. The broadest antimicrobial activity was found in rosemary and sage, inhibiting ten indicator pathogens, and the strongest antimicrobial activity was found in immortelle and sage, which showed the widest zones of inhibition. The most sensitive indicators were Staphylococcus species and Yersinia enterocolitica. The supplemented cheeses met the official microbiological criteria and were mycotoxin negative. The surface mycobiota of control and experimental cheeses consisted mainly of Penicillium sollitum, based on the sequence analysis of the beta-tubulin and calmodulin genes. The antifungal effect of the added plants was clearly demonstrated in cheeses with added basil and sage (p < 0.05).
Full article
(This article belongs to the Section Food Hygiene and Safety)
Open AccessArticle
Prevalence of Contagious Mastitis Pathogens in Bulk Tank Milk from Dairy Farms in Lower Saxony, Germany
by
Jan Kortstegge and Volker Krömker
Hygiene 2024, 4(2), 122-134; https://doi.org/10.3390/hygiene4020009 - 26 Mar 2024
Cited by 2
Abstract
The aim of this study was to determine the prevalence of Streptococcus (Sc.) agalactiae, Prototheca spp., Staphylococcus (S.) aureus, and especially methicillin-resistant S. aureus as well as Myco-plasmopsis (M.) spp. and M. bovis in bulk
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The aim of this study was to determine the prevalence of Streptococcus (Sc.) agalactiae, Prototheca spp., Staphylococcus (S.) aureus, and especially methicillin-resistant S. aureus as well as Myco-plasmopsis (M.) spp. and M. bovis in bulk tank milk (BTM) on dairy farms in Lower Saxony, Germany. BTM samples were collected in January 2023 from 208 selected dairy farms. The samples were quantitatively culturally analyzed for S. aureus and Prototheca spp. Presumptive S. aureus colonies were further confirmed by MALDI-TOF. Presumptive Prototheca spp. colonies were confirmed by light microscopy. Sc. agalactiae and Mycoplasmopsis spp. were detected by real-time polymerase chain reaction (rtPCR). Sc. agalactiae was detected in two herds (1% (Confidence Interval 95% (CI) 0.3–3.4)). S. aureus was confirmed by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) in 38 herds (18.3% (CI 13.6–24.1)), assuming a threshold of >10 cfu/mL milk. A total of 154 isolates identified as S. aureus by MALDI-TOF were transferred to agar with added oxacillin for resistance testing, of which 19 isolates (12.3% (CI 8–18.5)) showed growth. The 19 isolates came from eight different farms (3.8% (2–7.4)). Prototheca spp. were identified in 13 herds (6.3% (CI 3.7–10.4)). Mycoplasmopsis spp. were detected by PCR in 18 herds (8.7% (CI 5.5–13.3)). Of these, M. bovis was present in three herds (1.4% (0.5–4.2)). The herd prevalence of Sc. agalactiae in BTM appears to be at low levels in the sampled area. The prevalence of Mycoplasmopsis spp. in the herds was higher than expected compared to previous studies. It is interesting to note that the percentage of M. bovis in the total Mycoplasmopsis spp. was only 16.7%.
Full article
(This article belongs to the Section Veterinary, Livestock, and Biosafety)
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Open AccessOpinion
Reusable Medical Device Pre-Cleaning in Care Units: What Are the Indicators to Prevent Biofilm Formation and Control Occupational Biological Risk?
by
Anaclara F. V. Tipple, Rúbia Lícia R. Sodré, Lais C. Nascimento and Dayane M. Costa
Hygiene 2024, 4(1), 115-121; https://doi.org/10.3390/hygiene4010008 - 20 Mar 2024
Abstract
The pre-cleaning of reusable medical devices is essential for successful cleaning, as it prevents biofilm formation that can compromise disinfection and sterilization. This study aimed to reflect on the recommendations regarding the pre-cleaning of reusable medical devices carried out in care units, such
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The pre-cleaning of reusable medical devices is essential for successful cleaning, as it prevents biofilm formation that can compromise disinfection and sterilization. This study aimed to reflect on the recommendations regarding the pre-cleaning of reusable medical devices carried out in care units, such as wards, based on recommendations from guidelines/standards related to this important step in reusable medical device reprocessing. However, recommendations for pre-cleaning in care units are not unanimous and contrast with detailed recommendations on reusable medical device reprocessing in the Central Sterile Services Department (CSSD). This topic is an unresolved issue, strongly related to patient and worker safety, which points to the lack of investigations to provide indicators of best practice and highlights the need for shared responsibility management between care units and CSSD.
Full article
(This article belongs to the Section Infectious Disease Epidemiology, Prevention and Control)
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