C. difficile rates reduced with HPV Technology

Published on 1st March 2013

Manian et al. recently published results from a retrospective, quasi-experimental study of the impact of hydrogen peroxide vapor (HPV) technology on the impact of endemic, nosocomial Clostridium difficile-associated diarrhea (CDAD).  

Details of the study, are available on-line in the December 10, 2012 issue of American Journal of Infection Control.  The study involved a 900 bed community hospital.  During the study intervention period, vacated rooms underwent terminal cleaning with bleach followed by HPV decontamination.

The study results showed a significant drop in nosocomial CDAD rates from 0.88 cases/1,000 patient-days to 0.55 cases/1,00 patient days (rate ratio, 0.63; 95% confidence interval: 0.50-0.79, P<0.0001).

For more on the study, visit the American Journal of Infection Control.

New environmental protection system combats urban terrorism threat

Published on 18th February 2013

Threats against civilian and private security vehicles using airborne contaminants, such as car-jacking and kidnap attempts, can now be protected against following the launch of the new Bioquell LEAF system. 

The Bioquell LEAF, lifeline emergency air filtration system, is specifically designed to be installed into the rear of civilian and private security vehicles including SUVs, limousines and private security vehicles.  Upon attack with chemical agents such as CS gas or smoke grenades, the driver can rapidly activate the LEAF system which draws air in through a filter assembly designed to remove contaminants, delivering clean breathable air to the occupants of the vehicle without the need for face masks.  The system has been designed to provide optimum airflow that places the passenger compartment under positive pressure, ensuring airborne threats are unable to enter the vehicle through any other route. This enables the occupants to breathe clean air, providing valuable time for the driver to exit the attack scene and move the vehicle and its occupants to safety.

Developed by leading defense filtration technology manufacturer, Bioquell, the LEAF system is ideally suited to vehicles carrying high risk individuals such as VIPs, senior politicians and government officials, or valuable cargo such as cash in transit. With a replaceable filter unit, it can protect against a range of aerosolized threats including tear gas, smoke grenades, riot gas, CS gas, CN gas, pepper spray, mace, CR gas and anthrax.

Commenting on the new launch at IDEX 2013, Tracy Kennedy, Commercial Manager at Bioquell, said “The risk to key individuals from threats such as terrorists, rioters, opportunist attacks and kidnap or carjacking attempts is ever present. While vehicles have been able to be protected against bullets, bombs and missiles, our new Bioquell LEAF system provides a rapid emergency response mechanism for the more modern threat of aerosolized agent attacks.  In today’s world, it is important to be prepared for every situation and our new system provides yet another level of assurance for vehicle occupants.”

  

Johns Hopkins Study - HPV Technology Reduces Patient HAI Risk

Published on 31st December 2012

Johns Hopkins Hospital Study Shows Hydrogen Peroxide Vapor Technology Reduces Patient Risk of Superbug Infection

Findings indicate Bioquell system should be used in high-risk settings to maximize patient safety

Horsham, PA - December 31, 2012 - A new study conducted by infection control experts at Johns Hopkins Hospital demonstrates that patients admitted to hospital rooms decontaminated using Bioquell hydrogen peroxide vapor technology, rather than standard cleaning protocols, were significantly less likely to acquire multidrug-resistant organisms (MDROs), or so-called hospital superbugs. The study will be published in the January 2013 issue of Clinical Infectious Diseases.

The Bioquell system consists of automated devices that disperse an Environmental Protection Agency (EPA)-registered sterilant into the air and onto surfaces and then convert the sterilant to a harmless state.

Previous research has shown that being admitted to a hospital room where the previous patient was infected or colonized with an MDRO, such as Clostridium difficile, methicillin-resistantStaphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE), increases the subsequent patient’s chance of acquisition. The objective of this study was to determine whether the Bioquell system, which has been shown to eliminate surface contamination in patient rooms, could negate this risk. Researchers found that patients admitted to rooms decontaminated using the automated technology were 64% less likely to acquire MDROs compared to patients admitted to rooms disinfected using conventional methods, such as mopping with bleaching agents.

“The findings indicate that Bioquell hydrogen peroxide vapor disinfection should be implemented in high-risk environments to maximize patient safety,” said James Salkeld, head of healthcare at Bioquell. “Before this research, hospitals had legitimately asked whether they could afford the 90 minutes it takes to perform a Bioquell cycle. With the study showing acquisition being reduced by over 50% in patients admitted to decontaminated rooms, this begs a new question: can they afford not to?”

Study Design and Results

The 30-month prospective cohort study was performed on six high-risk units. Following a 12-month pre-intervention phase, hydrogen peroxide vapor (HPV) was implemented on 3 units to decontaminate the rooms of patients known to be infected with MDROs, following their discharge. Researchers noted that the prior room occupant was known to be infected with an MDRO in 22% of 6350 admissions.  Monthly environmental samples for MDROs were collected on all study units for three pre-intervention months and six intervention months.  The risk of MDRO acquisition in patients admitted to rooms decontaminated using HPV was compared with rooms disinfected using standard methods.

Patients admitted to rooms decontaminated using HPV were 64% less likely to acquire any MDRO (incidence rate ratio [IRR], 0.36; 95% confidence interval [CI], .19-.70; p<.001) and 80% less likely to acquire VRE (IRR, 0.20; 95% CI, .08-.52; p< .001) after adjusting for other factors.  The proportion of rooms environmentally contaminated with MDROs was reduced significantly on the HPV units (relative risk, 0.65, p= .03), but not on non-HPV units.

Over 1,300 rooms were decontaminated using HPV during the course of the study, with no health and safety problems reported. The implementation of Bioquell’s advanced technology was also reported to be well accepted by unit staff. Bioquell, Inc. provided the robotic hydrogen peroxide vapor generators and supplies for the study, as part of the company’s commitment to support infection control research.  

The study can be found on the Clinical Infectious Diseases website at http://cid.oxfordjournals.org/content/early/2012/10/01/cid.cis839.abstract

 

Click here to download the press release.

Burns units combat superbug outbreaks with HPV disinfection bundle

Published on 20th August 2012

A bundle of infection control measures using the latest hydrogen peroxide vapor (HPV) disinfection technology has significantly reduced the incidence of nosocomial MRSA and Acinetobacter baumannii in one of Europe’s leading burns units.

Work conducted at Saint-Antoine Hospital in Paris, France by Frédéric Barbut and his team has recently been published in Burns, a leading scientific journal, demonstrating the effectiveness of regular HPV disinfection of rooms following discharge of patients known to be affected by multidrug-resistant bacteria. The Saint-Antoine Hospital burns unit is one of two major reference burns centers in Paris. It had an ongoing problem with Acinetobacter infections when it experienced a major MRSA outbreak in 2007. This lead to the closure of the unit in July 2008.

As a result, the entire unit was decontaminated using Bioquell’s HPV technology and an infection control bundle (ICB) was implemented when the unit was reopened in September 2008. The ICB comprised regular HPV disinfection of the rooms following discharge of patients colonized or infected by multidrug-resistant organisms (MDRO), pre-emptive cohort isolation of newly admitted patients before being proven culture negative and cohorting of colonized or infected patients. Additionally two air disinfection systems were installed in the corridors of the unit and improvements made to material storage.

Frequent HPV disinfection was show to be effective at significantly reducing environmental contamination (bacterial and fungal) from surfaces and the air on the unit and eliminating pathogens from the environment. The infection control bundle stopped the MRSA outbreak, resulting in a significant reduction in the incidence of nosocomial MRSA (89.3%) and A. baumannii (88.8%). It also prevented further outbreaks of these organisms in the burns unit.

Commenting on this research, James Salkeld head of healthcare at Bioquell said, “Interestingly, results showed that surfaces were still contaminated with pathogens including Acinetobacter, E. coli and S. aureus in addition to MRSA, after standard terminal cleaning and before HPV treatment. Aspergillus was also isolated from the air before HPV.”

“Bioquell’s HPV disinfection process eliminated pathogens from the environment and significantly reduced total bacterial surface counts as well as fungal air and surface counts on both a unit and room scale. In fact, no pathogens were isolated from surfaces or the air samples after our HPV decontamination.“

After the implementation of the ICB, the incidence of nosocomial MDRO infection/colonization reduced significantly by 84.9%. There was a 36% reduction in the rate of nosocomial ESBL-producing Enterobacteriaceae cases but the reduction was not statistically significant. Evidence of at least two A. baumannii outbreaks and one MRSA outbreak in the unit was seen in the pre-intervention period. No outbreak of Acinetobacter or MRSA has occurred since the implementation of the ICB.

The latest research will been published in the next Burns journal (September) but is already available online at http://www.burnsjournal.com/article/S0305-4179(12)00225-2/abstract.

  

HPV shows UV the light for room biodecontamination

Published on 13th April 2012

Latest comparative research shows that hydrogen peroxide vapor (HPV) technology is more effective at reducing bacterial contamination in hospitals than ultra violet light-based (UVC) systems.

The head-to-head study, published in Infection Control and Hospital Epidemiology, was conducted by leading infection control practitioners at the Hospital of Saint Raphael and Yale University School of Medicine, both in New Haven, Connecticut.  Their results showed that Bioquell’s HPV was significantly more effective for reducing biological contamination, including spores, in patient rooms compared with a UVC system. This was especially evident for areas that were out of direct line of sight of the UVC system.  Overall, half of the surfaces contaminated with bacteria before exposure to UVC remained contaminated after UVC exposure.

Various locations within 15 patient rooms were studied. Of the 75 locations sampled prior to HPV decontamination, 70 (93%) yielded aerobic bacteria growth while after decontamination with HPV, 65 (93%) of the 70 locations yielded no growth (P < 0.0001). Of the 5 sites that yielded growth, there was a range of growth from 1 to 4 colony-forming units (CFUs) per plate. For UVC decontamination, 68 (91%) of the 75 sites sampled yielded bacterial growth before decontamination and 35 (51%) of the 68 sites yielded no growth after decontamination
(P < 0.0001). Of the 33 sites that yielded growth, there was a range of 2 to 160 CFUs per plate.

Of equal importance was the comparison of locations out of direct line of sight of the HPV and UVC equipment. Eleven of the 33 sites (33%) that yielded bacteria after UVC decontamination were samples taken from areas located in the patient’s room, while 22 of the 33 sites (67%) were located in the patient’s bathroom, out of direct line of sight of the UVC device (P < 0.0001). Effectiveness of HPV decontamination showed no difference based on location, indicating all areas were uniformly exposed.

In addition to the standard biological indicators (BIs) that used 6-log and 4-log Geobacillus stearothermophilus, Clostridium difficile indicators were also used. Here, the differences were also quite pronounced with the Bioquell system achieving a greater than 6-log C. difficile reduction compared with an average 2-log reduction for the UVC system.

Commenting on the research, James Salkeld, Head of Bioquell Healthcare said, “Our view, which is well supported by this independent research, is that Bioquell, which has demonstrated unsurpassed microbiological and unique clinical efficacy, should be used as an infection control tool for spores, resistant pathogens and in high acuity areas. This research shows that UV systems which exhibit comparatively poor efficacy and are beset by ‘shadowing’ issues, are not suitable when you need to ‘be sure’. As a patient, I know which process I would want to have been deployed in my room and believe that hospitals who choose to invest in automated systems have every right to expect full, three-dimensional decontamination, every time.”

The study compared the Bioquell HPV system and the Tru-D UVC system in a head to head study.

The full report can be accessed at http://www.jstor.org/stable/10.1086/665326.

  

Bioquell Bug Stoppers raise awareness in fight against HAIs

Published on 7th March 2012

In the United States, healthcare associated infections (HAIs) and their cost to the healthcare system are staggering.  The CDC estimates that approximately 1 in every 20 hospitalized patients will contract an HAI.  Cost estimates range upward of $40 billion dollars annually in the fight against HAIs.  Recently released CDC statistics show infection rates and deaths from HAIs climbing.  Deaths attributed with Clostridium difficile infection rates alone have jumped to a range of 14,000 per year.  To help in the fight against HAIs, Bioquell has launched its educational Bug Stoppers campaign.

The Bioquell Bug Stoppers campaign delivers a novel yet fun approach to educating healthcare professionals and ancillary workers on the ‘super bugs’ that cause HAIs.  Depicting HAIs as bug criminals conducting crimes against patients, the campaign delivers easy to understand facts through a set of fun educational tools.  In addition to advocating standard measures for arresting the spread of bug crimes, the campaign provides information on Bioquell’s Rapid Response Bug Stopper Squad for helping hospitals develop risk-based strategies to eliminate HAIs from their environment.

“We work with numerous healthcare professionals around the world who are passionate about infection control and increasing awareness of the risk of HAIs,” comments James Salkeld, head of Bioquell Healthcare. “Our Bug Stoppers campaign provides these professionals with educational tools that healthcare professionals can provide to their colleagues to build a greater appreciation of the risks of HAIs and improve practices that aid in its prevention.”

For more information on the Bug Stoppers campaign, contact Bioquell through the Bug Stoppers website at www.bugstoppersusa.com.

HPV room disinfection faster and safer than aHP

Published on 5th March 2012

A recent independent study confirms hydrogen peroxide vapor technology as superior to the aerosolized hydrogen peroxide process. A team at St. George’s Hospital, London, UK, unquestionably established that hydrogen peroxide vapor (HPV) technology from Bioquell is faster, safer, and more effective for room biodecontamination than aerosolized hydrogen peroxide (aHP).

Incomplete kill of pathogens on surfaces in rooms presents a risk of infection to hospital patients. The study assessed the inactivation of specific organisms known to cause healthcare associated infections (HAIs) - Clostridium difficile, multi-drug resistant Acinetobacter baumannii and Methecillin Resistant Staphlycoccus aureus (MRSA).  The Bioquell HPV system was shown to be significantly more effective at inactivating the microorganisms than the aHP system tested. Test discs containing the microbes situated around corners, out of direct line of sight of the aHP machine, remained active. In fact, the aHP system failed to inactivate MRSA or A. baumannii dried from suspension at any of the locations assessed.

Both systems were tested with 6-log and 4-log biological indicators (BIs) distributed throughout the test area, the standard measure for decontamination processes. Bioquell’s HPV technology demonstrated almost complete inactivation of 6-log and 4-log biological indicators (BIs). This compared with inactivation of less than 15% of the 6-log BIs by the aHP technology and one third of the 4-log BIs. It was determined that poor hydrogen peroxide distribution associated with the aHP process compared with the complete dispersal of the HPV was one of the reasons for the poor inactivation results.

To assess the speed of each cycle, a comparison of hydrogen peroxide concentration levels in the room after 2 hours was made for both systems. Here, the HPV system had a lower hydrogen peroxide level (1.3ppm) compared with the aHP hydrogen peroxide level (2.8ppm) at the 2 hour cycle mark, demonstrating faster cycle times.

The study also called into question the safety of the aHP system. According to the aHP manufacturer’s instructions at the time, the room did not require sealing with tape and the room was safe to enter after two hours. However, this new report found that both the aHP protocols exposed operators to unsafe levels of hydrogen peroxide with concentrations of peroxide in excess of the OSHA PEl outside the room during the cycle and inside the room at the end of the cycle. In contrast, there were no health and safety issues found with the Bioquell system. Here, the HPV manufacturer supplied hydrogen peroxide sensors to ensure levels were safe at re-entry.

Commenting on the report, James Salkeld, head of Bioquell Healthcare said, “I am pleased that this study reinforces the superior efficacy, speed, and safety of the Bioquell technology. In my view, the reasons for moving to a high-tech, automatic system is to ensure you eliminate all pathogens, every time, and this study restates Bioquell’s credentials as the only technology that can achieve this. This is something we are very proud to highlight as Bioquell technology continues to be the only room bio-decontamination technology to have evidence showing reductions in HAI rates within hospitals.”

Complete details of this head-to-head study are published in the Journal of Hospital Infection, February 2012 and compare a Bioquell HPV generator with a competitive aHP generator.  The full article ‘Efficacy, efficiency and safety aspects of hydrogen peroxide vapor and aerosolized hydrogen peroxide room disinfection systems’ by T.Y. Fu, P. Gent and V. Kumar is available online at http://www.sciencedirect.com/article/pii/S0195670112000102 or at http://www.journalofhospitalinfection.com/article/S0195-6701(12)00010-2/abstract.
 

Table 1. Improved inactivation (median log reduction in activity) of HAI microorganisms within a 13 cubic meter (459 cubic foot) annex to a 50 cubic meter (1766 cubic foot) main room following room disinfection treatment by HPV compared to aHP.

	Median log reduction in activity following HPV		Median log reduction in activity following aHP
	Location 5 not in direct line of sight	Location 8 Door	Location 5 not in direct line of sight	Location 8 Door
MRSA	7.2	7.2	2.0	1.7
Acinetobacter baumannii	6.0	6.0	0.5	1.8
Clostridium difficile	5.2	5.2	0.6	>3.6

 Click here to download full press release.

C-Tick Approval for HPV ‘Superbug Busting’ Technology

Published on 7th February 2012

The latest generation hydrogen peroxide bio-decontamination technology from Bioquell has now achieved Australian C-Tick approval. Targeted at the life science and healthcare markets, this unique bio-decontamination methodology is used to eradicate microbes from the environment including the problematic hospital ‘superbugs’.

The C-Tick mark provides assurance that products have been tested to the appropriate standards for conformity to the EMC (Electro Magnetic Compatibility) and Radio Telecommunications standards by a registered testing laboratory. Product compliance is regulated and managed by the Australian Communications and Media Authority (ACMA). Through a mutual agreement, the C-Tick mark is also recognized in New Zealand.

Bioquell, leading hydrogen peroxide vapor (HPV) environmental bio-decontamination specialist, worked closely with Capella Science, its authorized agent in Australia, to ensure the C-Tick mark was achieved for a wide range of its products, including the popular Bioquell Q-10 and Bioquell Z-2 HPV suites. These systems are ideal for treating small rooms and larger areas such as bays, side wards and pharmaceutical cleanrooms. Part of Bioquell’s HPV range can also be connected to isolators and incorporated into pharmaceutical production lines where bio-decontamination in situ is required.

Bioquell’s HPV technology works in three key ways to destroy a wide variety of bacteria, viruses and fungi: it attack cell walls, destroys cell contents and damages the genetic material.

Commenting on the new standard, Paul Doyle, managing director of Capella Science said, “Being able to bring this advanced bio-decontamination into Australia and New Zealand is going to seriously help our pharmaceutical and healthcare markets. Alongside a large library of peer-reviewed scientific evidence, the C-Tick mark will provide additional assurance to our customers that this new technology is both safe and effective at eradicating environmental biological contamination.”

Click here to download full press release.

Bioquell awarded development contract for new SV Vehicle

Published on 18th January 2012

Bioquell - provider of specialist low temperature, residue-free bio-decontamination and filtration technologies to the healthcare, life sciences and defense sectors – announces that it has been awarded a £1.2 million development contract relating to the new vehicle being developed by General Dynamics UK for the UK Ministry of Defense. 

General Dynamics UK was awarded a contract by the UK Ministry of Defense for the Demonstration phase of the Specialist Vehicle (SV) Programme for the Reconnaissance Block 1 Vehicles and Common Base Platform in July 2010. 

Bioquell UK Limited, a subsidiary of Bioquell PLC, develops and manufactures, among other things, Chemical, Biological, Radiological and Nuclear (CBRN) filtration systems as well as Environmental Control Systems (ECS). 

General Dynamics has awarded Bioquell UK Limited a development contract worth approximately £1.2 million relating to ECS and CBRN systems for the demonstration phase of the SV Programme. 

Once this initial development contract has been fulfilled, it is expected that contracts relating to the manufacture and in-service phases will be awarded and expected to run for at least five years. 

Commenting on this contract award, Nick Adams, Group Chief Executive of Bioquell PLC, said:  “We are extremely pleased to have been awarded this prestigious development contract relating to the British Army’s new Specialist Vehicle program.”

Click here to download full press release.

Bioquell Z-2 now with Yokogawa compatibility

Published on 4th January 2012

Cutting edge bio-decontamination technology now interfaces with market leading data logging system to provide robust and secure information capture for the life science and pharmaceutical markets.

Bioquell, leading hydrogen peroxide vapor (HPV) environmental bio-decontamination specialist, has developed an interface for its latest generation Bioquell Z-2 HPV system and Yokogawa’s data acquisition and display station – DXAdvanced Daqstation. This new interface designed to link to the DX1000 and DX2000 series of data recorders allows key parameters to be logged by the Yokogawa devices, providing a simple and secure method to store the key bio-decontamination cycle data. Additionally, the Yokogawa station does not have to be directly linked to the Bioquell Z-2 as the information can be transferred over a computer network.

The Yokogawa DX1000 and DX2000 devices can also be supplied to be 21 CFR Part 11 compliant. This feature is widely required throughout the pharmaceutical industry.

Commenting on the new interface, Oliver Cumberlege, head of Bioquell research and development, said, “With more and more regulations and standards being introduced into life science operations and pharmaceutical manufacturing processes, clear and accurate data logging has never been more important. This new interface provides users with an ability to record our HPV bio-decontamination cycle using their own Yokogawa Daqstation systems. This will help to provide confidence of the Bioquell microbial eradication process through a separate auditable data logging system.”

Click here to download full press release.

Detailed microbe database now online

Published on 18th November 2011

Covering a wide range of microbes, experts from leading environmental bio-contamination specialist, Bioquell, have developed a comprehensive and freely available online ‘bug’ database. The micro site features over 30 of the most common environmental contaminants of importance in various sectors including healthcare, life sciences, pharmaceutical and defense. This online resource provides valuable insight into the world of bacteria, viruses and fungi.

Each entry includes a high-resolution image and detailed information about the bug’s biology, allowing readers to understand key points about its microbiology. The symptoms/effects of the bugs are reviewed explaining its habitat, transmission and control. Finally, technical information is provided for each bug, which typically includes various references to other useful scientific papers/articles. 

Commenting on this new online resource, Dr. Jon Otter, Head of Microbiology at Bioquell said, “Our advanced hydrogen peroxide vapor technology kills bugs that are often difficult to picture. This new section on our website provides an appreciation of some of the key microbes we are often asked to tackle, plus a few of the more obscure ones. By understanding a wide range of microbes, our teams can ensure the success of our hydrogen peroxide vapor (HPV) bio-decontamination technology in a wide variety of applications.” 

Visit the microbiology database at www.bioquell.com/technology/microbiology.

Calls for better environmental control after latest superbug threats

Published on 18th November 2011

To avoid the world coming under threat from untreatable infections, more focus on the management of the environment is essential claims a leading expert. Superbugs are becoming more resistant to the current portfolio of antibiotics and investment in developing new drugs has been scaled back. Minimizing the risk of pathogen transfer from healthcare surroundings to the patient needs to be a key focus to help prevent unwanted infections.

The European Center for Disease Control and Prevention (ECDC) announced yesterday that in some countries up to 50 per cent of blood poisoning cases caused by one bug (Klebsiella pneumoniae, a common cause of urinary and respiratory conditions) were resistant to carbapenems, the most powerful class of antibiotics.

Focus has centered on the over prescribing of antibiotics having led to this global problem of drug resistant bacteria. The Centers for Disease Control and Prevention (CDC) recently announced a new tracking system that promises to help hospitals take steps against the overuse of antibiotics.

Commenting on the requests for better antibiotic control, James Salkeld, head of healthcare at leading bio-decontamination experts Bioquell said, “The calls for antimicrobial stewardship and increased research into antibiotics are welcome, although they only address part of the problem. The advent of untreatable pathogens has raised the stakes, and should bring about a genuine move to zero tolerance infection control policies, including hand hygiene and decontamination of the patient surroundings. These Gram-negative bacteria have been shown to persist in the environment even after multiple rounds of manual cleaning, calling for automated no touch decontamination technologies to be used.”

Latest research presented at the Conference of the Infectious Disease Society of America in October 2011 described two uses of no touch decontamination to combat Gram-negatives. The first described an intervention using automated hydrogen peroxide vapour (HPV) to eliminate a particularly virulent pathogen (NDM-1 K. pneumoniae) from a hospital environment, preventing further acquisition. The second study, performed over six years, showed that only by implementing (HPV) decontamination was a leading US hospital able to prevent infections from Gram-negative bacteria. Before this treatment, several intervention approaches had been implemented, but it was the implementation of a coordinated room bio-decontamination process using Bioquell HPV that finally led to the stopping of outbreaks and ongoing infections.

Download complete press release by clicking here.

Hydrogen Peroxide Vapor presented at infectious disease conference

Published on 20th October 2011

Hydrogen peroxide bio-decontamination technology is one of the hot topics at this year’s 49th Annual Meeting of the Infectious Diseases Society of America and the HIV Medicine Association. Three scientific abstracts are being presented on hydrogen peroxide vapor (HPV) at the meeting in Boston, Massachusetts on October 20-23, 2011.

Commenting on this latest research, James Salkeld, Head of Healthcare at Bioquell said, “Hydrogen peroxide vapor technology continues to have a strong profile among infection control professionals at all levels. Its efficacy at dealing with key healthcare associated infections (HAIs) such as Clostridium difficile and Acinetobacter is becoming better known, providing a rapid solution to help in bringing outbreaks under control and reducing endemic infection.”               

The abstracts include reports of reducing endemic cases of Clostridium difficile and controlling outbreaks of Acinetobacter baumannii and NDM-1-producingKlebsiella pneumoniae. 

Performed at the Wellstar group of hospitals in Atlanta, GA, the first study illustrates a system-wide reduction in the incidence of C. difficile, VRE and MRSA following the introduction of a bundle of prevention and control measures including Bioquell’s HPV proactive service (onsite equipment and bio-decontamination specialists). Here C. difficile rates fell by 36%, VRE by 68% and MRSA by 11%. 

Management of a multi-year outbreak of Acinetobacter baumannii in an ICU setting was highlighted in the second study at Albany, NY. With the introduction of Bioquell HPV technology in 2010, rates dropped by 80% against baseline and 95% compared to the peak of the outbreak. Prior to the HPV technology, standard infection control methods had failed to bring the outbreaks under control. Whilst the introduction of surveillance cultures made some impact, implementation of HPV technology solved the problem.

The third study was conducted at a Howard County Hospital, affiliated with Johns Hopkins, MD. Although NDM-1-producingKlebsiella pneumoniae was not found in the environment during the study, the team decided to use Bioquell HPV technology to disinfect the patient care area. Such treatment is vital when dealing with some of the hard to treat Gram-negatives.

 The three abstracts are titled:

•  A System-Wide Reduction in the Incidence of C. difficile and MDROs due to an Infection Prevention & Control Bundle
• Management of a multi-year MDR Acinetobacter baumannii outbreak in the ICU setting
• Management of a New Delhi Metallo-beta-lactamase-1 enzyme (NDM-1)-Producing Klebsiella pneumoniae : Infection Control and Medical Implications

Click here to download complete press release.

Raising awareness of HAIs and superbugs with website launch

Published on 19th October 2011

With a continual rise in multidrug-resistant germs, a new website has been launched to raise awareness of many of the main pathogens that cause healthcare associated infections (HAIs). Designed to help healthcare professionals and ancillary staff, www.bugstoppersusa.comhas been specially developed to provide easy-to-digest information on the illicit antics of nosocomial pathogens such as Clostridium difficile, MRSA, Klebsiella pneumoniae and norovirus.

Echoing Crimestoppers, the website treats pathogens as criminals who can only be arrested through greater awareness. The site holds data on a wide variety of bad bacteria, villainous viruses and fearsome fungi. Each criminal provides a microscopic image of the bug alongside a memorable character design. A short criminal profile and an outline of some key facts and are provided. These are designed to make learning about the bugs more fun while still being highly educational. There is also a quick link to a more detailed, scientific profile of the pathogens available in the microbiology section of the supporting Bioquell website (www.bioquellus.com).

Bug of the month starts with Clostridium difficile, a shady character known to lurk in healthcare environments. Awareness and hand hygiene precautions are critical to help manage this potential killer.

In addition to the usual suspects, there are a few surprise entries such as Bacillus anthracis (anthrax) and variola virus (smallpox). There are also entries for many members of the multidrug and pandrug-resistant families including the latest resistant-gene superbugs like NDM-1 and ESBL-producing gram negatives.

To help promote further awareness, the criminal characters have been turned into a set of Bug Trump cards, ideal for infection control team training sessions and around the hospital. Posters and other desktop tools are also available.

Commenting on the new website, James Salkeld head of Bioquell Healthcare said, “We work with numerous healthcare professionals around the world and they all are passionate about increasing awareness of the risk of HAIs. Our new website and supporting Bug Stoppers campaign has been developed with healthcare professionals to provide their colleagues with tools that can help to build a greater appreciation of the risks of HAIs and improve practices that aid in its prevention.”

The new website can be found at www.bugstoppersusa.com and more details of the Bug Stoppers campaigns can be obtained by contacting Bioquell through the site.

Click here to download full press release.

Bio-decontamination information for US following website launch.

Published on 10th October 2011

A new website that explains how to effectively neutralize ‘superbugs’ and other biological contamination has just been launched. Targeted at the US life science, healthcare, food and defense industries, www.bioquellus.com has been specially developed to provide information on ambient temperature, residue-free germ eradication solutions.

Included are detailed applications for a range of products and services employing a patented process of hydrogen peroxide vapor (HPV) generation for the bio-decontamination of contaminated equipment, rooms or even buildings. Computer controlled HPV generators produce gaseous hydrogen peroxide vapor, which at a controlled dew-point status kills microorganisms.  The same equipment then recycles the gas/vapor through a catalytic converter and dehumidifier, reducing it to a harmless combination of water vapor and oxygen.

The site covers areas that show rapid bio-decontamination means reduced factory downtime, improved productivity and increased profitability, while eliminating ‘fogging’ with formaldehyde, now confirmed by the World Health Organization as a carcinogen.

It also offers unique and very effective solutions to cross-infection environmental challenges  including all the major causes of HAIs, (MRSA, VRE, Acinetobacter, Clostridium difficile, Klebsiella), viruses and fungi. Even the newly emerging superbugs such as those containing the NDM-1 and KR-2 genes are discussed in the microbiology section.

CBRN (Chemical, Biological, Radiological and Nuclear) filtration systems are also covered from a military aspect, as many of these are now installed as standard in some of the world’s most modern military vehicles.

Commenting on the new website, Mike Herd, vice president of Bioquell, Inc. said, “The bio-decontamination of microorganisms such as bacteria, viruses and fungi has enjoyed a raised profile in recent years. This has resulted from a number of factors including world events such as SARS and the terrorist threats/homeland security attacks using anthrax at the turn of the millennium, to developments in good manufacturing practice for the pharmaceutical sector and a need to stem the spread of healthcare associated infections (HAIs) and antibiotic resistant ‘superbugs’ such as MRSA and Clostridium difficile. Our new website offers a significant amount of valuable data on environmental contamination, and importantly discusses a wide variety of solutions to help overcome biological challenges.”

The new Bioquell Inc. website can be found at www.bioquellus.com.

Bioquell hydrogen peroxide vapor outclasses ASP Glosair aHP

Published on 1st August 2011

Bio-decontamination in hospitals is significantly more effective using hydrogen peroxide vapour (HPV) technology compared to aerosolised hydrogen peroxide (aHP), according to the latest research findings from Sweden.

In an independent, head-to-head trial of two room decontamination technologies, Bioquell’s HPV inactivated 100% of the Geobacillus stearothermophilus biological indicators (BI) using a single cycle. The aHP system from ASP Glosair (previously branded Sterinis) only managed to inactivate half of the BIs despite the use of three back to back cycles.

The team of research doctors, based at Lund University Malmö also demonstrated further performance benefits when using the Bioquell Q-10 HPV equipment. It reached higher peak hydrogen peroxide room concentrations (338ppm vs. 160ppm) and achieved a shorter cycle time (3 hours vs. 3.5 hours).

The trial was set up following calls two years ago for head-to-head bio-decontamination studies by leading environmental microbiology expert, Dr John Boyce. The Malmö team built a full-scale mock-up of an isolation room to run the trial. This mimicked the new Infectious Disease facility at Skäne University Hospital (SUS). In the trial, only one Bioquell Q-10 suite was used, and two ASP Glosair (Sterinis) aHP machines, as recommended by the manufacturers.

The advanced hydrogen peroxide vapour (HPV) technology used by Bioquell technicians bio-deactivates a wide range of animal and human pathogens. It is a safe and environmentally friendly process of high level room and equipment decontamination.

Commenting on this latest research, James Salkeld, Bioquell’s Head of Healthcare, said:

“We’ve known that different bio-decontamination systems achieve different results. I’m proud of the solid base of research that Bioquell’s HPV technology has been founded upon and this has been reflected convincingly in this latest peer-reviewed scientific paper. Hospital infection control teams can continue to be rest assured that using our “true HPV” technology will eliminate environmental bio-decontamination and stop the spread of health care associated infections in their tracks.”

The research paper ‘A head-to-head comparison of hydrogen peroxide vapour and aerosol room decontamination systems’ by Holmdahl et al is available in the Journal of Infection Control and Hospital Epidemiology published online 22 July 2011 (http://www.jstor.org/pss/10.1086/661104).

Click here to download the press release.

Contaminated surfaces now comprehensively linked to nosocomial pathogen transmission

Published on 25th July 2011

The latest authoritative review of the role played by contaminated surfaces in the transmission of nosocomial pathogens has recently been published. This categorically dispels the apparent widespread view that contaminated surfaces are not important in transmission. It has also provided compelling evidence that proves environmental hygiene is an essential part of any infection control programme.

Leading microbiologists at St Thomas’ Hospital and King’s College London and at world-renowned bio-decontamination specialist Bioquell, have collaborated to produce a comprehensive scientific paper that explores the environmental transmission process. Dr. Jonathan Otter, Dr. Saber Yezli and Prof. Gary French noted that surfaces were now playing a more important part in the epidemic and endemic transmission of the major pathogens linked to healthcare associated infections: C. difficile, VRE, MRSA, A. baumannii, P. aeruginosa and Norovirus.

In the article it was noted that nosocomial pathogens shed by patients can contaminate hospital surfaces at concentrations sufficient for transmission. These pathogens can survive for extended periods and can persist despite attempts to remove them. One other key source of transmission explored was the transference to the hands of healthcare providers and subsequently back to the patients. They also reviewed evidence that improving environmental bio-decontamination helps to bring outbreaks under control and reduce endemic nosocomial pathogen transmission.

Overall they indicated that improvements to environmental hygiene should include measures to improve the efficacy of any cleaning/disinfection process and measures should also be adopted to reduce the shedding of pathogens.

James Salkeld, Head of Healthcare at Bioquell commented, "This review summarises a change in opinion on the role of the environment that has occurred over the last decade. I’m sure that it will be a useful summary for all healthcare professional with an interest in this area of research."

The research paper ‘The role played by contaminated surfaces in the transmission of nosocomial pathogens’ by Otter et al is available in Infection Control and hospital epidemiology, July 2011, Vol. 32, No7, pages 687-699. http://www.jstor.org/pss/10.1086/660363

Click here to download the press release

Bioquell passes 2000 room milestone in 2011

Published on 6th July 2011

Over 2000 rooms have been ‘bioquelled’ in 2011, eliminating unwanted microbes from a variety of hospital and pharmaceutical environments.

The UK based Bioquell RBDS (room bio-decontamination service) team target bacteria, viruses and mould contamination. This professional service stops health care associated infection (HCAI) in its tracks. It also ensures bio-pharma and food production units are free from unwanted biological incursion.

The advanced hydrogen peroxide vapour (HPV) technology used by Bioquell technicians bio-deactivates a wide range of animal and human pathogens. It is a safe and environmentally friendly process of high level room and equipment decontamination.

Commenting on this latest milestone, Matt Parks, Bioquell’s Director of Professional Services, said:

"Our UK team have now treated over 2087 rooms this year with our hydrogen peroxide vapour decontamination technology. Through their hard work and dedication, the team has helped our healthcare, life science and food industry clients reduce the risk of subsequent contamination affecting patients and the public at large."

Click here to download the press release

Award of a £4 million contract by DEFTECH of Malaysia for Bioquell Defence CBRN systems

Published on 6th July 2011

Bioquell announces that DRB-HICOM Defence Technologies Sdn Bhd (DEFTECH), a substantial Malaysian defence corporation, has awarded Bioquell a contract worth approximately £4 million for the supply of specialist CBRN filtration systems for incorporation into military vehicles being manufactured by DEFTECH in Malaysia. Bioquell will start to supply these CBRN systems at the beginning of 2013 and the contract is scheduled to run for five years.
Commenting on this Malaysian contract award, Nick Adams, Group Chief Executive of Bioquell PLC, said:
“We are extremely pleased to have been awarded this £4 million CBRN filtration systems contract from a leading Malaysian defence group.”
“This contract award – which helps build our defence order book - underscores Bioquell’s increasing success in the Asia Pacific region.”

Click here for more details about Bioquell PLC and to download the press release.

Award of c. US$ 1 million contract for specialist bio-decontamination in China

Published on 6th July 2011

Bioquell PLC (LSE: BQE) (“Bioquell”) – provider of specialist low temperature, residue-free bio-decontamination technologies to the healthcare, life sciences and defence sectors – announces that the Chinese authorities have completed the approvals necessary for the registration of Bioquell China.

In addition, Bioquell announces that it has been awarded a contract to supply specialist hydrogen peroxide vapour bio-decontamination equipment to research organisations within the Chinese Government’s Ministry of Agriculture worth approximately US$1 million. This bio-decontamination equipment is scheduled to be shipped in the second half of the year – and will be installed and serviced by Bioquell China.

Commenting on this contract award in China, Nick Adams, Group Chief Executive of Bioquell PLC, said:

“We are delighted to have won a significant first contract for our unique hydrogen peroxide vapour bio-decontamination equipment from Chinese government research organisations.”

“This contract award helps demonstrate the benefits of our substantial investment in the Asia Pacific region - and specifically the establishment of Bioquell China.” 

Click here for more details about Bioquell PLC and to download the press release

New bio-decontamination white papers released

Published on 6th July 2011

Two white papers have been recently released from Bioquell that show the latest cutting edge information about hydrogen peroxide vapour technology and bio-decontamination processes

These white papers are available for download below:

Applications and integration of hydrogen peroxide vapour for biotech/bioprocess clients
By Richard Lucas, Ph.D., Bioquell UK Ltd.

This white paper discusses the role and requirements of a modern bio-decontamination solution. It explores the key areas that need to be considered when seeking a solution and provides an illustration of the application of hydrogen peroxide vapour bio-decontamination technology within the biological production industry.

Download this white paper by clicking here

Improving efficiency in bio-contamination control and risk mitigation using H2O2 decontamination processes
By James L Drinkwater, Bioquell UK Process & Compliance Director, PHSS Chairman  – Pharmaceutical & Healthcare Sciences Society.

This white paper considers environmental monitoring and contamination control strategies using the benchmark hydrogen peroxide vapour (HPV) gaseous bio-decontamination process. Using best practice and the latest technology, significant efficiency savings can be identified at different process stages.

The white paper is available for download here

Two new scientific papers published by Bioquell’s leading microbiologists

Published on 6th July 2011

Two new scientific papers published by Bioquell's leading microbiologists in Food and Environmental Virology and Infection Control and Hospital Epidemiology.

Minimum Infective Dose of the Major Human Respiratory and Enteric Viruses Transmitted Through Food and the Environment
Saber Yezli and Jonathan A. Otter
http://www.springerlink.com/content/x3610717t66n9234
Food and Environmental Virology, Volume 3, Number 1, March 2011
 

The Role Played by Contaminated Surfaces in the Transmission of Nosocomial Pathogens
Jonathan A. Otter, Saber Yezli, Gary L. French
http://www.jstor.org/pss/10.1086/660363
Infection Control and Hospital Epidemiology Volume 32, Number 7, July 2011

Bioquell Ireland sponsored a ‘Hygiene Spot Audit’ Competition

Published on 6th July 2011

This year's ‘Hygiene Spot Audit’ Competition in Our Lady of Lourdes Hospital in Drogheda was won jointly by The Labour Ward and First Floor New Build.

Sponsored by Bioquell Ireland, the competition was run during 2010 and it has encouraged the wards to be quite competitive. The external auditors have become welcome figures and questions haev started to be asked about when the awards will be given next year.

The winners were presented with trophies that are proudly displayed in their wards along with a special prize of a basket of fruit. A perpetual trophy with the winners will also be hung in the main reception and the winners added to it every year.

Bioquell expands into China

Published on 6th July 2011

With continued growth and demand for for bio-decontamination products in China, Bioquell has now opened a new office in the Shenzen region. This local office be able to provide in depth advice on all aspects of hydrogen peroxide vapour bio-decontamination and assist clients with their specific needs.

 

 

Bioquell Techonoloy (ShenZhen) Limited Room 2510B 25/F, Building Tiley Central Plaza No. 3 Haide Road Nanshan District, Shenzhen P.R.China. P.C: 518054 T:    +86 755 8631 0348 F:    +86 755 8631 0211

Bioquell awarded International Business of the Year

Published on 6th July 2011

Sponsored by HSBC, Bioquell excelled in this category which was open to any business in Test Valley region of Hampshire which trades overseas.

The judging criteria required companies to demonstrate a commitment to international trade, increased turnover in export / import and show a passion for international trade.

More details have been presented about the evening and all of the finalists including Bioquell in the TVBA press release.

For more details about the awards, please visit the TVBA Awards dedicated site.

 

Bioquell receiveing the Best Internationl Business of the Year: Pictured are Cheryl Adams of HSBC, Matt Parks of Bioquell Ltd, and the Award Ceremony's Guest of Honour, Stephen Payne  OBE OBE, RDI.

Bioquell expands to new office in Singapore

Published on 6th July 2011

As a result of continued expansion, Bioquell's Asia Pacific office has now relocated to larger premises in Singapore.

With effect from 16^thMay 2011, Singapore office will be relocated to 207 Henderson Road #01-05 Singapore 159550. All contact numbers remain the same.

Bioquell Asia Pacific Pte Ltd
207 Henderson Road
#01-05
Singapore 155550

T:     +65 6592 5145   F:     +65 6227 5878

Another first for advanced bio-decontamination service - China

Published on 6th July 2011

Bioquell recently carried out its’ first bio-decontamination service deployment in the People’s Republic of China. Advanced hydrogen peroxide vapour (HPV) technology was used to commission a new drug producing operation in Tianjin City for a major multi-national pharmaceutical company.

The state-of-the-art pharmaceutical facility will soon begin to produce intravenous medication. This will be initially for sale in the ever expanding Chinese domestic market.
 

Construction of the 4,000m³ facility was finished on schedule and underwent the Bioquell RBDS (Room Bio-Decontamination Service) treatment. The target area was processed within 24 hours in order to minimise any impact on the client’s activities. The bio-decontamination procedure upgraded the facility to a grade B status in preparation for final validation activities. The site is expected to enter production over the coming year.

The deployment was a joint venture between Bioquell’s UK and Asia Pacific teams. Equipment and engineers were deployed from the UK and additional engineer support was provided from Singapore.
 

Commenting on the project, Matt Parks, Director of Professional Services at Bioquell said, “As the pharmaceutical industry grows around the world, we are finding more demand for our specialist services. The fact that we were able to bio-decontaminate such a large area in such a short time is testament to the skill and experience of our highly trained RBDS engineers.”

Download press release
 

Large crowds attracted to advanced bio-decontamination presentation

Published on 26th April 2011

The application of bio-decontamination to different processes was highlighted at the recent ContaminExpo in March.  Three leading companies combined to deliver a powerful presentation titled ‘From bio-cleaning to terminal bio-decontamination of an isolator’.

Attended by researchers, cleanroom users and engineers, the talk explained the different steps that must be considered when undertaking bio- decontamination in a hospital or pharmaceutical environment.

The joint collaboration between Bioquell, Schülke and EuroBioConcept also produced a display that showed real synergy between the different suppliers. A Bioquell L-2 hydrogen peroxide vapour (HPV) generator, capable of utilising Schülke’s hydrogen peroxide was connected directly to a EurobioConcept Chemosafe isolator. This isolator is specially designed for hospital preparations. Visitors were also able to view the Bioquell PORT rapid bio-decontamination transfer chamber. Additionally, the new Bioquell R-30 was also present. This is the latest generation of powerful catalytic aerators and it can help reduce room decontamination treatment cycle times.

Schülke is a leading supplier of detergents and disinfectants for cleanrooms. EuroBioConcept designs and manufactures isolators. Bioquell provides bio-decontamination technology to eradicate a wide range of bacteria, viruses and fungi.

The 12th ContaminExpo was held in Paris on March 15-17, 2011.

Notes to editors

Bioquell RBDS is a specialist bio-decontamination service offered by Bioquell. Trained engineers are deployed to sites where they use hydrogen peroxide vapour technology to decontaminate rooms, large areas and whole sites.

About Bioquell
Bioquell specialise in the design, manufacture and application of complete bio-decontamination solutions for airborne and surface contamination in the healthcare, life sciences, food production and defence sectors. Bioquell's unique hydrogen peroxide vapour (HPV) bio-decontamination technology has been used across the globe to eradicate problematic bacteria, viruses and fungi, throughout a wide range of applications. Deployment of Bioquell's HPV process provides residue-free, safe and repeatable sterilisation of rooms, buildings, equipment and sensitive electronics. It is a clear alternative when replacing traditional decontaminants such as formaldehyde or chlorine-based products.

Bioquell also provides bespoke chemical, biological, radioactive and nuclear (CBRN) filtration equipment for different applications in the defence industry. This equipment is complemented by integral air conditioning systems and auxiliary power units. For more information, please visit www.bioquell.com.

For more information
Martin Whiting, Marketing Manager T: +44 (0)1264 835 841 E: martin.whiting@bioquell.com

African countries to benefit from bio-decon technology investment

Published on 12th April 2011

Vaccine production in Africa will soon benefit from advanced bio-decontamination technology. Four hydrogen peroxide vapor generators are being provided to enable animal vaccines to be produced in a clean and safe environment.

These latest generation Bioquell Z-2 units are being dispatched to labs in Cameroon, Ethiopia, Kenya and Senegal, thanks to funding from GALVmed. This “not for profit” alliance consists of public, private and government partners funded by the Bill and Melinda Gates Foundation, UK International Development Department and the European Union.

Animal vaccination to ensure healthy livestock is critical in many African countries. Vaccines for four key animal diseases are the focus of GALVmed’s current project. These diseases have an enormous negative economic and social impact within poor resource households. The diseases include: Contagious Bovine Pleuropneumonia (CBPP), Contagious Caprine Pleuropneumonia (CCPP), Peste des Petits Ruminants (PPR) and Newcastle Disease (ND). The new bio-decontamination technology will help to ensure the safe, local manufacture of the vaccines. Many households will now benefit from easier access to and affordability of these life saving drugs.

The advanced hydrogen peroxide vapor (HPV) technology from Bioquell bio-deactivates a wide range of animal and human pathogens. It is a safe and environmentally friendly means of securing high level room and equipment decontamination.

Commenting on this latest project, Giles Snare, Bioquell’s Head of Life Sciences, said:

“We are delighted to be supporting important projects such as these with our hydrogen peroxide vapor decontamination technology. Without appropriate contamination control, vaccine production can be easily disrupted by biological contamination. Bioquell has successfully provided HPV decontamination systems to reduce this risk in many facilities across the world.”

The Bioquell Z-2 generator is ideally suited for decontaminating laboratory rooms and equipment. It provides a high level and validated 6-log sporicidal reduction on all exposed surfaces. This level is the minimum standard used for validating autoclaves/sterilizing equipment.
 
Notes to Editors:

1. Animal vaccine manufacturing often necessitates the use of live viruses which have the potential to contaminate both secure and non-secure surfaces, during the manufacturing process. 
    
2.  Typically the Bioquell Z-2 is positioned in a central location within a target room. The room is sealed and a decontamination cycle is set to run from outside the room utilizing the generator’s detachable control lectern.  Hydrogen peroxide vapor is distributed throughout the room to a point when the air cannot hold anymore H₂O₂ and starts to lay it down on all surfaces as micro-condensation. This invisible and uniform layer of hydrogen peroxide is a powerful oxidizing agent that rapidly destroys micro-organisms through a process of cellular destruction. At the end of a decontamination cycle, the generator automatically re-evaporates the H₂O₂ micro-condensation and breaks it down via a built in catalyst into oxygen and water vapor.

Latest research into formaldehyde replacement bio-decontamination techniques

Published on 16th March 2011

Latest research into formaldehyde replacement bio-decontamination techniques is now available

Following a well-attended international scientific workshop held earlier this year, presentations, covering the regulatory climate around the use of formaldehyde and evaluations of alternative decontamination techniques, are now available online.

The EPIZONE workshop for formaldehyde replacement, co-sponsored by Bioquell and Tecnilab, was held in January at Central Veterinary Institute, Lelystad in the Netherlands.  This event gathered together international key opinion leaders who discussed the use of various decontamination technologies which are seen as viable alternatives to traditional formaldehyde fumigation techniques.

In addition to the research data, a number of case studies are also available. The presentations can be found on the EPIZONE website.

Speaking about the event, Giles Snare, head of life sciences at Bioquell, said “It is important that alternatives to formaldehyde bio-decontamination are explored so that this hazardous chemical can be phased out. Currently formaldehyde (methanal) vaporisation systems are the most common method of bio-decontamination used by many laboratories across the world but there have been several studies to show the serious carcinogenic effects of using this active agent.”

Formaldehyde is an effective disinfectant as it kills most bacteria and fungi (including their spores). However as far back as 1987, the U.S. EPA classified formaldehyde as a probable human carcinogen and after more studies the WHO International Agency for Research on Cancer (IARC), in 1995, also classified it as a probable human carcinogen. Further information and evaluation of all known data led the IARC to reclassify formaldehyde as a ‘known human carcinogen’1 associated with nasal sinus cancer and nasopharyngeal cancer. Recent studies have also shown a positive correlation between exposure to formaldehyde and the development of leukaemia, particularly myeloid leukaemia2.

The use of formaldehyde as a bio-decontamination agent in laboratories is a potential significant risk to the long term health of those who are in direct contact during the process. It is also a risk to those who have to clean the residues of para-formaldehyde which are often left following the formaldehyde bio-decontamination process. These para-formaldehyde residues form slowly in aqueous formaldehyde solutions as a white precipitate.

John Edwards, Bioquell’s EU sales manager who also attended the event commented, “It is widely accepted that there is a low level of process control and monitoring during the formaldehyde bio-decontamination process as it based on manual cleaning protocols, compounding safety concerns with the proven health risk. As a result many commercial organisations have assessed the risk of this process and have converted to alternative, less hazardous, but effective bio-decontamination agents, such as hydrogen peroxide vapour (HPV). This is seen most evidently in Europe where a significant move away from formaldehyde has been observed.”

For access to the latest presentations please visit the EPIZONE website via the link http://bit.ly/hs3rhZ.

References:

1.       IARC Monographs on the Evaluation of Carcinogenic Risks to Humans Volume 88 (2006) Formaldehyde, 2-Butoxyethanol and 1-tert-Butoxypropan-2-ol, WHO Press, 2006( English )

2.       Formaldehyde exposure and Leukaemia: A New Meta-Analysis and Potential Mechanisms, 681 (2-3), Mutation Research/Reviews in Mutation Research, March-June 2009, pp. 150–168

Download full news article here

Launch of Bioquell Q-10 in Korea

Published on 9th March 2011

Woo Jung BSC based in Seoul, South Korea has recently launched the Bioquell Q-10 into the Korean market for use in the healthcare and life sciences sectors. CEO Benjamin Chun is enthusiastic about the room bio-decontamination opportunities in Korea and believes that in addition to the new equipment, the Bioquell Committed Technology service in hospitals will be well received there. This launch follows on from the recent success that Woo Jung BSC  achieved when they were awarded Dealer of the Year 2010 for the Asia Pacific region.

Benjamin Chun  and some of his dedicated team at Woo Jung BSC are shown below at the product launch.

Dealer of the year for the Asia Pacific region 2010

Published on 18th February 2011

Benjamin Chun - Chief Executive of Woojung BSC, Inc - Bioquell's distributor in South Korea received his award as dealer of the year for the Asia Pacific region from Nick Adams (Bioquell Group CEO) and Don Bissell (Bioquell, Head of Asia Pacific) at the Japanese Society for Environmental Infections Conference 2011 - 18 February 2011 in Yokohama.

Bioquell engineering team achieves professional recognition

Published on 21st January 2011

Bio-decontamination specialist Bioquell is celebrating after two members of its engineering department were successfully elected as Members of the Institution of Mechanical Engineers.

Jane Lauder, Compliance Engineer and James Corrigan, Design Engineer undertook a rigorous approval process which included the preparation of detailed reports and an in-depth interview. Both can now apply to be Chartered Engineers, providing further recognition of their professional industry status.

Commenting on the appointments, Oliver Cumberlege, Engineering Director at Bioquell said, “Both Jane and James have worked hard to achieve this recognition and their dedication has been well rewarded. The Bioquell engineering team is at the forefront of developing innovative bio-decontamination technology and with their help, we will continue to build market leading solutions for our customers.”

Bioquell employees raise funds for Hampshire’s Air Ambulance

Published on 21st January 2011

Following a couple of fund raising initiatives during January, employees at Andover-based bio-decontamination company, Bioquell have raised £260 to support the local Hampshire Air Ambulance service.

Organised and run by the employees themselves, the proceeds from a winter raffle and sale of calendars were combined with the local charity benefiting from the initiative. The money was presented by the main organiser, Joan Fussell, Bioquell’s long-standing receptionist to Tony Humphries who represented the Hampshire Air Ambulance service.

Commenting on the fund raising, Joan said, “We hold an annual fund raising event and this year, following a landing by the air ambulance in the Bioquell car park we decided to donate the funds to this local and highly valuable service. The Hampshire Air Ambulance is located nearby at Thruxton aerodrome, and we know that it survives solely on public donations and fund raising. You never know when you may need it.”

The Hampshire Air Ambulance made an unscheduled landing in the large Bioquell car park during a routine emergency call out to someone in the local area in October. As a result of this and a subsequent visit by their fund raising team, Joan and the organising committee nominated the charity as its sole beneficiary for the fund raising efforts. Tony Humphries was delighted with the donation.

Latest news around the online world 2010

Published on 13th December 2010

Latest news around the online world accessible on http://twitter.com/bioquell

The Role of Hydrogen Peroxide Vapor Systems in Infection Control

Published on 9th December 2010

By Mark Hodgson

In the continual challenge faced by infection preventionists to drive down healthcare-acquired infection (HAI) rates, the impact of the environment as a reservoir of pathogens is becoming increasingly clear.(1-3) It has been demonstrated that not only do pathogens shed by prior occupants of a room remain viable for prolonged periods,(4-6) but that these present a significantly increased risk of infection to subsequent room occupants.(7-8) While routine cleaning can reduce the microbiological burden in a patient room it does not always eliminate the presence of bacteria and hence risk of infection.(9-10) Even where very stringent cleaning regimens are in place, it is a constant challenge to maintain high-quality cleaning in a room.(10-11) As increasingly resistant organisms are shed by patients into the environment, the need to prevent infection becomes ever more pressing. How clean do you need to get to reduce infection rates?

The hydrogen peroxide vapor (HPV) system relies on micro-condensation to effect total elimination of pathogens, including endospore forming bacteria such as Clostridium difficile, from the inanimate environment.(12-13) It has been established that the closest proxy for "total elimination" is a full six-log reduction of spore-forming bacteria, usually in the form of biological indicators.

The basic question is, "How clean do you need to get to reduce infection rates?" At present, there is simply not enough data to answer this question and, due to the difficulties with designing infection control studies, we may never know the answer. What we do know is that at present all of the clinical data published on reducing infection rates though area sterilization is based on a total elimination of pathogens, validated by a six-log kill; other lower-level kill methods have not yet been shown to reduce infection rates.(12-15)

This is surprising, as the detectable bioburden in the hospital environment is rarely more than 100 to 1000 cfu/cm3; however, the complications of room topology, and the presence of dust, grime or biofilm significantly increase the resistance of bacteria to decontamination methods. Decontamination cycles designed to produce less than total elimination are frequently found to leave a contaminated environment.

HPV can be used proactively to prevent infection or reactively to stop outbreaks. HPV is used in hospitals worldwide, primarily for the terminal disinfection of rooms used to care for patients with MDROs to reduce the risk of acquisition for subsequent room occupants.(13) The most efficient way to achieve this is to have HPV decontamination equipment on the hospital site integrated into the hospital's procedures. This can be achieved either as a service or through equipment purchase. Another key application of HPV in hospitals is for decontamination during outbreaks.(15) Decontamination of areas used to care for patients who have acquired an outbreak strain can help to prevent the outbreak reoccurring from an environmental source. Other applications in hospitals include decontamination for mobile medical equipment, fixed installations in high risk areas, and preventative decontamination of lower risk areas.

HPV is infinitely scalable from a single room to an entire unit, or even an entire hospital. When the process of HPV was first introduced to U.S. hospitals, the equipment required specialist technicians to operate, today as the technology has improved, hospital staff can be trained to perform decontaminations safely and effectively. How it works:

1. After the patient has vacated housekeeping remove the bed linens and trash.

2. Set up the room and equipment

3. Enter user password in control panel

4. Select "parametric cycle" on control panel

5. Select the room being sterilized from the menu

6. Start the process

7. When the control panel tells you the process is complete confirm the concentration is less than 1 ppm.

8. Remove the equipment and return the room to service.

HPV fills the space in the room distributing evenly through the space regardless of the room configuration, this allows the vapor to work around corners in shadow areas and behind equipment and other obstructions. Once the saturation vapor pressure of peroxide is reached a micro condensation layer of hydrogen peroxide is deposited on to all the surfaces in the room. The micro-condensation layer is a highly concentrated hydrogen peroxide producing a rapid kill of all microorganisms, one feature of the micro-condensation process is that the kill rate is independent of the concentration of peroxide in the air, typical time dose relationships do not apply using this method. The micro-condensation process provides a full three-dimensional kill.

Following a dwell time to allow a full six-log kill the aeration unit is activated. Hydrogen peroxide vapor is drawn in to the aeration unit and the peroxide is broken down in to oxygen and water vapor. This leaves the room free from pathogens and much safer for the next occupant.

Regarding consumables, a number of studies have shown that the exterior packaging of unopened supplies in rooms occupied contact precautions patients will become contaminated with pathogens shed by the patient.(16) As a result of this contamination, standard practice is to dispose of unused consumables when the patient is discharged. It costs the hospital money to replace the unused items and the materials must be disposed of, possibly explaining why healthcare is the second largest user of landfill in the country. Micro-condensation HPV systems have been shown to safely decontaminate the packaging of unopened consumables items in the patient room being sterilized.16 This has been shown to produce tangible cost-benefit for the hospitals.

This process has been applied to hospitals throughout the world to reduce infection rates; in the U.S. alone more than 1,500 rooms a month are treated using this process. As the number of published studies showing reduced infection rates increases, the level of acceptance of the process is increasing.(17) HPV is now regularly deployed to stop outbreaks and prevent infections in some of America’s busiest hospitals. Many hospitals have benefited from the major savings available from the application of HPV due to reduced infection rates.

Mark Hodgson is head of healthcare sales for BioQuell Inc.

References

1. Yukoe, et al. A Compendium of Strategies to Prevent Healthcare Associated Infections in Acute Care Hospitals. Infect Control Hosp Epidem. October 2008.

2. Guide to the Elimination of Clostridium difficile in Healthcare Settings. APIC. 2008.

3. Management of Multidrug-Resistant Organisms In Healthcare Settings. CDC. 2006.

4. Hirai Y. Survival of bacteria under dry conditions; from a view of nosocomial infection. J Hosp Infect. 1991;19:191-200.

5. Wagenvoort JHT, Sluijsmans W, Penders RJR. Better environmental survival of outbreak vs. sporadic MRSA isolates. J Hosp Infect.2000;45:231-234.

6. Bonilla HF, Zervos MJ, Kauffman CA. Long-term survival of vancomycin-resistant Enterococcus faecium on a contaminated surface. Infect Cont Hosp Epidemiol 1996;17:770-772.

7. Huang SS, Datta R, Platt R. Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants. Arch Intern Med. Vol. 166. Oct. 9, 2006.

8. Drees M, Snydman D, Schmid C, et al. Prior Environmental Contamination Increases the Risk of Acquisition of Vancomycin-Resistant Enterococci. Clin Infect Dis. 2008;46:678-685.

9. Hayden MK, Bonten MJ, Blom DW, Lyle EA, van de Vijver DA and Weinstein RA. Reduction in Acquisition of Vancomycin-Resistant Enterococcus after Enforcement of Routine Environmental Cleaning Measures. Clin Infect Dis. June 2006:42.

10. Dancer SJ. Importance of the environment in methicillin-resistant Staphylococcus aureus acquisition: the case for hospital cleaning. Lancet. Vol. 7. December 2007.

11. French GL, Otter JA, Shannon KP, Adams NM, Watling D, Parks MJ. Tackling contamination of the hospital environment by methicillin-resistant Staphylococcus aureus (MRSA): a comparison between conventional terminal cleaning and hydrogen peroxide vapour decontamination. J Hosp Infect. 2004;57:31-37.

12. Boyce JM, Havill NL, Otter JA, et al. Impact of hydrogen peroxide vapor room decontamination on Clostridium difficile environmental contamination and transmission in a healthcare setting. Infect Control Hosp Epidemiol. 2008;29:723-729.

13. Passaretti K, et al, Adherence to Hydrogen Peroxide Vapor (HPV) Decontamination Reduces VRE Acquisition in High Risk Units, ICAAC 2008. 2009.

14. Schouten MA, Otter JA, van Zanten AR, Houmes-Zielman G, Nohlmans-Paulssen MK. Environmental decontamination of an intensive care unit to control outbreaks of multidrug-resistant Gram-negative rods using hydrogen peroxide vapor (HPV). Int J Antimicrob Agents. 2007;29 Suppl. 2:S479.

15. Manian, et al. Impact of an Intensive Terminal Cleaning and Disinfection (C/D) Program Involving Selected Hospital Rooms on Endemic Nosocomial Infection (NI) Rates of Common Pathogens at a Tertiary Care Medical Center; SHEA 2010.

16. Otter, et al. Decontamination of unused, packaged consumables contaminated with vancomycin-resistant enterococci (VRE) using hydrogen peroxide vapour (HPV); SHEA 2010.

17. Rutala, et al. Dinsinfection, Sterilization and Antisepsis 2010 Edition APIC.

For the full article on Infection Control Today, Click here.

Webinar: Survival of Bacteria and Spores on Surfaces and an Introduction to Hydrogen Peroxide Vapor

Published on 16th November 2010

Webinar to be presented November 16th, 2010 at 10am EST

Environmental contamination with various microorganisms can be problematic in several industries including healthcare, lifescience/laboratory and pharmaceutical sectors. Surface contamination can be difficult to eradicate in these sectors due to the ability of microbes to survive on wet and dry surfaces for extended periods, complex and difficult to clean environments and variations in the scope and quality of cleaning and disinfection regimens. Vapour-phase technologies are emerging as common decontamination methods in several sectors including healthcare, lifescience, pharmaceutical, military and other sectors. Unlike the manual application of liquid disinfectants, vapour-phase methods do not rely on the operator to ensure adequate distribution of the active agent and certain vapour-phase methods also offer the potential for a higher level of disinfection on all accessible surfaces within an enclosure than can be achieved using liquid disinfectants. Hydrogen peroxide vapour (HPV) is one vapour-phase decontamination method that has several useful properties including broad-spectrum microbicidal activity, rapid cycle times, no residues, compatibility with most materials including sensitive electronics and validation using biological indicators. Applications of HPV include the decontamination of patient rooms and wards in hospitals, laboratories and pharmaceutical factories and military equipment in the field and in bases. The talk will discuss advantages and disadvantages of using HPV in these settings.

Register Here!

The webinar is to be presented by Jonathan Otter who is the Scientific Director of the Healthcare Division at Bioquell and a research scientist at King's College London (UK). He graduated with a 1st class honours degree in Microbiology from the University of Nottingham (UK) in 2001 and has recently completed his PhD in the molecular epidemiology of community-associated MRSA in London and King's College London. Research interests include environmental sampling, disinfection and decontamination in healthcare, pharmaceutical and life science settings and the transmission and control of MRSA and other hospital pathogens. Jonathan is a member of the Pharmaceutical and Healthcare Sciences Society and is currently part of a working group revising guidelines for environmental monitoring in cleanrooms and other containment areas.

 

Sterilisation / Redefining Decontamination Safety: Hydrogen peroxide vapor offers advantages

Published on 9th September 2010

CONTAMINATION CONTROL - Sterilization | Redefining Decontamination Safety: Hydrogen peroxide vapor offers advantages over other processes
By Martin Orlowski
 
The inherent safety of hydrogen peroxide vapor decontamination allows operators to execute and monitor the process from outside while operations continue.

Although widely expected for a long time, the classification of formaldehyde as a carcinogen by the World Health Organization means that the United States is now likely to follow other parts of the world by issuing a ban on the use of the chemical. Such an action will result in the need to revise decontamination protocols across many industry sectors as modifications are made. Fortunately, a proven alternative in the form of hydrogen peroxide vapor already exists and provides an opportunity to redefine the health and safety risks associated with large-scale decontaminations in various production environments.

The use of hydrogen peroxide vapor within the pharmaceutical industry is not new. Its use has dominated aseptic isolator sterilization for over 15 years, and one does not need to look far to see why. The technology is beautifully simple, but an advanced element of control means that more than just a hot plate is required. Regardless of the target application, a liquid form of hydrogen peroxide solution is flash evaporated in a controlled manner and the vapor evenly distributed.

The process continues until the right conditions are achieved; this state is maintained for a predetermined period of time. The final phase catalyzes the vapor into harmless byproducts—water vapor and oxygen—to return the system to its original, yet sterile, condition. This residue-free characteristic has added to the technology’s success, as have its ease of validation and material compatibility, over both the long and short terms.

Since its conception, the technology has evolved from a focus on small, contained systems such as isolators and chambers to greater spaces such as rooms, suites, and even entire buildings. However, such scaling up comes with its own unique set of challenges, resulting from the shift away from dealing with systems specifically designed for hydrogen peroxide vapor decontamination. Issues of validation, health, and safety are among those needing to be addressed.

To read the full version of this article, click here...

Bioquell invests for future growth

Published on 21st May 2010

Leading bio-decontamination company, Bioquell, officially opened its new UK manufacturing site on Friday 21 May 2010. The Right Honourable Sir George Young, Bt. MP. cut the ribbon that marks a significant stage in the ongoing investment the company is making as it expands to meet a growing global demand.

Speaking at the event, Nick Adams, Chief Executive Officer said “The new site enables Bioquell to design, manufacture and assemble the latest bio-decontamination equipment that is used in the healthcare, life science and defence industries around the world. Our technology is at the forefront of best practice bio-decontamination and this expansion will enable us to meet the growing demand we have for our products.”

Bioquell’s unique hydrogen peroxide vapour (HPV) technology has been used across the globe to eradicate problematic bacteria, viruses and fungi. Its systems provide ‘residue-free’, safe and repeatable sterilisation of rooms, buildings, equipment and sensitive electronics making HPV the clear alternative when replacing traditional decontaminants such as formaldehyde or chlorine-based products.

 

Opening ceremony Bioquell UK Ltd 21st  May 2010.
Left to right: Nick Adams CEO Bioquell, Mayoress Francis Lynn,
Mayor Councillor Chris Lynn, Nigel Keen Chairman Bioquell, Rt Hon. Sir George Young MP.

More information: +44 (0)1264 835 835

Martin Whiting, Marketing Manager  
Nick Adams, Chief Executive Officer

Automated filling and capping systems

Published on 22nd December 2009

A UK-based bio-therapeutic products manufacturer is using two high specification automatic aseptic filling and plugging systems at its brand new clinical trials facility. Supplied by Watson-Marlow Flexicon, the FPC50 systems, one of which is subjected to virus-based products, are housed in isolator units built by based Extract Technology, a specialist manufacturer of aseptic isolators. Extract Technology was introduced to the project by Bioquell UK of Andover, a provider of hydrogen peroxide vapour (HPV) bio-decontamination solutions, which interfaced its own Clarus L HPV generator with both isolators. The Clarus L completes an automated high level disinfection process to achieve six-log sporicidal reduction on all surfaces within the isolator. This is achieved by depositing a fine layer of hydrogen peroxide condensation during the decontamination phase which is then evaporated in the aeration phase providing a residue-free process with excellent material compatibility - including sensitive electronics

For the full article, click here: Read the e-Lab article...

Ten Steps to Preventing Infection in Hospitals

Published on 27th October 2009

Bioquell system cited by the Online Wall Street Journal as one of ten steps to prevent infection in hospitals

By Stephanie Simon, Wall Street Journal

The facts are frightening: As many as one in 10 patients hospitalized in the U.S. will come down with an infection—often due to the very care that is supposed to be restoring health.

These infections afflict nearly two million patients a year, cause close to 100,000 deaths and cost up to $6.5 billion.

But they are not inevitable.

Here are 10 ways to prevent infection in health-care settings—a list gleaned from conversations with doctors, nurses, administrators, the nonprofit Committee to Reduce Infection Deaths, and the Association for Professionals in Infection Control and Epidemiology.

We've divided the list into two parts: first, promising new technologies, and second, a look at back-to-basics techniques that many hospitals have reinvigorated, with great success.

For the full article, Click here...

Award by the NHS Purchasing and Supply Agency to Bioquell

Published on 16th October 2009

Award by the NHS Purchasing and Supply Agency to BIOQUELL
of a framework agreement relating to the supply of
Gaseous Room Decontamination Equipment and Services to the NHS

BIOQUELL PLC (“BIOQUELL”) (LSE: BQE), the UK leader in specialist bio-decontamination technology and testing/compliance services, announces that the Group has been awarded a framework agreement (the “Framework Agreement”) by the National Health Service (“NHS”) Purchasing and Supply Agency (“PASA”) for the supply of BIOQUELL’s bio-decontamination equipment and specialty services into NHS hospitals.

This Framework Agreement award facilitates the provision by BIOQUELL to NHS hospitals of:

• Gaseous Room Decontamination Equipment;
   
• Gaseous Room Decontamination Service; and/or
   
• Emergency Call Out Service for Gaseous Room Decontamination.

The Framework Agreement runs until 30 September 2011; however, PASA has the option to extend it until 30 September 2012.

Two companies have been awarded a framework agreement for the supply of Gaseous Room Decontamination technology to NHS hospitals. PASA reviewed both parties’ submissions and awarded the highest score, totalling 95%, to BIOQUELL’s unique bio-decontamination technology.

Background

The award of this Framework Agreement follows on from many years of work, in the UK and internationally, by BIOQUELL deploying its hydrogen peroxide vapour (“HPV”) bio-decontamination technology to eradicate “superbugs” from the hospital environment, including:

• the publication in August 2009 of a joint report by the Department of Health and PASA on the use of BIOQUELL’s HPV bio-decontamination technology in seven NHS Showcase hospitals – where “99% of staff would recommend it”;
   
• BIOQUELL winning a prize in February 2009 from the Department of Health and PASA for the technology with the greatest contribution to controlling Clostridium difficile in hospitals; and
   
• the award in October 2007 of Category One status to BIOQUELL’s technology by the Department of Health’s ‘Rapid Review Panel’ (“RRP”). (BIOQUELL’s technology remains the only bio-decontamination technology with Category One RRP status.)
  
  Commenting on the Framework Agreement award by the NHS Purchasing and Supply Agency, Nick Adams, Chief Executive of BIOQUELL PLC said: 
  
  “We are delighted by the award of this NHS decontamination framework agreement which represents the culmination of nearly ten years of extremely hard work - including research and trials – to demonstrate the use of BIOQUELL’s bio-decontamination technology to eradicate ‘superbugs’ from the hospital environment and reduce the rate of Healthcare Associated Infection.”
  
  “We look forward to helping NHS hospitals drive down their Healthcare Associated Infection rates - and in particular assisting them in combating the issues created by the new strain of Clostridium difficile.”

Enquiries

Nick Adams   BIOQUELL PLC    01264 835 900
Mark Bodeker  www.bioquellplc.com

 

 

Notes to Editors / further information

• link to Showcase Hospital Report: “99% of staff would recommend it”: Click here...
   
• link to award for greatest contribution in controlling Clostridium difficile: Click here...
   
• link to Rapid Review Panel Category One status award by the Department of Heath: Click here...
   
• link to BIOQUELL press release relating to award of Category One status: Click here...
   
•  link to BIOQUELL case studies on Department of Health website: Click here... 

DoH & PASA Publish report on Success of BIOQUELL System in Showcase Hospital Programme

Published on 17th August 2009

The Department of Health and NHS Purchasing and Supply Agency have published a report outlining the successful deployment of the BIOQUELL Proactive service in seven NHS Showcase Hospitals as part of the HCAI Technology Innovation Programme.

BIOQUELL's RRP1 technology was deployed as part of the programme in order to assess the ease of use in an everyday hospital environment.

The conclusions of the report are resoundingly successful:

"The BIOQUELL system - which is known to be an effective way of disinfecting rooms and equipment - can be used without undue disruption to staff or patients"

"99% of staff would recommend it"

 

 

In response to this report, BIOQUELL's Head of RBDS Matthew Parks commented:

"By placing BIOQUELL's Proactive decontamination Service into busy operational NHS settings, the DOH have been able to assess the benefits of our service. Despite the inherent problems of introducing new technologies into existing operational structures, I am delighted that we achieved such a high level of approval with all hospital staff. With hospitals always extremely busy it is extremely good news that we were able to implement this service with 83% percent of those surveyed reporting no delay to the admission or discharge of patients."

To read the full report Click here...

BIOQUELL assist with clean up

Published on 1st July 2009

Plant should be back online after hydrogen peroxide treatment

Contamination of a bioreactor with a rare virus caused Genzyme Corp. (Cambridge, Mass.) to close one of its plants temporarily to sanitize the facility. The cleanup is on track, according to a spokeswoman.
 

We’re continuing the vaporous hydrogen peroxide treatment at the facility, and we believe it will all be complete by the end of July. —Lori Gorski, Genzyme Corp.

    “We’re continuing the vaporous hydrogen peroxide treatment at the facility, and we believe it will all be complete by the end of July,” Lori Gorski, a spokeswoman for Genzyme, told Contamination Control in an interview.
    Vesivirus 2117 was identified in a bioreactor used in the production of Cerezyme (imiglucerase for injection) at the company’s plant in Allston, Mass. The plant also produces Fabrazyme (agalsidase beta). Both drugs are used to treat rare genetic disorders.
    Vesivirus 2117 impairs the viability of cells used in the manufacturing process and is not known to cause infections in humans, according to a June 25 news release. The company confirmed that the same virus strain contaminated production twice in 2008, once in Allston and once at a plant in Belgium.

Read more - Contamination Control interview...

BIOQUELL Launch new Clarus L2 HPV Generator

Published on 25th June 2009

BIOQUELL are pleased to announce the launch of our brand new HPV generator for complete surface bio-decontamination - the Clarus L2. This exciting new upgrade to the Clarus L which has successfully served the industry for over 9 years includes a variety of impressive new features to better resolve complex contamination issues which can arise in this vast and diverse sector.

Key features include:

• Optimised cycle performance for fast and effective bio-decontamination
• Can be used with standard 1/2 litre or 1 litre bottles so is suitable for multiple cycles
• Can bio-decontaminate rooms and enclosures up to 75m³
• Critical condition monitoring with alarming set points compatible with GMP and GLP requirements
• Advanced software and controls allow for simple integration into a building management system (BMS) or with the Clarus PORT rapid decontamination transfer chamber

Potential applications for this unit include:

• GMP Cleanrooms
• Aseptic Processing
• Biologics
• Biosafety/security
• Material transfer chambers
• Decontamination of autoclaves / freeze driers
• Robotic enclosures
• Safety cabinets / isolators

For more information on this exciting new product, contact BIOQUELL.

Briefing on the outbreak of Swine Influenza Virus

Published on 27th April 2009

More than 100 people in Mexico have died of Influenza-like illness recently and 20 of these cases have been confirmed as H1N1 Swine Influenza Virus (SIV). One confirmed case has been reported from Spain.

SIV is an Influenza type A virus, which is an enveloped RNA virus from the Orthomyxoviridae. Influenza viruses are classified based on antigenic structures on the envelope called neuraminidase “N” and haemagglutinin “H”. SIV is classified as an H1N1 virus based on the configuration of H and N.

To find out more about the nature of swine influenza and how BIOQUELL's hydrogen peroxide vapour decontamination technology can be of use in the control of outbreaks, explore this website.

BIOQUELL takes top prize at the Department of Health HCAI Technology Innovation Summit

Published on 3rd March 2009

BIOQUELL has won a prestigious award from the Department of Health and NHS Purchasing and Supply Agency (PASA) in recognition of its Hydrogen Peroxide Vapour (HPV) decontamination technology, offering the greatest contribution in controlling Clostridium difficile.

The awards have been created to highlight and celebrate innovation and success within the field of HCAI related technology and technological developments. They recognise that new and innovative technologies are helping to save lives and are making it easier for doctors and nurses to fight infection.

The Department of Health and PASA launched the awards programme to highlight and celebrate innovation and success within the field of HCAI related technology and technological developments.

Matt Parks, Head of BIOQUELL's UK healthcare decontamination practice, said on receiving the award;

"We are thrilled to have won such a prestigious award following many years of hard work carrying out painstaking "superbug" eradication research in hospitals around the world. Winning this award highlights the importance of BIOQUELL’s presence within the NHS to help combat the threat posed by Hospital Acquired Infection”.

Extract from the PASA news release:

BIOQUELL’s fully managed  RBDS decontamination service was recently showcased in the HCAI technology innovation showcase programme as one of only six technologies trialled throughout seven UK hospitals. The trials proved that such a service can easily be implemented as part of a hospitals infection control regime offering quick turn around times in the decontamination of infected areas.

New technologies on trial to combat healthcare infections

Published on 18th September 2008

NHS PASA News release
September 18th 2008        

New infection beating products are being tested and evaluated in seven ‘Showcase Hospitals’ across England in a project led by the NHS Purchasing and Supply Agency (NHS PASA).

Evidence of the effectiveness of each product is being collected along with the views of staff on how easy they are to use. NHS PASA will then work with the hospitals to make the successful products widely available across the NHS as quickly as possible.

This is one strand of the Healthcare Associated Infections (HCAI) Technology Innovation Programme, a joint project between the Department of Health and NHS PASA, which aims to speed up the development and introduction of new technologies to help combat infections, especially MRSA and C. difficile. 

Secretary of State for Health, Alan Johnson today visited one of the Showcase hospitals, Imperial College Healthcare NHS Trust in London.

He said: “Hand hygiene, high standards of cleanliness, bare below the elbows, deep clean of hospitals and screening patients for MRSA are all vital elements of our strategy for tackling infection, so too is sensible use of antibiotics. But now we are stepping up a level and looking increasingly towards technology and design to play its part in the fight against infection which is why I am delighted to be launching the ‘Showcase Hospital’ scheme.”

Showcase Hospitals Programme Manager Paul Cryer said: “Infection control is one of the biggest challenges facing the NHS today and new technologies and products have the potential to make a real difference in reducing levels of healthcare infections.

“That’s why NHS PASA is grateful to staff at the Showcase Hospitals for helping us to find out what works best so we can make the new products widely available across the entire NHS for the benefit of all, knowing they are effective.”  

Each Showcase Hospital has a Project Nurse dedicated to the Programme and NHS practitioners from other trusts are actively encouraged to visit and find out first hand about the proven benefits of the new products.

The first review of new products is underway and includes evaluation of a vapour decontaminating system for use on equipment and clinical areas, a device to detect whether surfaces and equipment are sufficiently clean and a skin preparation product for disinfection of the skin prior to invasive procedures.

The seven Showcase Hospitals are:

• The Royal Wolverhampton Hospitals NHS Trust
• Imperial College Healthcare NHS Trust, London 
• County Durham and Darlington NHS Foundation Trust
• Calderdale and Huddersfield NHS Foundation Trust
• Southampton University Hospitals NHS Trust
• Central Manchester and Manchester Children’s University Hospitals NHS Trust
• The Lewisham Hospital NHS Trust.

Note to editors:

1. For further information or to arrange an interview with Paul Cryer please contact Alison Pitts-Bland on 020 7972 5398 or Alison.pitts-bland@pasa.nhs.uk

2. NHS Purchasing and Supply Agency, an executive agency of the Department of Health, works to ensure that the NHS in England makes the most effective use of its resources by getting the best possible value for money when purchasing goods and services, now Buying Solutions - http://www.buyingsolutions.gov.uk/suppliers/details/supplier-2305/

3. The first phase of products and technologies being reviewed are:

• Hydrogen Peroxide Vapour System - BIOQUELL. Highly effective for decontaminating enclosed rooms, wards and equipment. 

• Clean-Trace Hygiene Monitoring System - 3M. Adenosine triphosphate bioluminescence testing system which can detect in seconds whether surfaces and equipment are sufficiently clean.

• BARDEX  I.C. - Bard. A silver alloy and hydrogen coated Foley catheter, designed to reduce bacterial colonisation that cause urinary tract infections.

• ChloraPrep - Enturia Ltd. Sterile, single patient use applicator to disinfect the skin prior to invasive procedures. Contains 2% chlorhexidine gluconate in 70% isopropyl alcohol.

• Flexi-Seal Faecal Management System - ConvaTec. A closed system designed to contain infectious diarrhoea, indicated for patients with acute faecal incontinence.

• Zassi Bowel Management System – Hollister. Diverts and contains potentially infectious stool in a drainable or closed system and allows delivery of rectally administered medication.

4. The HCAI Technology Innovation Programme was launched in January 2008 in the Department of Health publication – Clean, Safe Care – Reducing Infection and Saving Lives. Further information at www.clean-safe-care.nhs.uk

BBC News Films ‘New Weapons Against Hospital Bugs’ at Lewisham Hospital

Published on 18th September 2008

The Lewisham Hospital NHS Trust is very proud to have been selected as one of seven Showcase Hospitals in the country, as an example of good practice on infection control. A number of 'bug-beating' technologies are being trialled at Lewisham and BBC News came to spend a day filming the work being done at the hospital.

To view the footage please follow the link to the BBC web pages.

http://news.bbc.co.uk/1/hi/health/7622306.stm

Robot set to tackle killer hospital bugs

Published on 9th September 2008

ROBOTS have been called in to local hospitals to beat life-threatening infectious bugs thanks to a landmark new NHS scheme. According to Imperial College Healthcare NHS Trust, the hospital group is one of only seven in the UK to test a range of new technologies - including a vapour decontaminating robot. Now, hospitals such as Charing Cross, Hammer-smith and Queen Charlotte’s will test the effectiveness of six new technologies which have been designed to reduce levels of infection, especially MRSA bloodstream infections and C. difficile.

The view the full article as published in the Fulham h&f news Click  here...

To be directed to the h&f web site Click here...

BIOQUELL moves to newly renovated production facility

Published on 22nd July 2008

BIOQUELL has moved it's UK operation into a newly renovated building which has been designed to accomodate our research & development, manufacturing and customer service requirements.

The new premises at Royce Close on the West Portway Industrial Estate boasts brand new offices and a complete manufacturing facility along with a custom built research and development area, signaling a significant commitment to the continued development of BIOQUELL's unique product and service range.

The move follows a particularly successful year for BIOQUELL, with a number of key contracts won including the award of the Joint Material Decontamination System ('JMDS') sub-contract by the US Military and the placement of BIOQUELL's pro-active service in seven showcase hospitals throughout the UK by the Department of Health (for more information on this placement, Click here...). This, combined with our growing network of dealers and increased global business has led to the need for a modern facility with further room for expansion as the company continues to thrive.

Impact of Hydrogen Peroxide Vapor Room Decontamination on Clostridium difficile

Published on 21st July 2008

Infection Control & Hospital Epidemiology Article, Published July 2008

Impact of Hydrogen Peroxide Vapor Room Decontamination on Clostridium difficile Environmental Contamination and Transmission in a Healthcare Setting

John M. Boyce, MD; Nancy L. Havill, MT; Jonathan A. Otter, BSc; L. Clifford McDonald, MD; Nicholas M. T. Adams, BSc; Timothea Cooper, RN; Angela Thompson, MSc; Lois Wiggs; George Killgore, DrPH; Allison Tauman, PharmD; Judith Noble-Wang, PhD

From the Hospital of St. Raphael (J.M.B., N.L.H., T.C., A. Tauman) and Yale University School of Medicine (J.M.B.), New Haven, Connecticut; the Centers for Disease Control and Prevention, Atlanta, Georgia (L.C.M., A. Thompson, L.W., G.K., J.N.-W.); and Bioquell, Andover, United Kingdom (J.A.O., N.M.T.A.).

BIOQUELL technology showcased in seven NHS hospitals

Published on 7th July 2008

BIOQUELL’s ‘proactive’ Hydrogen Peroxide Vapour (HPV) decontamination service has been chosen to be one of only six technologies to be placed in seven NHS showcase hospitals. The HCAI Technology Innovation Programme is a new initiative set up by the DoH to develop, promote and press forward new technologies into our hospitals that have the potential to make a real difference in the battle against HCAI’s.

BIOQUELL’s experience in providing high level decontamination equipment and services has been rewarded with a DoH led contract that will see the patented Clarus^® technology used as a proactive service within seven designated showcase hospitals over a four month trial period.

Matthew Parks – Head of Room Bio-Decontamination Services at the Hampshire based company commented:

 ‘We are confident that the proactive service will prove to be a great success, just as they have been in similar deployments throughout the UK, Europe and America. We look forward to reviewing and promoting the results, with a goal to be working alongside all British hospitals in the near future’.

BIOQUELL’s unique decontamination technology is supported by robust scientific data and is the only technology of its kind to be awarded Category One Status by the DoH’s expert Rapid Review Panel. An article due to be published later this year (Boyce et el - Infection Control and Hospital Epidemiology 2008, in press.) proved a reduction in the acquisition of C. difficile infections whilst being operated within a busy healthcare setting.

Benefits of BIOQUELL’s HPV technology

• Safe to use with all sensitive electrical and electronic equipment.
  An active distribution of penetrates into difficult to reach areas ensuring uniform bio-decontamination
   
• Proven biological efficacy against a wide range of nosocomial pathogens including methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile, vancomycin-resistant enterococci (VRE) and Acinetobacter baumannii.
   
• The process is rapid ensuring minimum disruption to any room, ward or facility. For example, a single side room can be decontaminated in less than 2 hours, an entire ward can be decontaminated in 12 hours. All adjacent areas can operate as normal during the procedure.

For more information on the BIOQUELL’s equipment and services please visit our website at www.bioquell.com and navigate to our HEALTHCARE pages. To request our latest brochure please contact Wayne Hoyle Tel: 01264 835 828 or send and enquiry to: enquiries@bioquell.com

Best foot forward for cleaner hospitals

Published on 16th June 2008

A consultant from Winchester hospital is to climb a mountain in order to raise money to buy a BIOQUELL hydrogen peroxide vapour generator, following the success of research carried out last year, showing that by using the HPV generator they were able to eradicate MRSA from the clinical environment.

Dr Matthew Dryden is setting off this week to climb Mt Kinabalu in Borneo and in the process hopes to raise money for Winchester and Andover hospitals to purchase the generator to help in the ongoing fight against hospital superbugs such as MRSA, Clostridium difficile (C diff) and Norovirus.

BIOQUELL will match any donations raised by Dr Dryden towards the purchase of their technology. Anyone who would like to support the trust to beat superbugs may sponsor Dr Dryden through the Winchester and Eastleigh Charitable Trust Fund at the hospital or on line - Click here... 

BIOQUELL Nominated for Prestigious PLC Award

Published on 6th March 2008

The Technology Award recognises companies whose business growth and success is attributable to the development of one or more technologies and on the development of technology-led products or services which have demonstrated significant innovation either in terms of the technology itself or its application.

BIOQUELL have been nominated for a prestigious PLC award in "The Best Technology" category.

 

The PLC awards event was founded in 1987 to reward excellence in the smaller quoted company sector. The winners of each of the seven award categories are presented with their awards at the annual PLC Awards Dinner, which is held in March in London. The PLC Awards Dinner is "the" City event of the year and is attended by 1,500 guests, including quoted companies, investment banks, fund managers, investment analysts, and corporate advisors.

East Sussex Hospitals NHS Trust Commence Deployment of RBDS Proactive Team

Published on 22nd January 2008

East Sussex Hospitals NHS Trust has become the second Trust to deploy BIOQUELL’s Hydrogen Peroxide Vapour (“HPV”) bio-decontamination technology. In order to reduce hospital acquired infections the Trust is undertaking a ‘deep clean’ programme in line with the Government’s initiative to carry out a national ward-by-ward clean.

Matthew Parks, Head of BIOQUELL’s Room Bio-Decontamination Service, said:

"We are delighted to be working with the East Sussex Trust – the second dedicated proactive team deployed within the UK. With this specialist decontamination resource, the hospitals are able to focus on eradicating nosocomial pathogens from the environment and hence reduce hospital acquired infections. This preventative approach has been proven to work in hospitals in the US and I am excited to see BIOQUELL’s technology being used in our hospitals.
Equally, we are continuing to support the NHS' requirement for decontamination technologies by offering emergency decontamination call outs and also equipment for the hospitals to purchase and operate themselves.”

This contract is another important win for BIOQUELL who have invested heavily in the research and development of its HPV decontamination systems. In March 2007 the BIOQUELL Z was launched – a system which can be purchased and operated by the hospitals. This option gives users the control and flexibility to decontaminate ICU's, patient side wards, isolation rooms and equipment where ever and when ever it is required.

Further information on the deployment of BIOQUELL’s technology against hospital acquired infection in NHS hospitals is available on the Department of Health's web site. Click HERE to be directed to the relevant web pages.

 

PRESS RELEASE FROM
EAST SUSSEX NHS TRUST
16th January 2008

Trust launches enhanced deep cleaning programme

East Sussex Hospitals NHS Trust is undertaking a £450,000 enhanced deep cleaning programme for all its wards and clinical areas. It forms part of the national deep clean of hospitals announced by Health Secretary Alan Johnson in November last year.

The Trust has welcomed the additional national deep clean funding which will enhance its own ongoing campaign to reduce Clostridium difficile, MRSA and other hospital acquired infections.

Dr Umasankar, Consultant Microbiologist and Director of Infection Control, said:

“Infection control and patient safety is a priority for this Trust. We have made significant progress on reducing infections showing a year on year reduction in the number of hospital cases. However, we are not complacent. It is important for everyone in the Trust and the community to help reduce infection rates by understanding the importance of implementing good infection prevention and control at all times. This enhanced deep cleaning programme will decontaminate our hospitals.”

David Philliskirk, Director of Facilities and Estates, said:

“Cleaning and deep cleaning is carried out at the Trust Hospitals on a daily basis – but this new programme is something more than that. This is literally getting into every nook and cranny of every ward and clinical unit and treating them with some of best disinfection materials available.”

The deep clean programme will be completed by the 31st March 2008 and involves a considerable amount of work across the hospital’s 74 wards and clinical units.

Every ward will be thoroughly cleaned including bed frames, lockers, behind radiators, air vents, lights, shelves, corridors, bathrooms, floors, computers, telephones, kitchens, curtains, linen skips, trolleys, fans and work surfaces.

Along with traditional disinfectants other methods such as hydrogen peroxide vaporisation and steam cleaning will be used where appropriate. A specialist contractor will use the latest equipment to disperse hydrogen peroxide vapours throughout the wards to decontaminate every surface and area of any germs likely to cause infection.

Patients will be moved from an area about to be cleaned to one which has already been cleaned to enable the programme to take place. The Trust’s infection control staff will sign off each area as compliant with Department of Health guidelines before cleaners can move on.

Tina Lloyd, Lead Nurse for infection control, said:

“We apologise to patients and their families who may be inconvenienced by being moved around while this deep clean is undertaken. We shall take great care to do the cleaning as quickly, efficiently and safely as possible to minimise disruption without compromising the aim of the exercise – to reach the highest possible standards of cleanliness.”

The deep clean is the latest in a series of initiatives the Trust has undertaken to help reduce hospital acquired infections. These include the introduction of alcohol gel dispensers and the bedside and ward entrances. A new ‘bare below the elbow’ uniform policy. A poster campaign to encourage visitors to clean their hands and remind staff of the need for good hand hygiene. Limiting the movement of patients around the hospital, daily and weekly monitoring of infections, and new antibiotic prescribing guidelines.

A new action plan to reduce hospital acquired infections has been developed and the measures the Trust has taken are based on the latest research and have been worked through with the close co-operation and agreement of the Department of Health Cleaner Hospital Team.

In November 2007, the Trust received positive ratings for cleanliness in the Patient Environment Action Team (PEAT) evaluation. Eastbourne DGH received a ‘good’ and Conquest received an ‘acceptable’ rating for environment.

To view this press release on the East Sussex NHS Trust website, Click here.

Gloucestershire Hospitals NHS Foundation Trust deploy BIOQUELL

Published on 11th January 2008

BIOQUELL announces that Gloucestershire Hospitals NHS Foundation Trust is the first hospital trust in the UK to deploy a BIOQUELL 'Proactive' team on a preventative basis, to combat hospital acquired infection.

The BIOQUELL ‘proactive’ team comprises an on-site team of highly trained BIOQUELL engineers and specialist, proprietary hydrogen peroxide vapour sterilisation equipment which is used to decontaminate rooms or equipment in a hospital on a preventative basis against “superbugs” including Clostridium difficile, MRSA, Acinetobacter, VRE or norovirus. (To date, BIOQUELL has two ‘proactive’ teams deployed in hospitals in the US.)

Commenting on this long term contract win, Nick Adams, Chief Executive of BIOQUELL PLC said:

“After a decade of research and development into the decontamination of “superbugs” and sterilisation of rooms containing sensitive electronic equipment, we are delighted to see BIOQUELL’s unique hydrogen peroxide vapour technology being deployed in a proactive manner against hospital acquired infection in the UK.”


Further information on the deployment of BIOQUELL’s technology against hospital acquired infection in NHS hospitals is available on the Department of Health's web site. Click HERE to be directed to the relevant web pages.

 

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PRESS RELEASE FROM THE
GLOUCESTERSHIRE HOSPITALS
NHS FOUNDATION TRUST
9th January 2008

 

The latest weapon in the fight against infection is launched today at the Gloucestershire Hospitals NHS Foundation Trust.

As of Friday January 11th, the BIOQUELL proactive team will be in place and on site at Gloucestershire Royal Hospital and Cheltenham General Hospitals to deep clean areas with
high-tech equipment.

“Effectively this is a rapid response team to help us keep the hospitals as clean as possible,” said Director of Infection Prevention and Control at Gloucestershire Hospitals NHS Foundation Trust, Dr Jim Stone.

The company BIOQUELL uses mobile machinery which can deep clean areas using Hydrogen Peroxide Vapour (HPV) Clarus Technology. This oxidises organisms, removing bacteria, fungi and viruses. Therefore, if a patient with an infection is in a side room, it can be deep cleaned effectively after they leave, reducing infection rates and open to new patients more quickly.

“Staff and patients cannot be present during cleaning due to the vapour,” said Dr Stone, “but they will be able to return to the ward within an hour, depending on the size of the area cleaned".

“Due to bed pressures and the difficulty in decanting patients, the system will be used opportunistically, making it ideal for cleaning side rooms and bays.”

Matthew Parks, Head of BIOQUELL’s Room Bio-Decontamination Service, said:

“It is exciting to see our technology, which is also used to provide sterile conditions for pharmaceutical production facilities, used as a proactive and preventative measure in the Gloucestershire NHS Trust hospitals. This technology will benefit patients by providing them with a sterile room in which to be treated.”

 

 

To view this press release on the Gloucestershire Hospitals
NHS Foundation Trust web site Click HERE.. 

Hydrogen Peroxide Vapor can control Nosocomial MRSA Outbreak - Clinical Infectious Diseases Article

Published on 15th November 2007

18 September 2007 (Reuters Health [Deborah Mitchell])-Hydrogen peroxide vapor, in combination with decolonization of staff and patient carriers, successfully controlled an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) on a surgical ward that had previously been MRSA free, a British research team reported at the 47th annual Interscience Conference of Antimicrobial Agents and Chemotherapy.

In January 2007, MRSA was detected during the routine culture of minor surgical wound infections in 2 patients who were located in different sections of a ward at the Royal County Hospital in Winchester. Further screening of all 28 patients on the ward identified MRSA colonization in 11 (39.2%).

MRSA was also detected in 6 out of 52 healthcare workers on the ward, and environmental sampling indicated “substantial” MRSA contamination throughout the ward on various surfaces.

The hospital infection control team, led by Dr. Matthew Dryden, decided to use hydrogen peroxide vapor, which has previously been used for MRSA in other hospitals, to decontaminate the area.

The patients and staff were decolonized; other microbial control measures included reinforcement of the importance of proper hand hygiene, cleaning, and decontamination. Because of the shortage of available beds, the ward could not be cleared of patients, so the hydrogen peroxide vapor was administered in sections over a 2-day period. The patients, staff and the ward environment were monitored for the next 4 weeks.

At follow-up, all of the staff members and patients remained decolonized for MRSA. Over this period, all of the 69 patients who were discharged were MRSA negative. Of the 81 patients who were admitted, 3 tested positive for MRSA. After the hydrogen peroxide vapor decontamination, no new MRSA acquisitions occurred among the patients or staff.

Only 1 environmental site - a bed frame - remained MRSA positive after hydrogen peroxide vapor treatment.

Otter, a microbiologist at BIOQUELL Ltd. in Andover, UK, and his group initially believed this to be a single‐strain MRSA outbreak, but distinct subtypes were detected in 5 out of 9 patients who were colonized, and 7 out of 8 variants in the staff and environment matched a patient isolate.

The presence of the 5 distinct MRSA subtypes suggests repeated MRSA exposure due to the admission of different MRSA-positive patients.

Overall, the investigators conclude that hydrogen peroxide, plus patient and staff decontamination, ended the MRSA outbreak and that the effect was maintained up to at least 4 weeks.

BIOQUELL developed the hydrogen peroxide vapor for microbial decontamination about 10 years ago, and it has been used in the health sector for about 5 years, Otter continued.

“We can't say which of these interventions was most important, but chances are it was a combination,” Otter said. “It is a multifaceted problem.”

Hydrogen peroxide vapor can also be used successfully as a prophylaxis, Otter said. In June of 2005, St. Raphael's Hospital in New Haven, Connecticut, USA, tried it after a Clostridium difficile outbreak. Daily decontamination was performed for 10 months in hospital rooms of discharged patients who had had C. difficile. “We were able to show a 53% reduction in the rate of nosocomial C. difficile-associated disease compared with the historical period, and that the difference was statistically significant,” Otter said.

The message from this study, he concluded, is “when you do have an outbreak of a nosocomial pathogen, hydrogen peroxide vapor is now a viable option as part of the outbreak response.”

Editor's comment. "According to my consultant Dr. Keith Kaye at Duke Medical Center, who has researched hydrogen peroxide vapor sterilization technology, the technology is probably good for spores (e.g., C. difficile and anthrax), viruses (e.g., severe acute respiratory syndrome virus), and bacteria (e.g., MRSA). The biggest limitation of the technology is time. It takes 4-8 h until a room can be safely used."

To view this article on the Clinical Infectious Diseases website, Click Here... 

Rapid Review Panel upgrades BIOQUELL technology to Level One Status

Published on 26th October 2007

BIOQUELL PLC (“BIOQUELL”) (LSE: BQE), the UK leader in specialist decontamination technology and testing/compliance services, announces that its “superbug” eradication technology has been upgraded by the Department of Health’s Rapid Review Panel (“RRP”) to Category One status.

Background

• The RRP was set up by the Government in 2004 to facilitate the rapid review by an independent panel of leading UK infection control experts of the products / technologies which could be used to combat hospital acquired infections – or “superbugs” - in NHS hospitals.
• BIOQUELL’s hydrogen peroxide vapour (“HPV”) decontamination technology was one of the first technologies to be reviewed by the RRP. On 1 December, 2004, following a review of the scientific data available at the time, the RRP awarded BIOQUELL’s technology Category Two status, which meant that “basic research and development has been completed and the product may have potential value; in use evaluations / trials are now needed in an NHS clinical setting”

Promotion to RRP Category One status

• Earlier this year BIOQUELL submitted extensive scientific data to the RRP relating to its research activities and the deployment of its unique HPV decontamination technology against “superbugs” in hospitals in the UK, US and continental Europe.
• Having now completed its assessment, the RRP has upgraded BIOQUELL’s HPV technology to Category One status, which means that: “Basic research and development, validation and recent in use evaluations have shown benefits that should be available to NHS bodies to include as appropriate in their cleaning, hygiene or infection control protocols.”
• To date the RRP has reviewed 42 products or technologies to combat “superbugs” in the ‘Cleaning, Disinfection and Decontamination’ category and has awarded Category One status to only two – one being BIOQUELL.
• BIOQUELL’s technology is the first product to be promoted to a new category by the RRP – which is indicative of the quality and volume of scientific efficacy data generated by BIOQUELL to support the use of its technology to eradicate “superbugs” in hospitals.
• Further information on the promotion of BIOQUELL’s technology to Category One status is available on the Health Protection Agency’s website Click HERE to view the RRP announcement.

BIOQUELL’s technology against Clostridium difficile

• A significant proportion of the scientific data submitted by BIOQUELL to the RRP relate to the eradication of Clostridium difficile (“C.diff”) from sensitive electronic medical devices as well as rooms and wards in hospitals. For example, BIOQUELL has had a team permanently based at a leading US hospital for more than two years carrying out proactive decontaminations against C.diff. – and research from this hospital suggested that the use of BIOQUELL's technology directly contributed to a statistically significant 53% reduction in C.difficile associated disease.

NHS / Department of Health “Clean, Safe Care” best practise website

• Abstracts of BIOQUELL’s technology have recently been uploaded to an NHS / Department of Health website highlighting case studies relating to best practise involving the eradication or management of hospital acquired infection. Click HERE to be directed to the DoH website
• The best practise website includes a description of the use of BIOQUELL’s technology to eradicate C.diff at Maidstone and Tunbridge Wells NHS Trust following a C.diff outbreak (which has been the subject of an independent report which was recently made public) click HERE to be directed to the report.

Commenting on the promotion by the Rapid Review Panel of BIOQUELL’s unique “superbug” eradication technology to Category One status, Nick Adams, Chief Executive
of BIOQUELL PLC said:

“Clostridium difficile, MRSA and other “superbugs” remain a real, increasing and sensitive problem for hospitals in the NHS and around the world, as was underscored by the Prime Minister’s announcement of a deep-clean for every NHS hospital last month. Further, there have been a number of recent reports highlighting the major clinical issues caused by C.diff in hospitals. Despite the sensitivity of these problems, we are pleased that BIOQUELL is being asked to help more and more NHS hospitals combat Clostridium difficile.
We are also delighted that the top UK experts on the Rapid Review Panel have concluded that the use of BIOQUELL’s unique decontamination technology to combat “superbugs” is now supported by robust scientific data – and it has now been awarded Category One status. We are also pleased to be the first technology to be upgraded to Category One status by the Rapid Review Panel.”

Enquiries:

Nick Adams
Mark Bodeker 
BIOQUELL PLC    01264 835 900

 

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Further information

Clostridium difficile (“C.diff”) is a spore forming bacteria. Spore formers, including for example anthrax (Bacillus anthracis), are extremely tough and able to survive for years in the environment (including the hospital environment).

The alcohol handgels used in many hospitals as a key part of infection control are ineffective against spore formers. In addition, the use of bleach cleaning does not eradicate C.diff from the hospital environment.

In 1978 it was discovered that C.diff was responsible for causing disease in patients in hospitals and hence was considered to be a hospital acquired infection or “superbug”.

In 2003 a new strain of C.diff appeared which: (i) was much more virulent - with hospitals experiencing significantly higher levels of sickness and death – and (ii) was significantly more resistant to certain classes of antibiotics. This new strain of C.diff, commonly referred to as BI/NAP1 or the 027 strain, was first identified in Canada and over the last four years appears to have spread to healthcare facilities down the East coast of the US. It has also been detected at a number of hospitals in the UK.

“Environmental contamination makes an important contribution to hospital infection.” J.M. Boyce, Journal of Hospital Infection June 2007; 65:50-54.

“The New Clostridium difficile – What does it mean?”, J.G. Bartlett and T.M. Perl, New England Journal of Medicine, 8 December 2005, 352;23; 2503-2505

“Toxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe”, M. Warny et al., The Lancet, 24 September 2005, Vol 366; 1079–1084

“Severe Clostridium difficile – associated disease in populations previously at low risk – four states, 2005”. CDC, MMWR, 2 December 2005, 54(47); 1201-1205  

Department of Health Post BIOQUELL Case Studies as “Best Practice” on website

Published on 5th October 2007

The Department of Health have recently posted a number of BIOQUELL's Hospital Case Studies on the efficacy and efficiency of Hydrogen Peroxide Vapour in the hospital environment on their website as "Best Practice". 

To be transferrred to the Department of Health website to view these case studies, click on the DoH logo:  

Award of Joint Material Decontamination System (US military) sub-contract

Published on 2nd October 2007

BIOQUELL PLC (“BIOQUELL”), the UK leader in specialist bio-decontamination technology and testing/compliance services, announces that it is a member of the Teledyne Brown Engineering, Inc. (“TBE”) Team that has been awarded a contract relating to the United States Department of Defense (“DOD”) Joint Material Decontamination System (“JMDS”).

The JMDS is required to have the ability to decontaminate sensitive equipment, and interiors of vehicles, aircraft, ships and fixed site facilities that have been exposed to Chemical, Biological, Radiological and Nuclear (“CBRN”) warfare agents. Users of the JMDS will include the United States Army, Navy, Air Force and Marine Corps.

TBE has informed BIOQUELL that the DOD has awarded TBE the initial System Development and Demonstration (“SDD”) phase of the JMDS contract which is worth approximately $14.7 million (of which BIOQUELL’s share is expected to be some $7 million) and will last two years.  The SDD phase is reimbursed on a cost plus basis.

The DOD’s request for proposal dated 13 March 2007 described a SDD phase which would last two years - and requested firm prices for two production options: the low rate initial production (“LRIP”) option of 23 JMDS units and the full rate production (“FRP”) option of 1,843 units.

Enquiries

Nick Adams   BIOQUELL PLC    01264 835 900
Mark Bodeker

Deep Cleaning Service from BIOQUELL

Published on 24th August 2007

Today the Prime Minister announced a high profile new policy initiative that every NHS hospital is to be deep cleaned. The aim of the intervention is to ‘restore hospitals to their initial state of cleanliness to rid them of MRSA and Clostridium difficile.’ This deep clean is likely to be challenging for a number of reasons, including:

• Ward deep cleaning using liquid cleaning agents can take up to three days (Jeanes et al. J Hosp Infect 2005;61:85-86);
• Modern wards are often full of “high-touch”, complex electronic devices which are typically not compatible with liquid cleaning agents; and
• Conventional cleaning methods using liquid disinfectants do not rid surfaces of nosocomial pathogens (French et al. J Hosp Infect 2004;57:31-37). 

BIOQUELL’s hydrogen peroxide vapour (HPV) technology has been proven to kill MRSA, C. difficile and other nosocomial pathogens including glycopeptide-resistant enterococci (GRE) and Acinetobacter on hospital surfaces. Furthermore, because HPV is a vapour-phase method, all surfaces in the ward - including hard-to-reach areas and sensitive electronic items - are decontaminated. The decontamination of an entire ward (confirmed using 6-log Geobacillus stearothermophilus biological indicators) using BIOQUELL’s HPV technology is complete in less than 12 hours (or 2 hours for a side room), after which the ward can resume normal operation because the only residues from HPV are water vapour and oxygen.
 
If you would like to discuss how BIOQUELL could be involved in your ‘deep clean’, please contact us directly

Category III decontamination service launched

Published on 29th May 2007

Recognising that healthcare and pharmaceutical BSL2 and BSL3 Laboratory’s have different needs, BIOQUELL have launched an entirely new service option for the decontamination of controlled areas.

This new service offers:

• Guaranteed 24 hour call out – in response to HSE reportable spillages
• Annual site inspection
• Provision of risk assessment and method statement
• Fully challenged decontamination cycle*
• Detailed report and decontamination certificate
• Entire laboratory decontamination in under 2 hours
• Independently verified technology
• An alternative fumigation method to formaldehyde
• Preferential member rates for further decontamination deployments

Hydrogen Peroxide Vapour (HPV) has been used for the decontamination of laboratory’s and buildings within the pharmaceutical and healthcare sector for many years; however it has not been regularly used for BSL2/3 fumigation due to the cost of purchasing equipment and also the need for efficacy data concerning Mycobacterium tuberculosis (TB).

BIOQUELL’s decontamination technology now has proven efficacy against TB along with many other micro-organisms. BIOQUELL’s Room Bio-Decontamination Service (RBDS) has been independently verified by the HPA (formally CAMR) as a successful disinfectant system for cleanrooms, aseptic processing areas and hospital wards, offering a viable, proven and recommended alternative to formaldehyde fumigation.

The fumigation of a laboratory can be a lengthy and drawn out procedure, closing the laboratory for several days. Formaldehyde has always been the traditional fumigation method for laboratory decontamination, yet with long lead times, persistent residues and the need for post fumigation cleaning, it has never been considered an optimal solution. Classed as a Schedule 1 chemical under COSSH there is now a responsibility to prevent exposure to formaldehyde as far as is reasonably practical. Equally, concerns over the carcinogenicity of formaldehyde and introduction of strict regulations governing chemical emissions have prompted France to ban the sale and use of formaldehyde as of 1st January 2007. It is anticipated that this trend will continue and that the introduction of the Biocidal Products Directive (BPD) combined with the Integrated Pollution Prevention and Control (IPPC) will force other countries to follow suit.
 
Room Bio-Decontamination Service (“RBDS”) offers the benefits of hydrogen peroxide vapour technology without the capital outlay of equipment purchase. In operation for over 4 years, RBDS has a wealth of experience in room, building and laboratory decontamination completing over 10,000 decontaminations worldwide.

* Cycle verified by using G. stearothermophilus biological indicators.

For more information please contact BIOQUELL. 

Newly launched - BIOQUELL Z: Zone/room/building bio-decontamination

Published on 22nd May 2007

The control of the working environment is paramount where unwanted bio-burden can have such a detrimental effect.

In the fight against microbial contamination, BIOQUELL has launched the BIOQUELL Z, a radically new concept in safe and effective micro organism deactivation. Combining BIOQUELL’s acclaimed Hydrogen Peroxide (H_²0_²) Vapour (HPV) based Clarus™ technology with first hand experience of decontaminating over 2,700 rooms within the pharmaceutical and healthcare environment, the BIOQUELL Z has been designed to rapidly bio-decontaminate all exposed surface areas within a room of up to 500m³, with minimal effort. The BIOQUELL Z is ideally suited for routine disinfection of rooms thus acting as a preventative measure; as the technology is proven to be highly effective method to consistently eliminate micro organisms.

The BIOQUELL Z is designed for ease of use, allowing staff to decontaminate areas with minimum effort and set-up time. The unit is modular; whereby the control lectern detaches for positioning outside the target room, allowing for safe control. Once the contaminated area has been sealed and vacated, then the unit can be set to run its decontamination cycle. High velocity, multi-directional nozzles effectively distribute a controlled micro coating of hydrogen peroxide throughout, rapidly killing both airborne and surface micro-organisms. The unit’s unique parametric monitoring system automatically controls the amount of H^₂O^₂ vapour required. Once effective kill has been achieved, the H^₂O^₂ vapour is aerated and catalytically converted into harmless water vapour and oxygen. Following aeration, the decontaminated area is ready to be put back into immediate service, leaving no toxic residues or requiring additional cleaning or wipe-down. Due to the excellent materials compatibility of hydrogen peroxide vapour, all equipment (including sensitive electronics and consumables) can be left within the room ensuring that decontamination is achieved throughout. In as little as 4 hours, all surface areas within an area of 110m³ can be decontaminated and ready to be put back into service. The time can be dramatically reduced to 90 minutes by simply adding an R20 aerator. The Z unit is GxP compliant and comes complete with a printer and cycle parameter report, making it highly validatable. The whole process can be verified using 6-log pouched G stearothermophilus, biological indicators. Hydrogen Peroxide is fast becoming the disinfectant of choice with its proven efficacy against bacterial endospores, vegetative bacteria, viruses, fungi, mycoplasma, bacteriophage and other organisms. The BIOQUELL Z provides a rapid, safe and effective means of applying hydrogen peroxide vapour, promoting a clean and contamination free environment.  

Laboratory Fumigation - HPV Proven TB Efficacy

Published on 25th March 2007

The fumigation of a laboratory can be a lengthy and drawn out procedure, closing the lab for several days. Formaldehyde has always been the traditional fumigation method for laboratory decontamination, yet with long lead times, persistent residues and the need for post fumigation cleaning, it has never been considered an optimal solution. Classed as a Schedule 1 chemical under COSSH there is now a responsibility to prevent exposure to formaldehyde as far as is reasonably practical. Equally, concerns over the carcinogenicity of formaldehyde and introduction of strict regulations governing chemical emissions have prompted France to ban the sale and use of formaldehyde as of 1^st January 2007. It is anticipated that this trend will continue and that the introduction of the Biocidal Products Directive (BPD) combined with the IPPC will force other countries to follow suit.

 Hydrogen peroxide vapour (HPV) has been used for biodecontamination in the pharmaceutical and healthcare industry for many years, however it has not been regularly used for lab fumigation due to the cost of purchasing the equipment and also the need for efficacy data covering Mycobacterium tuberculosis (TB). BIOQUELL’s decontamination technology now has proven efficacy against TB (and many other micro-organisms) whilst at the same time Hydrogen peroxide vapour (HPV) is now recommended as a realistic option and should be considered as a viable alternative to formaldehyde fumigation.

 The Room Bio-Decontamination Service (“RBDS”) offers the benefits of hydrogen peroxide vapour technology without the capital outlay of equipment purchase. In operation for over 4 years, RBDS has a wealth of experience in room, building and laboratory decontamination completing over 10,000 decontaminations worldwide.

 Recognising that Labs, be they BSL2 or BSL3, have different needs to our healthcare and pharmaceutical customers BIOQUELL have launched a new service option which, for a yearly subscription comprises an annual site inspection and a 24 hour guaranteed response time (in cases of an HSE reportable spillage). On top of this, scheme membership provides access to our discounted rates for laboratories registered with us.

H202 EFFICACY Micro section

Published on 11th August 2006

Hydrogen peroxide vapour is well established as a bio-decontamination agent due to its “residue free” nature (the only residues are oxygen and water) and low temperature, vapour-phase application. HPV has been tested against many organisms and classes of organisms. However, because a great number of “common” micro-organisms exist, efficacy testing remains an ongoing process.

This page outlines the most significant current knowledge that can be attributed to known sources. This information can be used not only to look at specific organisms but also the efficacy of HPV against types and groups of organisms.

Figure one shows a widely accepted classification of the resistance of various micro-organisms to sterilisation and disinfection procedures based on the pioneering work of E.H. Spaulding1. This classification can be used as a guide when forming a hypothesis about the efficacy of HPV against a particular micro-organism.

If a particular organism is not listed here, it does not mean there is no data available or that HPV is not effective against it. Therefore, if a specific organism, which is of a particular importance is not listed within this document, please contact BIOQUELL to see if other data (analogous or specific) is available - or if further testing is required.

HPV has been shown to kill a wide range of micro-organisms including bacteria, viruses and fungi. The efficacy of HPV has been repeatedly demonstrated against bacterial endospores, which are typically the most resistant organism to any kind of bio-deactivation stress so as such are positioned at the top of the Spaulding classification.

The organisms listed are divided into broad taxonomic categories (ie. bacteria, viruses and fungi) and grouped according to their microbiological characteristics. This division will allow an easy comparison of an untested organism with other related organisms that have been tested. The appendix includes the abstracts for published journal articles.

Alexandra Hospital ‘Bug-Busting’ Trials

Published on 4th August 2006

A new weapon in the fight against hospital ‘superbugs’ is being deployed by Worcestershire Acute Hospitals NHS Trust.

Decontamination using hydrogen peroxide vapour has been proven as one of the most effective ways of eliminating the bugs which cause hospital-acquired infections such as MRSA and C diff.

Now, three wards at the Alexandra Hospital, Redditch, are to be bio-decontaminated  using the vapour, which is deadly to bacteria and viruses but is safe for patients because it is residue free and leaves behind only water vapour and oxygen.

Consultant Microbiologist at the Alexandra Hospital, Dr Jim Stone, explains: “Traditional methods of cleaning and disinfection can make a ward appear cleaner but not destroy all of the potentially harmful bacteria.

“One germ that is especially resistant to disinfectants is called Clostridium difficile, generally known as “C diff”.

“This is now the commonest cause of hospital-acquired diarrhoea in the UK and other parts of the world. Although person-to-person spread is the most important means of transmission, the environment is also very significant.

“This germ produces spores that are very hardy and difficult to get rid of but the use of hydrogen peroxide vapour, which has been developed by a company called BIOQUELL, is deadly to even the toughest bacterial spores. The method has been successfully tested by the US Environmental Protection Agency as a method of getting rid of organisms used in biological warfare!

“Although the residues left behind are completely safe, the ward does have to be vacated for about 24 hours for the process to be carried out and a physical clean performed.

“An opportunity has arisen to do this at the Alexandra hospital using a temporarily closed ward as a “decant” ward. Over a period of six weeks, three wards will be refurbished, cleaned and decontaminated using a team from BIOQUELL.”

However, Dr Stone also stressed that after the cleaning operation was completed, its long-term success depended on ongoing observation of rigorous infection-control procedures – not only by staff but also patients and visitors.

“For the maximum effectiveness long-term, all staff, patients and relatives must adhere to strict infection-control procedures, in particular hand washing,” he said.

“If this is not done the environment will ultimately be re-seeded with harmful micro-organisms and the benefit will be lost.”

For more information please contact:
Janet-Marie Clark on 01905 760551 or 07733 111361
or by email at janet.clark@worcsacute.wmids.nhs.uk

Clostridium difficile - U.S.A. hospital trial results published

Published on 22nd March 2006

Presentation of further results of a “superbug” eradication trial in a US hospital at a leading US medical conference Greater than 50% reduction in the number of patients contracting hospital acquired Clostridium difficile

BIOQUELL PLC, the UK leader in specialist bio-decontamination technology and testing/compliance services, announces further data relating to a “superbug” eradication trial in a US hospital.

“Superbug” eradication – background information

• For over nine months a BIOQUELL team has been participating in a trial of its technology at a large US teaching hospital.
• The purpose of the trial was to determine BIOQUELL’s success in reducing patient infection rates and  eliminating bacteria, including Clostridium difficile (“C.diff”), MRSA and VRE which are well known antibiotic resistant “superbugs” that are challenging healthcare providers world-wide.
• The trial was led by Dr John M. Boyce, Clinical Professor of Medicine, Yale University School of Medicine and one of the authors of the Centers for Disease Control and Prevention (CDC) 2002 ‘Guideline for Hand Hygiene in Healthcare Settings’.
• The preliminary trial results announced in December 2005 showed that BIOQUELL’s technology is highly effective at eliminating C.diff, MRSA and VRE from the hospital environment, including from sensitive electronic medical equipment.

Reduction in patient infection rates – new information

• The trial results show that after 9.5 months of a BIOQUELL “implant” team being at the hospital there has been a statistically significant 53% year-on-year reduction in the number of new, hospital acquired Clostridium difficile cases for the months when the hyper-virulent strain was present in the hospital.
• The results of the BIOQUELL trial were presented at the SHEA (The Society of Healthcare Epidemiology of America) annual conference in Chicago, 18-21 March, 2006.

Commenting on the above, Nick Adams, Chief Executive of BIOQUELL, said:

“The results from this nine month trial using BIOQUELL’s technology in a US hospital are really encouraging. A statistically significant 53% reduction in new hospital-acquired Clostridium difficile infections is impressive – particularly when the hyper-virulent strain is known to be present. C.diff continues to cause major problems for healthcare providers throughout the world and we expect that these results will create significant interest from hospitals in the US and elsewhere.”

 

Enquiries:
Nick Adams / Mark Bodeker :
BIOQUELL PLC 01264 835 900

 
Notes to editors:

Clostridium difficile (“C.diff”) has been a long standing issue for healthcare providers and a new, hyper-virulent strain is causing major problems for hospitals in the UK, parts of Europe and 16 states in the US, where significantly increased sickness and death rates are being seen.

C.diff is a spore forming bacteria. Spore formers, including for example anthrax (Bacillus anthracis), are extremely tough and able to survive for years in the environment (including the hospital environment).

The alcohol handgels used in many hospitals as a key part of infection control are less effective against spore formers. In addition, the use of bleach cleaning does not eradicate C.diff from the hospital environment.

In 1978 it was discovered that C.diff was responsible for causing disease in patients in hospitals and hence was considered to be a hospital acquired infection or “superbug”.
In 2003 a new strain of C.diff appeared which: (i) was much more virulent - with hospitals experiencing significantly higher levels of sickness and death – and (ii) was significantly more resistant to certain classes of antibiotics. This new strain of C.diff, commonly referred to as BI/NAP1 or the 027 strain, was first identified in Canada and over the last two years appears to have spread to healthcare facilities down the East coast of the US. It has also been detected in the UK including, for example, at Stoke Mandeville Hospital earlier this year.

Data on the Health Protection Agency website suggests that 43,682 patients in NHS hospitals were found to have C.diff in 2004.

“Toxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe”, M. Warny et al., The Lancet, 24 September 2005, Vol 366; 1079–1084

“Severe Clostridium difficile – associated disease in populations previously at low risk – four states, 2005”. CDC, MMWR, 2 December 2005, 54(47); 1201-1205

“The New Clostridium difficile – What does it mean?”, J.G. Bartlett and T.M. Perl, New England Journal of Medicine, 8 December 2005, 352;23; 2503-2505  

SCIENTIFIC LITERATURE REVIEW - FEB 2006

Published on 6th March 2006

LITERATURE REVIEW 

February 2006

1. MRSA environmental contamination and patient infection – the “missing link”

It has been strongly suspected for many years that MRSA environmental contamination is clinically significant and provides a reservoir for indirect transmission of MRSA between patients (Dancer 1999;Hota 2004). However, conclusive evidence has been lacking. A seminal paper published this month provides conclusive evidence based on molecular typing that MRSA environmental contamination is responsible for patient acquisition of MRSA (Hardy et al. 2006). This study investigated MRSA environmental contamination of an Intensive Care Unit (ICU) and found widespread, persistent contamination. There was strong evidence that at least 3 of the 26 MRSA acquisitions on the unit during the study period were directly from the contaminated environment. This was deduced by the fact that the strain infecting the patient was cultured from the environment prior to the admission of the patient and no other patient on the ICU was infected or colonised with the same strain prior to the patient acquisition. A further 11 of the 26 patients acquired MRSA that was distinct from the strains infecting or colonising other patients, so could have acquired the MRSA from an environmental source. Furthermore, the remaining 12 patients that acquired MRSA on the ICU during the study period could have acquired MRSA from another patient indirectly via a contaminated environment surface. BIOQUELL’s HPV technology can eradicate MRSA from the hospital environment (French et al. 2004;Jeanes et al. 2005) and it seems likely that more effective environmental decontamination will help to reduce the rate of cross-transmission of MRSA based on the results presented in this paper.

2. High levels of MRSA environmental contamination reported from Dublin, Ireland

High levels of MRSA environmental contamination were reported this month from Dublin, Ireland (Sexton et al. 2006). Twenty-five MRSA isolation rooms were prospectively evaluated for MRSA contamination over a four week period. MRSA was cultured from 269/502 (53.6%) surface samples, 70/250 (28%) air samples and 102/251 (40.6%) settle plates. On the fourth week of sampling, the levels of contamination were particularly high with 34/42 (81%) surfaces contaminated. These high levels are similar to those reported by French and colleagues, who reported 74% of 359 sites positive for MRSA in 23 MRSA pt areas (French et al. 2004). The high levels of air contamination suggest that airborne spread of MRSA could be an underestimated route of transmission.

3. Further evidence of zoonotic MRSA!

Beware your cat or dog with an infection – it could just be MRSA and it may be transmitted to you! One study from Canada reported a likely “two-way street” between MRSA infections in domestic pets and humans (Weese et al. 2006). Another study found indistinguishable MRSA causing infections in animals and colonisation in a human (Leonard et al. 2006).

4. Chlorhexidine impregnated cloths for the “source control” of VRE

“Source control” is the reduction of the bio-burden of a micro-organism colonising the skin to reduce the risk of environmental contamination and contamination of Healthcare Workers (HCW) hands. A study published this month showed that chlorhexidine impregnated cloths provide an effective alternative to soap and water for reducing environmental contamination, HCW hand contamination and ultimately patient acquisition of VRE (Vernon et al. 2006). This has infection control implications for other skin colonisers such as MRSA. 

5. And finally…MRSA colonization? Drink some green tea!

A study from Japan has demonstrated that treatment with green tea extract (tea catechin) significantly reduces the level of MRSA colonisation in sputum (Yamada et al. 2006)!

CLICK HERE FOR FULL CONTENT AND REFERENCES

January 2006

 

1. How do we control Clostridium difficile in the NHS?

The recent Healthcare Commission Report and the HPA accused one third of NHS Trusts of not adhering to government guidance for the control of C. difficile:

www.hpa.org.uk/infections/topics_az/clostridium_difficile/InterimReport05.pdf 

The effective control of C. difficile has recently taken on a new importance with the emergence of the epidemic 027 strain of C. difficile (Bartlett and Perl 2005). An editorial published this month in the BMJ in response to the Healthcare Commission Report highlights the need for up-to-date guidelines in a single document for NHS Trusts to follow in order to develop effective and appropriate local control policies (Green 2006). This is a difficult task because the transmission of the new strain of C. difficile is not well understood and expert opinion as to the optimal control strategy is divided. However, the 1994 guidelines are now 14 years old and in urgent need of an update (Green 2006).

2. MRSA enteritis in Japan

Gastroenteritis caused by enterotoxigenic MRSA was prevalent in a Japanese hospital in the early 1990s but has gradually became less prevalent in the late 1990s. A Japanese study published this month investigated the molecular epidemiology of enteritis-causing MRSA in a Japanese hospital (Okii et al. 2006). Staphylococcal enterotoxin (SE) production was significantly different in the enteritis-associated isolates from the early 1990s compared to the non-enteritis isolates from the late 1990s, even amongst strains that were indistinguishable or closely related by PFGE. The expression of SEA and high levels of Toxic Shock Syndrome Protein (TSST-1) was common in most enteritis-associated isolates but rare in non-enteritis isolates. This difference could be explained by regulation of the accessory gene regulator (agr) region of the genome, which affects the production of several proteins including SE in response to environmental factors. 

3. USA 300 CA-MRSA establishes itself in the US community setting

One particular clone of Community-Acquired MRSA (CA-MRSA) is establishing itself in certain communities in the USA. This clone is termed ‘USA 300’ based on its PFGE genotype profile. A report published this month has reported an increasing number of hospital-acquired infections caused by the USA 300 clone, which almost certainly originated in the community (Kourbatova et al. 2005). This so-called “reverse penetration” of CA-MRSA into the hospitals is likely to continue. Although CA-MRSA tends to be non-multi-resistant and hence readily treatable with antimicrobials, multi-resistant CA-MRSA has already emerged in certain parts of the world (Boyle-Vavra et al. 2005). CA-MRSA, including the USA 300 clone, often have virulence factors such as the Panton-Valentine Leukocidin (PVL) meaning that CA-MRSA infection can be severe and invasive in previously healthy individuals. We need to watch for signs of CA-MRSA in the UK.

4. And finally…contamination of stethoscopes and mobile phones!

A number of studies published this month in the Journal of Hospital Infection have identified contamination of stethoscopes and mobile phones in hospitals. Approximately 16-20% of stethoscopes are contaminated with Staphylococcus aureus, with MRSA making up approximately 20% of the cases (Hill et al. 2006). A simple strategy of education and provision of alcohol-based wipes in the ward offices and on notes trolleys almost eradicated contamination of stethoscopes over a three month period. A study from Northern Ireland entitled “Is your phone bugged?” investigated contamination of mobile phones amongst healthcare workers (HCW) (Brady et al. 2006). The vast majority of mobile phones were contaminated with bacteria and MRSA was isolated from 6% of 105 phones tested. These finding could have important infection control implications because mobile phones and stethoscopes could be reservoirs for indirect transmission of MRSA and other nosocomial pathogens.

CLICK HERE FOR FULL CONTENT AND REFERENCES

December 2005

1. HPV helps to stop an epidemic of Serratia marcescens in a NICU

The Royal Hallamshire Hospital in Sheffield had a persistent S. marcescens outbreak in their NICU. After several failed attempts to solve the problem using conventional means (such as a focus on hand hygiene and improved environmental hygiene), the team turned to BIOQUELL to provide Hydrogen Peroxide Vapour bio-decontamination of their unit (Bates and Pearse 2005). Through a combination of improved infection control measures and the HPV process the outbreak was halted and the authors concluded: ‘Our experience is that HPV provided a safe and practical means for the eradication of environmental S. marcescens from the NICU, which may otherwise have resulted in a continuation of the outbreak. This was clinically helpful in allowing beds to be re-opened quickly, in a specialty in which the number of beds is frequently inadequate.’

2. Community-acquired MRSA – is anybody safe?

The epidemiology of MRSA has changed; MRSA is emerging rapidly as a cause of infections in previously healthy individuals without the recognised risk factors for MRSA infection. Community-acquired MRSA (CA-MRSA) has less bias towards the old and immuno-compromised. One short report this month describes a serious case of community acquired MRSA pneumonia and bacteraemia in a previously healthy young lady in a country with a low prevalence of MRSA in hospitals (Torell et al. 2005). Even paediatrics is not safe from CA-MRSA: another report this month described a worrying increase in CA-MRSA colonisation in children in Taiwan, reporting that between 28 and 74% of community-acquired S. aureus infections in Taiwanese children are caused by MRSA (Chen and Huang 2005). We need urgent research to determine the most effective ways to stop CA-MRSA becoming endemic in our community.

3. MRSA diarrhoea – an underestimated infection control risk?

Staphylococcus aureus endotoxin mediated diarrhoea is one of the recognised plethora of diseases caused by this versatile micro-organism. However, MRSA diarrhoea is often overlooked and gastrointestinal colonisation with MRSA is not often screened for. An American study published this month reported that approximately 10% of 1543 patients prospectively evaluated had MRSA in their stool. 62% of these 151 patients had no previous history of MRSA and most were not under contact precautions (Boyce et al. 2005). Stool carriage results in wide-spread environmental contamination, especially during episodes of diarrhoea, so unrecognised gastrointestinal colonisation with MRSA could have important infection control implications.

4. The epidemic strain of C. difficile marches on!

A trio of papers were published this month in the New England Journal of Medicine following hot on the heels of a Lancet article in September regarding the epidemic strain of Clostridium difficile that is rapidly making the transition from epidemic to pandemic! The strain is designated 027 based on its ribotype, North-American Pulsotype (NAP) 1 based on its PFGE profile and Restriction Enzyme Analysis (REA) group BI. It seems that the strain is most often referred to as Type 027 in the UK and NAP1/BI in the USA at present.

John Bartlett, who originally described the association between C. difficile and C. difficile-associated diarrhoea in the 1970s, wrote an editorial describing the emergence of the new strain of C. difficile first in Canada, and now in the USA and Europe (Bartlett and Perl 2005). Significant advances have been made in the molecular characterisation of the new strain and in our understanding of why the epidemiology of CDAD has changed in recent years. NAP 1/027 has a missing down-regulator for toxin production (tcdD), resulting in a hyper-toxic strain plus the binary toxin of unknown function (Warny et al. 2005). However, this alone does not explain its emergence; current and historic NAP1/BI C. difficile strains have the binary toxin and missing down-regulator (McDonald et al. 2005). The key difference between the historic and current NAP1/BI is increased fluoroquinolone resistance in current strains, which would facilitate CDAD following exposure to a broader range of antibiotics, and exposure to fluoroquinolones was found to be a risk factor for CDAD with the new strain (Loo et al. 2005). Many questions regarding the new strain of C. difficile remain answered; principally, why does it cause such severe disease and why does it appear more virulent it closely related ancestors? I am certain we will be reading more about 027/NAP1/BI C. difficile in the near future!

5. And finally, zoonotic MRSA…from horses!

A paper published this month described an outbreak of MRSA in veterinary workers originating from horses (Weese et al. 2005). This follows on from a study in which MRSA was recovered from 10% of 260 sites sampled in a veterinary teaching hospital (Weese et al. 2004). There is increasing interest in the link between MRSA infection and colonisation in animals and humans, so there is likely to be more research published in this area over the coming months. 

EUROPEAN DISTRIBUTORS SOUGHT

Published on 3rd March 2006

The increasing success of BIOQUELL’s unique Hydrogen Peroxide Vapour technology means that business partnerships are now sought throughout Europe.

Bioquell require distributors / agents in a number of European countries in order to further expand our Clarus^® Hydrogen Peroxide Vapour bio decontamination activities into key lifescience sectors. These include; pharmaceutical, biotechnology, bio manufacturing, biologics, biotech, biomedical and biopharmaceuticals.

Please note that this development only concerns our Clarus^® HPV distribution. We remain fully committed to existing distribution agreements for Microflow Biological Safety Cabinets and Astec Fume cabinets.

Interested parties with established business within these markets should, in the first instance, contact Bioquell. Please provide details of current operations and a link to your web site.

BIOQUELL in THE TIMES - December 05

Published on 22nd December 2005

Dalek exterminates ward bugs



Machine that kills hospital infections is being ignored by the NHS, reports Nigel Hawkes.

The National Health Service has ignored a British technique for eliminating dangerous infections such as MRSA and Clostridium difficile from hospital wards.

A six month trial – conducted in the US with the co-operation of the Atlanta based Centres for Disease Control – has just finished and has provided solid evidence that bugs can be killed using a technique developed by Bioquell, of Andover, Hampshire.

The method was successful at Stoke Mandeville Hospital in Buckinghamshire after it suffered 300 cases of C. difficile infection and a dozen deaths. “We have been trying to set up a trial for the last year in the UK and got nowhere,” said Nick Adams, Bioquell’s Chief Executive, yesterday. “In the US it took three months to launch the trial and the results were so good we were asked to stay on.”

The problem in the NHS is serious. On Tuesday a report by the Healthcare Commission criticised hospitals for neglecting C. difficile infections, which kill 1,000 people a year in Britain, the same as MRSA. The US results were presented this week at a conference [ICAAC] in Washington by John Boyce, the head of the infectious disease section of the Hospital of Saint Raphael in New Haven, Connecticut. Dr Boyce is a specialist in hospital infections and was one of two who were flown to London by the Department of Health for its MRSA “experts” summit in January.

Bioquell’s technique is to empty wards of patients, seal doors and windows and install Dalek-like machines that pump out hydrogen peroxide, a powerful oxidising agent. When the mist passes the dew point, a near-invisible film is deposited on all surfaces. It kills bacteria without damaging materials. The agent degrades into water and oxygen, so requires no cleaning up. In a few hours the ward is clean and ready for patients to move back in.

The results presented by Dr Boyce were striking. Before treatment, swabs or sponges were used to monitor levels of infection. Of 210 tests in four wards, 51 proved positive for either MRSA, C. difficile, or VRE (vancomycin-resistant enterococci). After treatment, 190 tests were done but none showed any trace of the three bacteria. The effect on patients was encouraging. Among those who had been in the hospital for more than three days, and who were admitted from home rather than from a nursing home or another hospital, C. difficile infections were cut by 18 per cent.

Successful one off trials have been held at St Thomas’ Hospital in Central London, University Hospital Lewisham, in Southeast London, the Royal Hallamshire Hospital in Sheffield, the Royal Free in Hampstead, North London, and Kingston General Hospital in southwest London, in addition to Stoke Mandeville.

But, says Mr Adams, to achieve a long-lasting effect, Bioquell needs to install its own team in a hospital, maintaining biological cleanliness over a long period. This would cost each hospital about £100,000 a year. Going to clean up a single ward or group of wards, as at Stoke Mandeville, costs about £9,000 per ward. But the health costs of hospital acquired infections are estimated at £1 billion a year.

Mr Adams blamed outdated medical education for a reluctance to expand the trail. He said that most British Doctors were taught that bacteria did not survive for more than a few hours on surfaces, so they did not believe that sterilising surfaces had any real value.

In fact MRSA had been shown to survive for months, and VRE and C. difficile for several weeks.

Click here for the Times Online 

Clostridium difficile - U.S.A. preliminary results from trials

Published on 21st December 2005

BIOQUELL PLC, the UK leader in specialist bio-decontamination technology and testing services, announces a successful “superbug” eradication trial and an update on the clinical trials of its new wound healing technology.

“Superbug” eradication

• For the last six months a BIOQUELL team has been participating in a trial of its technology at a large US teaching hospital.
• The purpose of the trial was to determine BIOQUELL’s success in eliminating bacteria, including Clostridium difficile (“C.diff”), MRSA and VRE which are well known antibiotic resistant “superbugs” that are challenging healthcare providers world-wide.
• C.diff has been a long standing issue for healthcare providers and a new, virulent strain is causing major problems for hospitals in the UK, parts of Europe and 16 states in the US, where significantly increased sickness and death rates are being seen.
• The trial was led by Dr John M. Boyce, Clinical Professor of Medicine, Yale University School of Medicine, and Chief, Infectious Diseases Section at the Hospital of Saint Raphael, and one of the authors of the Centers for Disease Control and Prevention (CDC) 2002 ‘Guideline for Hand Hygiene in Healthcare Settings’.
• The trial results show that BIOQUELL’s technology is highly efficacious at eliminating C.diff, MRSA and VRE from the hospital environment, including from sensitive electronic medical equipment.
• The preliminary data suggest that the BIOQUELL technology may contribute to a reduction in the number of patients’ exposed and becoming ill from C.diff. BIOQUELL’s technology continues to be used in the hospital to study further its impact on the frequency of C diff.
• Further data on C.diff patient infection rates will be presented next year.
• The results of the BIOQUELL trial were presented at the prestigious ICAAC (Interscience Conference for Antimicrobial Agents and Chemotherapy, 16 – 19 December, 2005) conference in Washington.

Commenting, Nick Adams, Chief Executive of BIOQUELL, said:

“We are delighted that the results of the six month BIOQUELL trial in a US hospital have shown such encouraging results. The new strain of Clostridium difficile [027/NAP1] is creating major problems for healthcare providers around the world - and we expect that the results presented at the ICAAC conference will create significant interest from hospitals in the US and elsewhere."

Health Protection Agency announcement 21st December urges the NHS to step up measures to minimise risk of patients contracting Clostridium difficile. For full details click here

Click here for more about C.diff on the BBC.

Update on wound healing clinical trials

BIOQUELL continues to achieve good results from its new and novel wound healing technology which is currently undergoing clinical trials in the UK. It is anticipated that the academic experts involved in these trials will present data next year at medical conferences which will demonstrate that BIOQUELL’s technology reduces significantly the time taken to heal certain wounds. The identification of suitable partners to market this product overseas has started.

Commenting, Nick Adams, Chief Executive of BIOQUELL, said:

"We are also pleased that our wound healing technology continues to demonstrate good results from the ongoing clinical trials and we are increasingly confident that this technology has substantial commercial potential.” 

SEVERE CLOSTRIDIUM DIFFICILE - CDC

Published on 2nd December 2005

Severe Clostridium difficile--Associated Disease in Populations Previously at Low Risk --- Four States, 2005

From CDC report. Click here for full version on CDC.gov

Clostridium difficile is a spore-forming, gram-positive bacillus that produces exotoxins that are pathogenic to humans. C. difficile--associated disease (CDAD) ranges in severity from mild diarrhea to fulminant colitis and death. Antimicrobial use is the primary risk factor for development of CDAD because it disrupts normal bowel flora and promotes C. difficile overgrowth. C. difficile typically has affected older or severely ill patients who are hospital inpatients or residents of long-term--care facilities. Recently, however, both the frequency and severity of health-care--associated CDAD has increased; from 2000 to 2001, the rate of U.S. hospital discharge diagnoses of CDAD increased by 26% (1). One possible explanation for these increases is the emergence of a previously uncommon strain of C. difficile responsible for severe hospital outbreaks (2). Although individual cases of CDAD are not nationally reportable, in 2005, the Pennsylvania Department of Health (PADOH) and CDC received several case reports of serious CDAD in otherwise healthy patients with minimal or no exposure to a health-care setting. An investigation was initiated by the Philadelphia Department of Public Health (PDPH), PADOH, and CDC to determine the scope of the problem and explore a possible change in CDAD epidemiology. This report summarizes the results of the investigation in Pennsylvania and three other states, which indicated the presence of severe CDAD in healthy persons living in the community and peripartum women, two populations previously thought to be at low risk. The findings underscore the importance of judicious antimicrobial use, the need for community clinicians to maintain a higher index of suspicion for CDAD, and the need for surveillance to better understand the changing epidemiology of CDAD.

Case Reports

Case 1. A woman aged 31 years who was 14 weeks pregnant with twins went to a local emergency department (ED) after 3 weeks of intermittent diarrhea, followed by 3 days of cramping and watery, black stools 4--5 times daily. Stools specimens tested positive for C. difficile toxin, and the patient was admitted. Her only antimicrobial exposure during the preceding year was trimethoprim-sulfamethoxazole (for a urinary tract infection) approximately 3 months before admission. She was treated with metronidazole and discharged but was readmitted the next day for 18 days with severe colitis, receiving metronidazole, cholestyramine, and oral vancomycin. She improved on vancomycin and was allowed to return home. However, 4 days later she was readmitted with diarrhea and hypotension. She spontaneously aborted her fetuses. Despite aggressive treatment including a subtotal colectomy, intubation, and inotropic medication, the patient died on the third hospital day. Histopathologic examination of the colon demonstrated megacolon with evidence of pseudomembranous colitis.

Case 2. A girl aged 10 years (unrelated and without contact with case 1) went to a children's hospital ED because of intractable diarrhea, projectile vomiting, and abdominal pain. She had not taken antimicrobials during the preceding year. Stool specimens were positive for C. difficile toxin. The child had been healthy until 2 weeks before the ED visit, when she became symptomatic within days of her younger brother having a febrile diarrheal illness. The boy was not on anti-microbials when he became ill. His symptoms resolved within 2--3 days without medical treatment, but his sister had fever as high as 102°F (39°C), abdominal pain, and diarrhea. One week into her illness, she was examined by a clinician, who performed a rapid streptococcal antigen test on a swab from her oropharynx; the result was positive. The patient was prescribed amoxicillin but was unable to take it because of her stomach cramps and diarrhea; her symptoms worsened until she was having liquid stools up to 14 times daily. Symptoms resolved with hospital admission and the administration of intravenous fluids, electrolytes, and metronidazole.

Epidemiologic and Laboratory Investigations

In May and June 2005, a request for voluntary reports of peripartum CDAD (i.e., 4 weeks before and after delivery) was initiated by PDPH; case definitions for peripartum CDAD were developed and distributed nationally through the Epidemic Information Exchange (Epi-X) and locally through the PDPH Health Alert Network (HAN). The New Jersey Department of Health and Senior Services also distributed the alert statewide through its HAN system. A separate request for reporting of community-associated CDAD (CA-CDAD) along with a case definition was developed and distributed in June in Philadelphia and four surrounding Pennsylvania counties (Bucks, Chester, Delaware, and Montgomery) through local and statewide HANs.

Detailed, open-ended interviews were conducted with patients who were reported by hospital personnel to state and local health departments after distribution of the notices. Medical details, such as type of antimicrobial agent and duration, were confirmed with treating clinicians whenever possible. To determine the minimum population rate and rate per anti-microbial prescription of CA-CDAD, the number of cases reported from Philadelphia and four surrounding counties were divided by 2004 U.S. census population estimates for these five areas. The number of antimicrobial prescriptions were calculated on the basis of census estimates of the population surveyed, multiplied by national prescribing rate estimates (3). Available toxin-positive stool samples were cultured for C. difficile using standard methods. Isolates underwent pulsed-field gel electrophoresis (PFGE), toxinotyping, and detection of binary toxin and deletions in tcdC, a putative negative regulator of toxin production (2,4).

Ten peripartum and 23 CA-CDAD cases were reported from four states during May--June 2005, with onset dates ranging from February 26, 2003, to June 28, 2005. All but one of the cases occurred during 2004--2005. Age of nonperipartum cases ranged from 6 months to 72 years (mean: 26 years; median: 23 years). Peripartum cases occurred in patients from New Hampshire, New Jersey, Ohio, and Pennsylvania; because CA-CDAD surveillance was conducted only in the greater Philadelphia area, these cases were only from this area. Transmission to close contacts was evident for four cases: two were in children of CDAD patients with peripartum exposures, one was in an adult caring for a hospitalized parent with confirmed CDAD, and one was in an adult who visited a parent with confirmed CDAD in a nursing home. One peripartum mother who transmitted C. difficile to her child also transmitted CDAD to a family friend.

Eight (24%) of 33 patients reported no exposure to anti-microbial agents within 3 months before CDAD onset. Five of these were children, three of whom required hospitalization. Three of the eight cases without exposure to antimicrobial agents occurred in patients who had close contact with a person with diarrheal illness; two of these persons had confirmed CDAD. An additional three (9%) of 33 patients contracted CDAD after receiving <3 doses of antimicrobials; two received only 1 dose of clindamycin for group B streptococcus prophylaxis before CDAD onset. Clindamycin was the most common antimicrobial exposure noted; overall, 10 (30%) of 33 cases were in patients who reported exposure to the drug before disease onset; these 10 patients included the two who had <3 doses of antimicrobials. Fifteen (46%) patients required hospitalization or an ED visit. Thirteen (39%) patients had a relapse of disease and required antimicrobials.

The estimated minimum annual incidence of CA-CDAD in Philadelphia and its surrounding four counties during July 2004--June 2005 was 7.6 cases per 100,000 population, with one case of CDAD for every 5,549 outpatient antimicrobial prescriptions; this figure is based on national estimates of antimicrobial prescribing in ambulatory settings applied to the Philadelphia area. Two patient isolates were available for characterization and were compared with the recently described "epidemic strain" that has been detected as the cause of either severe hospital outbreaks or hospital-endemic cases of CDAD in 16 states (2; CDC, unpublished data, 2005). Neither shared the same toxinotype as the epidemic strain, but both were binary toxin positive; one isolate, from an Ohio peripartum CDAD case, was >80% related by PFGE to the epidemic strain, and the other, from a Philadelphia-area CA-CDAD case, had an 18-bp deletion in tcdC.

Reported by: E Chernak, MD, CC Johnson, MD, Philadelphia Dept of Public Health; A Weltman, MD, Pennsylvania Dept of Health. LC McDonald, MD, L Wiggs, G Killgore, DrPH, A Thompson, MSSc, Div of Healthcare Quality Promotion, National Center for Infectious Diseases; M LeMaile-Williams, MD, E Tan, MBBS, FM Lewis, MD, EIS officers, CDC.

Editorial Note:

Considered in the context of recent high-morbidity, hospital-associated outbreaks in North America, Great Britain, and the Netherlands (5), these cases of severe CDAD disease in populations previously thought to be at low risk might further reflect the changing epidemiology of CDAD. Certain features of CDAD that have been uncommon in the past, such as close-contact transmission, high recurrence rate, young patient age, bloody diarrhea, and lack of antimicrobial exposure, might be changing.

C. difficile exotoxins A and B cause colonic dysfunction and cell death. The epidemic strain produces 16 times more toxin A and 23 times more toxin B compared with other common strains (5). The increased severity of epidemic CDAD might result from this level of toxin production; however, the actual role of tcdC deletions in increased toxin production has not been determined. C. difficile toxinotype 0 is the historical standard type; variant toxinotypes have previously accounted for <20% of U.S. hospital isolates (6). Although the role of this binary toxin in human disease is unknown, it was previously detected in only 6% of clinical isolates but now is found uniformly in the epidemic strain (6). The isolates recovered during this investigation were both variant toxinotypes and carried the gene for binary toxin; one also carried the same 18-bp deletion in tcdC as the epidemic strain.

Virulent strains, which cause more severe disease in populations at high risk, might also cause more frequent, severe disease in populations previously at low risk (e.g., otherwise healthy persons with little or no exposure to health-care settings or antimicrobial use). Although the minimum annual incidence cited in this report is similar to previous estimates in ambulatory populations (eight to 12 cases per 100,000 population), the CA-CDAD case definition more stringently excluded hospital-acquired CDAD (7,8). The estimated case rate per antimicrobial prescription is twice as high as the <1 case per 10,000 incidence cited in these earlier studies (7,8). Because reporting in this investigation was voluntary, the true incidence of community CDAD is probably higher. Because historic surveillance data are not available, determining whether CDAD rates in peripartum women are changing is not possible; however, the only available report suggests a low baseline incidence, with only three obstetric cases identified among 74,120 obstetrics and gynecology admissions to one North Carolina hospital during 1985--1995 (9).

The findings in this report are subject to at least two limitations. First, because the report describes a convenience sample, the results are subject to reporting and selection biases. Second, because this sample was collected in a limited geographic region, results might not be generalizable to other regions. Moreover, although a single national estimate for ambulatory prescribing rates was applied to this region, substantial variation in these rates might exist.

Further investigation into the scope of CA-CDAD acquisition and related risk factors is warranted. Nonetheless, the cases described in this report demonstrate the need for clinicians to consider the diagnosis of CDAD in patients with severe diarrhea even if the patients do not necessarily have traditional risk factors such as recent hospitalization or antimicrobial use. Patients should seek medical attention for diarrhea lasting longer than 3 days or accompanied by blood or high fever. The findings underscore the fact that antimicrobial exposure is not benign and that judicious antimicrobial use in all health-care settings should continue to be emphasized.

Acknowledgments

This report is based, in part, on contributions by the New Hampshire Dept of Health. C Tan, MD, C Booker, MD, E Bresnitz, MD, New Jersey Dept of Health and Senior Svcs. R Nieman, MD, K Klemick, Abington Memorial Hospital, Abington, Pennsylvania. R Plotinsky, MD, EIS Officer, CDC.

References

McDonald CL, Banerjee S, Jernigan DB. Increasing incidence of Clostridium difficile-associated disease in U.S. acute care hospitals, 1992--2001 [Abstract]. In: Proceedings of the 14th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America, Philadelphia, PA; April 17--20, 2004.
McDonald LC, Killgore GE, Thompson A, et al. Emergence of an epidemic, toxin gene variant strain of Clostridium difficile responsible for outbreaks in the United States between 2000 and 2004. N Engl J Med 2005 (in press).
McCaig LF, Besser RE, Hughes JM. Antimicrobial drug prescriptions in ambulatory care settings, United States, 1992--2000. Emerg Infect Dis 2003;9:432--7.
Rupnik M, Avesani V, Janc M, Eichel-Streiber C, Delmee M. A novel toxinotyping scheme and correlation of toxinotypes with serogroups of Clostridium difficile. J Clin Microbiol 1998;36:2240--7.
Warny M, Pepin J, Fang A, et al. Increased toxins A and B production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe. Lancet 2005;366:1079--84.
Geric B, Rupnik M, Gerding DN, Grabnar M, Johnson S. Distribution of Clostridium difficile variant toxinotypes and strains with binary toxin genes among clinical isolates in an American hospital. J Med Microbiol 2004;53:887--94.
Levy DG, Stergachis A, McFarland LV, et al. Antibiotics and Clostridium difficile diarrhea in the ambulatory care setting. Clin Ther 2000;22:91--102.
Hirschhorn L, Trnka Y, Onderdonk A, Lee M, Platt R. Epidemiology of community-acquired Clostridium difficile-associated diarrhea. J Infect Dis 1994;169:127--33.
James A, Katz V, Dotters D, Rogers R. Clostridium difficile infection in obstetric and gynecologic patients. South Med J 1997;90:889--92.

CHINA REGISTERS HUMAN BIRD FLU CASES

Published on 17th November 2005

China yesterday confirmed its first human cases of bird flu, adding to fears of a global pandemic. The country's Ministry of Health reported two cases in the central province of Hunan and one in eastern Anhui, after initial reports stated that the two victims in Hunan had suffered from pneumonia.

The WHO said that it had been informed by China that a nine year old boy from Hunan was suffering from the H5N1 virus, although he was recently discharged from hospital, as was his 12 year old sister who fell ill and died last month. The third case was identified only as 'a woman in the Anhui province'.

In October China reported that hundreds of chickens and ducks had died in Wantang village in Xiangtan County, near Hunan's provincial capital of Changsha, but after mass culling and disinfection this week the area has been declared free of bird flu.

The H5N1 form of bird flu has already killed more than 60 people in Asia and is endemic in poultry in parts of the region.

WHO spokesman Roy Wadia also reported that a teacher in Hunan has fallen ill with symptoms of pneumonia and is being considered a suspect bird flu case, along with a poultry worker in the northeastern province of Liaoning, where an outbreak was recently reported among domestic birds.

Rapid Review Panel acknowledge BIOQUELL technology

Published on 1st December 2004

1 December 2004
BIOQUELL PLC
MRSA and “superbugs”
Publication of the Rapid Review Panel’s recommendations
relating to BIOQUELL’s unique infection control technology

BIOQUELL PLC (“BIOQUELL”), the UK developer of unique and patent-protected bio-decontamination technology, announces that the Rapid Review Panel (“RRP”) has now published its recommendations to the Department of Health in respect of BIOQUELL’s technology. BIOQUELL’s technology was placed in the second highest category.
The RRP made the following specific comments on BIOQUELL’s technology:
“The basic research and development, validation and in use evaluations have shown potential benefits, which should be available to NHS bodies, to include hydrogen peroxide vapour into their cleaning or infection control protocols.”
BIOQUELL notes that this wording tracks closely the RRP’s highest category wording.

The RRP added:
“The product has been shown to be effective in removing MRSA from the hospital environment. BIOQUELL hydrogen peroxide vapour is also said to have sporicidal activity which may be of use in relation to Clostridium difficile. Results suggest that BIOQUELL hydrogen peroxide vapour is most effective on non-porous surfaces. BIOQUELL hydrogen peroxide vapour is only appropriate for enclosed rooms/ units that can be emptied of patients / staff and sealed for the period of decontamination. The key question is whether the ability of BIOQUELL hydrogen peroxide to kill environmental micro-organisms will translate into reduced numbers of healthcare associated infections”

Since BIOQUELL made its submission to the RRP last August, it has undertaken more than 20 trials and evaluations of its unique RBDS service in NHS clinical settings. The results of these trials are encouraging and BIOQUELL will be working with the RRP to agree the basis on which it should supply additional data to have its technology upgraded to the first category.
The RRP announced its recommendations on seven products. One, a silver coated hydrogel catheter, was placed in the first category. BIOQUELL’s technology was one of two products in the second category.

Commenting on the recommendations of the RRP, Nick Adams, Chief Executive of BIOQUELL said:
“We are delighted that BIOQUELL’s unique infection control technology has been scrutinised by the world-leading infection control experts on the Rapid Review Panel and placed in the second highest category. The Panel has noted that the technology has “shown potential benefits, which should be available to NHS bodies, to include hydrogen peroxide vapour into their cleaning or infection control protocols” – and we look forward to working with such NHS bodies.
This technology has taken more than five years to develop and test (including a joint four-year research project with St Thomas’ Hospital, the results of which were published earlier in the year in the Journal of Hospital Infection). The positive recommendations of the Rapid Review Panel should make it significantly easier for us to sell our unique technology to eradicate MRSA and other “superbugs” in hospitals in the UK and internationally.”