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      Decontamination effect of neutral electrolysed water for spray nozzles of electric warm-water bidet toilet seats in the healthcare setting

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          Summary

          Background

          There has been an increasing demand for more sanitary bidet seats in many healthcare settings because of concerns regarding potential contamination of the spray nozzles of warm-water bidet toilet seats. This contamination is thought to possibly serve as a reservoir for horizontal transmission of drug-resistant bacteria.

          Aim

          This study was performed to determine the optimal Pseudomonas aeruginosa decontamination conditions and verify the effectiveness of these decontamination conditions.

          Methods

          An in vitro test of rinsing with neutral electrolysed water was performed using seven strains of P. aeruginosa. The decontamination effect of the neutral electrolysed water was verified by a field test involving an analysis of the number of bacteria isolated from samples collected from the spray nozzles and the sprayed water from 10 toilet seats at the internal medicine ward of Juntendo University Hospital.

          Findings

          The in vitro test results showed that the decontamination effect of neutral electrolysed water tended to be higher with higher free chlorine concentrations in the nozzle-cleaning water and shorter intervals of rinsing. The field test involving the hospital ward toilets showed that routine physical cleaning was satisfactorily effective.

          Conclusion

          The study results suggest that the risk of horizontal transmission of drug-resistant bacteria via the use of bidet toilet seats in hospitals can be reduced by general cleaning and appropriate control of the free chlorine concentration in the nozzle-cleaning water.

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          Most cited references21

          • Record: found
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          Investigation of the freely available easy-to-use software ‘EZR' for medical statistics

          Y Kanda (2012)
          Although there are many commercially available statistical software packages, only a few implement a competing risk analysis or a proportional hazards regression model with time-dependent covariates, which are necessary in studies on hematopoietic SCT. In addition, most packages are not clinician friendly, as they require that commands be written based on statistical languages. This report describes the statistical software ‘EZR' (Easy R), which is based on R and R commander. EZR enables the application of statistical functions that are frequently used in clinical studies, such as survival analyses, including competing risk analyses and the use of time-dependent covariates, receiver operating characteristics analyses, meta-analyses, sample size calculation and so on, by point-and-click access. EZR is freely available on our website (http://www.jichi.ac.jp/saitama-sct/SaitamaHP.files/statmed.html) and runs on both Windows (Microsoft Corporation, USA) and Mac OS X (Apple, USA). This report provides instructions for the installation and operation of EZR.
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            Pseudomonas aeruginosa and Pseudomonas putida outbreak associated with contaminated water outlets in an oncohaematology paediatric unit.

            Florence Paillard, O Baud, C Aumeran … (2006)
            This paper describes an outbreak of Pseudomonas aeruginosa and Pseudomonas putida that occurred in an oncohaematology paediatric unit between January and April 2005. Eight children had nosocomial infections due to P. aeruginosa (N=5) or P. putida (N=3), which were recovered from central venous catheter blood cultures (N=4), the catheter exit site alone (N=2), or the catheter exit site and the catheter tip (N=2). Subsequent investigation showed that contaminated water outlets represented the possible source of spread. Studies of nursing and environmental cleaning practices revealed two modes of catheter contamination. A reduction in the size of the catheter dressing at the exit site gave less protective cover during showers, and a detergent-disinfectant diluted with tap water had contaminated perfusion bottles. Repetitive intergenic consensus polymerase chain reaction indicated two discrete patterns for P. aeruginosa and one for P. putida. The water network was chlorinated, and disposable seven-day filters were fitted on all taps and showers. Due to the deleterious effects of chlorination on the water network and the cost of the weekly filter change, a water loop producing microbiologically controlled water was installed. In addition, the concentration of the detergent-disinfectant was increased and refillable sprayers were replaced with ready-to-use detergent-disinfectant solution for high-risk areas. Following these measures, no Pseudomonas spp. have since been isolated in clinical or environmental samples from the ward.
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              Fate of foodborne pathogens on green onions and tomatoes by electrolysed water.

              E.-J. Park, E. Alexander, G A Taylor … (2008)
              To investigate the efficacy of electrolysed water (EW) in killing Escherichia coli O157:H7, Salmonella typhimurium and Listeria monocytogenes on the surfaces of spot-inoculated green onions and tomatoes.
              Article 0 comments Cited 10 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Aiko Itami
                Journal
                Journal ID (nlm-ta): Infect Prev Pract
                Journal ID (iso-abbrev): Infect Prev Pract
                Title: Infection Prevention in Practice
                Publisher: Elsevier
                ISSN (Electronic): 2590-0889
                Publication date PMC-release: 22 April 2021
                Publication date Collection: June 2021
                Publication date (Electronic): 22 April 2021
                Volume: 3
                Issue: 2
                Electronic Location Identifier: 100143
                Affiliations
                [a ]Department of Infection Control Science, Graduate School of Medicine, Juntendo University, Tokyo, Japan
                [b ]Department of Research Institute, TOTO Ltd., Chigasaki, Kanagawa, Japan
                [c ]Department of Clinical Laboratory, Juntendo University Hospital, Tokyo, Japan
                Author notes
                [∗ ]Corresponding author. Address: Analytical Technology Center, Research Institute, TOTO Ltd. 2-8-1 Honson, Chigasaki, Kanagawa 253-8577, Japan. Phone: +81 467 54 3346; Fax: +81 467 54 1171. aiko.itami@ 123456jp.toto.com
                Article
                Publisher Item ID: S2590-0889(21)00032-9 Publisher ID: 100143
                DOI: 10.1016/j.infpip.2021.100143
                PMC ID: 8336319
                PubMed ID: 34368750
                SO-VID: fadd0974-b697-457a-b198-4b92147b5a18
                Copyright © © 2021 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 14 December 2020
                Date accepted : 14 April 2021
                Categories
                Subject: Original Research Article

                Keywords: warm-water bidet toilet seat,pseudomonas aeruginosa,neutral electrolysed water,decontamination
                Data availability:
                Keywords: warm-water bidet toilet seat, pseudomonas aeruginosa, neutral electrolysed water, decontamination

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