This study evaluated the effectiveness of hand wiping as a potential alternative to traditional handwashing protocols. It aimed to determine whether the use of handwipes could reduce bacterial hand contamination to a level comparable to that achieved using hand soap, thereby supporting water-safe care and reducing the need for a water source in hospital-based hand hygiene protocols. The removal of Escherichia coli K12 and Geobacillus stearothermophilus (GS) spores (used as a surrogate for Clostridioides difficile) from the hands of twelve study participants was assessed over two study phases. The efficacy of a reference hand soap and four handwipes was determined by measuring bacterial reduction (Log10 CFU/mL) following a standardised handwashing or wiping procedure. When used to remove E. coli K12 from the hands, all four wipes were as effective or significantly more effective than washing with the reference soap. In contrast, when used to remove GS spores, the four wipes were either as effective or significantly less effective than washing with soap and water, despite two being marketed as 'sporicidal'. The effectiveness of hand wiping differed with wipe and individual demonstrating that, even when following visual and verbal instructions, an individual's execution of a hand hygiene procedure can significantly differ between handwashing or hand wiping events and may be influenced by the method/product used. These findings suggest that handwipes may be a viable 'water-free' alternative in certain clinical contexts. However, consistent performance cannot be relied upon, and additional considerations are needed if the presence of more resilient organisms is likely.
Microplastics (MPs) in wastewater are increasingly recognised as potential vectors for pathogens and antimicrobial resistance (AMR), yet their role across treatment remains poorly understood. This study tracked viral, bacterial, and AMR associations with MPs from hospital wastewater through to coastal receiving waters, including simulated combined sewer overflow (CSO) events, using quantitative real-time PCR, and shotgun metagenomics. MP concentrations found naturally in the wastewater matrix, declined from 467 to 33 particles L⁻¹ during WWTP passage, achieving 93% removal. Norovirus (GI and GII) and bacteria colonised beads and wet wipes throughout, with wet wipes retaining higher viral and AMR loads than plastic beads, likely due to structural complexity. Sequential sampling across treatment stages showed a reduction in norovirus and bacterial loads by ∼1 log, yet pathogens remained detectable on beads and wet wipes in final effluent. NoV GI predominated, while NoV GII concentrations and the class I integron-integrase (intI1) gene varied by treatment stage and sample type. Metagenomics showed enrichment of potentially pathogenic genera (Aeromonas, Pseudomonas, Flavobacterium) in bead and wet wipe biofilms, and network analysis identified associations between Aeromonas and clinically relevant beta-lactam resistance genes (OXA, CTX). Shifts at the activated sludge stage indicated bead and wet wipe associated communities in effluent reflect treatment microbiota rather than influent sources. Environmental MP concentrations are below those required to deliver an infectious viral dose, suggesting MP-mediated transmission is unlikely under normal conditions. However, during CSO events, beads and wet wipes retained high viral loads and may act as pathogen transport vectors. These findings highlight CSO management as a priority for reducing MP-associated pathogen risks in receiving waters.
Condensate water is one of the environmental niches aboard space stations that is most prone to microbial growth. This study reports one of the first applications of a detailed characterization of the microbial composition of condensate water collected from inside the China Space Station during flight, as well as an evaluation of effective cleaning and disinfection strategies for microbial control. To maximize the recovery of microorganisms from the condensate-water environment, we developed a custom high-throughput microbial isolation and cultivation device (cChip) based on the isolation chip method (iChip) and used it for high-throughput cultivation of microorganisms from onboard areas of the China Space Station that are susceptible to microbial proliferation. In addition, to evaluate on the ground the decontamination efficacy of four disinfection methods already used in orbit (wiping with pure-water wipes, 75% alcohol wipes, quaternary ammonium salt wipes, and ultraviolet irradiation), we constructed a microbial contamination model on authentic textile flight materials using the isolated strains in proportions determined from high-throughput sequencing data. The efficacy of these four disinfection approaches against the contamination model was then assessed using contact plates, PMA-qPCR, and qPCR. In total, 14 bacterial strains and 9 fungal strains were obtained. Notably, members of the genera Oceanobacillus, Rhodococcus, and Fusarium were not recovered by conventional isolation methods and could be isolated only with the cChip, demonstrating the strong potential of the cChip for recovering previously uncultivable microorganisms. Among the tested methods, alcohol wipes showed the highest bactericidal efficacy against bacteria in the contamination model, achieving a inactivation efficiency of 99.97%, whereas ultraviolet irradiation showed the highest fungicidal efficacy against fungi, achieving a inactivation efficiency of 99.98%.
Blepharitis and meibomian gland dysfunction (MGD) commonly cause ocular surface symptoms, but comparative evidence for commonly used eyelid-cleansing strategies remains limited. We compared the 4-week efficacy of preformulated eyelid cleansing wipes, hypochlorous acid-assisted cleansing, and saline-assisted cleansing in adults with blepharitis-associated ocular surface disease. In this single-center, randomized, assessor-masked, parallel-group trial, adults aged 18-70 years were assigned to one of three cleansing interventions for 4 weeks. The primary endpoint was the baseline-adjusted Week 4 visual analog scale (VAS) score for the selected study eye in the full analysis set. Pairwise comparisons were performed only after a significant overall test, with Holm adjustment. Seventy-two participants were randomized; 64 were included in the full analysis set, and 59 had observed Week 4 VAS data. The overall between-group difference in baseline-adjusted Week 4 VAS was significant (P = 0.007). Adjusted mean Week 4 VAS values were 27.47 (95% CI, 22.18-32.76) in the wipe group, 33.16 (95% CI, 27.80-38.51) in the hypochlorous acid group, and 40.83 (95% CI, 34.93-46.72) in the saline group. The wipe group had lower Week 4 VAS than the saline group (adjusted difference, - 13.35; 95% CI, - 21.51 to - 5.20; Holm-adjusted P = 0.005). No other pairwise comparison remained significant. Between-group differences in Schirmer test result, corneal fluorescein staining, and MGD expressibility were interpreted as supportive secondary findings. In this single-center, assessor-masked randomized trial, preformulated eyelid cleansing wipes were associated with a lower baseline-adjusted Week 4 VAS symptom score than saline-assisted mechanical lid cleansing. Confirmatory superiority over hypochlorous acid was not established, and sign-based secondary findings should be interpreted as supportive.
To evaluate the effectiveness of a twice-daily application of a wipe impregnated with emollient and barrier ingredients in reducing incidence of pressure injury (PI) in aged care consumers. A single-blinded, multicentre randomised controlled trial. Randomisation was stratified by facility, using simple 1:1 randomisation within each stratum. 20 residential aged care facilities in Rural and Metropolitan New South Wales and the Australian Capital Territory, Australia. 858 aged care consumers aged ≥65 years at risk of developing a PI. Participants were randomised 1:1 to receive either standard hygiene practices, repositioning and use of pressure redistribution surfaces (standard care) or twice-daily applications of a pre-packaged wipe impregnated with emollient and barrier ingredients (Contiplan) to the sacrum, buttocks and heels in addition to standard care for the study duration. The primary outcome was the incidence of PIs per 1000 consumer days. Treatment effects were estimated using an intention-to-treat approach, with the absolute difference and 95% CI estimated using the Wald method. The relative difference in the incidence of PIs was estimated using a negative binomial regression model (with log link). 858 participants were included in the study. There was a 50% relative reduction in the incidence of PI in the intervention compared with the control (95% CI 0.31 to 0.81, p=0.005), with an absolute rate difference of 0.31 fewer PIs per 1000 consumer days (95% CI 0.11 to 0.51). The use of wipes with emollient and barrier properties significantly reduced the incidence of PIs and prolonged the time to first PI, demonstrating efficacy as a PI preventive strategy in aged care. Australian and New Zealand Clinical Trials Registry, ACTRN12622001360707.
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Cross-contamination from contaminated wiping cloths is an underrecognized route of pathogen transmission in healthcare settings. Reused, misapplied, or ineffective disinfectants can transfer viable bacteria between surfaces. Staphylococcus aureus and Pseudomonas aeruginosa persist under hospital conditions and are frequently isolated in healthcare environments. While many studies assess bacterial inactivation, few examine how chemistry and wipe material influence transfer when bacterial inactivation is incomplete. Hydrogen peroxide (HP), a quaternary ammonium compound (QAC), and an ethoxylated alcohol (EA) cleaner were tested with cotton, microfiber, and meltblown polypropylene wipes. Wipes inoculated with ∼ 7 log10 CFU of S. aureus or P. aeruginosa were used on 1 ft2 Formica. Bacterial transfer to surfaces and gloves was quantified between the chemistry and material combinations using single- and multi-layer setups. HP-based wipes demonstrated the highest bactericidal efficacy, transferring little to no viable bacteria. Polypropylene wipes consistently transferred fewer bacteria than cotton or microfiber wipes. Wipes with QAC or EA, particularly those made of cotton, transferred significantly more bacteria to surfaces and gloves. Adding layers of wipe material reduced bacterial transfer, especially for microfiber. Chemistry and wipe material both significantly impact bacterial transfer during cleaning. HP with polypropylene wipes offered the most effective reduction in cross-contamination. Cotton and microfiber wipes paired with QAC or EA exhibited higher transfer risks, likely due to electrostatic interactions contributing to reduced antimicrobial activity. These findings emphasize the need for optimized wipe-chemistry combinations to ensure effective surface decontamination.
While skin cleansing with octenidine has shown promise in preventing health care infections, its effectiveness for preventing late-onset sepsis in neonates is unproven. To compare the incidence rates of late-onset sepsis (LOS) in neonates admitted to the neonatal intensive care unit (NICU) who were cleansed daily with octenidine wipes vs those cleansed with sterile water. This single-center, open-label, parallel-group randomized clinical trial was conducted in the level II and level III NICUs of a tertiary care hospital in India between September 1, 2023, and August 31, 2025. All neonates admitted to the NICU within 48 hours of birth without early-onset sepsis or preexisting skin lesions and not discharged from the NICU before 72 hours were included. Neonates were assessed and randomly assigned to receive once-daily full-body cleansing with either 0.1% octenidine dihydrochloride antimicrobial wipes or sterile water applied with sterile gauze until discharge, transfer to another facility, or death. Separate wipes or gauze were used for the upper and lower body, with genital cleansing performed last. No rinsing was performed after application to allow residual antimicrobial activity. Skin condition was assessed daily using the Neonatal Skin Condition Score. The primary outcome was LOS rates (occurring >72 hours after birth through 28 days of life) among neonates cleansed with octenidine wipes vs with sterile water until discharge or transfer to the maternal bedside, assessed using relative risk (RR). Time to LOS was compared using the hazard ratio (HR). All cases were independently adjudicated by 2 blinded neonatologists. Secondary outcomes included LOS at 7 and 14 days, all-cause mortality, length of NICU stay, and adverse skin reactions. Of 530 neonates eligible for intention-to-treat analysis (299 males [56.4%]; median gestational age, 35.0 weeks [IQR, 32.0-37.0 weeks]), LOS occurred in 39 of 266 (14.7%) in the octenidine group and 34 of 264 (12.9%) in the sterile water group (RR, 1.10; 95% CI, 0.75-1.70; P = .60). Time to LOS was similar between groups (HR, 1.11; 95% CI, 0.71-1.78; P = .63). Secondary outcomes for the octenidine vs sterile water interventions were similar, including LOS by 7 days (24 neonates [9.0%] vs 23 [8.7%]) and 14 days (15 [5.6%] vs 11 [4.2%]), all-cause mortality (12 [4.5%] vs 5 [1.9%]), and length of NICU stay in days (median, 11.0 [IQR, 6.0-21.0] vs 10.0 [IQR, 6.0-19.0]). Adverse skin reactions occurred in 15 neonates (5.6%) in the octenidine group and 16 (6.1%) in the sterile water group (RR, 1.10; 95% CI, 0.55-2.10). In this randomized clinical trial, daily skin cleansing with octenidine wipes showed no evidence of reducing the incidence of LOS in NICU neonates compared with sterile water, suggesting that infection prevention strategies should focus on multimodal interventions rather than relying solely on skin cleansing. CTRI Identifier: CTRI/2023/08/056562.
Wearable wristband passive samplers are a tool for evaluating personal exposures to chemical mixtures such as semivolatile organic compounds. However, these samplers are ineffective for particulate-bound chemicals such as metals because they do not accumulate enough particles for analysis. Here, we sought to broaden the sampling to include metals by incorporating polyurethane foam (PUF) into a wearable wristband. We asked study participants (n = 82), recruited in two cohorts, to wear the wristband for five consecutive days. We also collected floor dust wipes, vacuumed dust, soil, and water from participants' homes and collected whole blood for analysis. Metal contents (Pb, Cu, Mn, and Fe) in the PUF positively correlated with respective metal levels in dust wipes (e.g., Spearman rho = 0.54, p < 0.0001 for Pb). Pb levels in PUF wristbands and floor wipes were not strongly predictive of blood Pb levels, suggesting that participants experienced multiple routes of exposure (e.g., dust, water, diet) that were not fully captured by the PUF wristband. The levels of Pb and Cu, normalized to Fe, were lower in soil compared to the other environmental samples, indicating that particles on the PUF were similar to those in indoor dust rather than outdoor sources. Overall, these results suggest that the addition of PUF to the wristband provides a surface for particle deposition, enabling personalized assessments of ambient metal exposures with increased sensitivity relative to dust wipes.
Mixed urinary incontinence, involving concurrent or diagnostically unclear components of urge- and stress-related dysfunction, remains poorly addressed by current therapeutic strategies. State-of-the-art electrostimulation relies primarily on sacral neuromodulation for urge-predominant symptoms, requiring bulky (~3 cm³) and costly (>$10,000) implants, while stress incontinence is largely managed by mechanical or surgical interventions that do not restore sphincter neuromuscular function. Here, we propose wireless-powered implanted programmable electrostimulation of sphincters (WIPES) that bypasses long nerve loops and provides on-site stimulation at the urethral sphincter. The adhesive-patch-like soft implant integrates wireless power receiving and tunable pulse generation, enabling long-term controlled stimulation with reduced size (<0.3 cm³) and weight (<0.9 g). In rats with experimentally induced urge or stress incontinence (in separate rat models of urge and stress incontinence established under the same experimental conditions), WIPES delivered free-moving stimulation and achieved average alleviation rates of 90.62% (UUI) and 97.92% (SUI) in voiding frequency and volume. WIPES was associated with peri-urethral neuromuscular remodeling and improved bladder-urethral functional outcomes, supporting its potential role in coordinated continence control.
In an online survey of >1000 ophthalmologists, most reported using alcohol wipes or swabs to clean tonometry tips (73%) and diagnostic (63%) or laser (50%) contact lenses. Use of disposable devices or high-level disinfection (HLD) was uncommon and driven largely by facility policies or regulatory requirements. Only 19% of those using HLD did so because they believed it to be safer. Ocular surface toxicity and device damage were commonly seen with HLD. Reports of infection transmission were exceedingly rare, with 99% indicating they had never encountered a case. More than 75% of respondents were strongly opposed, while only 3% strongly supported requiring HLD for tonometry tips and diagnostic or laser lenses. In the absence of evidence that common cleaning methods - such as alcohol wipes or soap and water - pose significant infection risk, the use of HLD for these routine devices should be left to the discretion of ophthalmologists.
Several residential buildings in Denmark were highly contaminated with polychlorinated biphenyls (PCBs), exceeding indoor air guidance values, and were set for demolition. We conducted a comprehensive evaluation of occupational exposure to PCBs during the demolition process using personal and stationary air sampling, hand and surface wipes, t-shirts, and glove wipes, and compared them to previously analyzed silicone wristbands and the original PCB sealant source. We further evaluated the utility of hygiene measures like handwashing for reducing exposure. Samples were analyzed for all 209 PCBs via microwave-assisted extraction and gas chromatography-tandem mass spectrometry (GC-MS/MS), and > 140 PCB features (individual congeners and co-elutions) were detected in at least one sample. Overall, tetra-CBs were the dominant homolog group across all samples, but the most abundant individual congeners depended on the sample matrix, with lower chlorinated PCBs being more prominent in air compared to wipes and wristbands. Levels of personal exposures were highly task-specific, with workers who cut the PCB-containing sealants having the highest exposure across sample types. Handwashing was shown to reduce PCB levels on workers' hands, while PCBs were also observed to permeate typical textile work gloves and worn t-shirts showed varying degrees of contamination. Across all sample types, total congener analysis demonstrated that traditional indicator-based calculations underestimated total PCB content by 25% or more. Overall, our results indicated that personal protective equipment and simple hygiene can reduce exposure, and demolition workers have high potential for PCB exposure when handling contaminated materials, necessitating careful exposure mitigation and task-specific controls.
To evaluate the effect of daily eyelid wipes on ocular-surface health and comfort during the early adaptation period of orthokeratology (Ortho-K) wear in children. This single-masked, randomized clinical study was conducted at a tertiary eye hospital from July to October 2025. Fifty-eight myopic children (aged 8-12 years) initiating Ortho-K were randomly assigned to an eyelid-wipe group or a control group. The examiner was masked to group allocation. Baseline and 1-month measurements included noninvasive tear breakup time, lipid-layer thickness, tear meniscus height, meibomian gland expressibility, corneal fluorescein staining, matrix metalloproteinase-9 levels, and Ocular Surface Disease Index. After 1 month, noninvasive tear breakup time and lipid-layer thickness showed no significant between-group differences in change ( P =0.12 and P =0.07, respectively). Meibomian gland expressibility improved more in the eyelid-wipe group (2.5±0.9-1.9±0.8) than in controls (2.4±0.8-2.3±0.9), with a significant between-group difference in change ( P =0.002). Corneal fluorescein staining at the 1-month visit was lower in the eyelid-wipe group than in controls (0.9±0.8 vs. 1.3±0.9, P =0.03). Ocular Surface Disease Index scores showed a greater reduction in the eyelid-wipe group than in controls ( P =0.02). Tear meniscus height and matrix metalloproteinase-9 levels did not differ significantly between groups. All participants continued wipe use, and no adverse events were reported. Daily sterile eyelid wipes safely improved meibomian gland function and comfort without inducing inflammation, suggesting a simple adjunctive approach to enhance early ocular-surface adaptation in pediatric Ortho-K wearers.
In humans, microorganisms within hair follicles differ from those on the skin surface and may contribute to autoimmune skin diseases such as alopecia areata and vitiligo. Owing to the low biomass of hair follicle microorganisms, precise sample acquisition and strategies to avoid contamination with genetic material are critical. To address this, we developed and evaluated a sampling methodology using a nonhuman wildlife proxy model - the wild roe deer (Capreolus capreolus) - to identify effective approaches for minimizing skin contamination prior to biopsy. Animal was obtained during licenced hunts and frozen at -20°C shortly postmortem. Four sets of biopsy and skin surface swab samples were collected from the right front leg: 1) untreated skin; 2) skin cleaned with isopropyl alcohol (IPA) wipes; 3) skin treated with cyanoacrylate glue (CAG); and 4) skin treated with CAG followed by IPA wipes. Swabs were collected via Copan FLOQSwabs, whereas biopsies were obtained with single-use 1 mm biopsy punches. Nucleic acids were subjected to droplet digital PCR (ddPCR) for 16S rRNA and 18S rRNA gene copy number quantification. Additionally, the swab samples were subjected to 16S rRNA V3-4 region and ITS-1 sequencing. ddPCR analysis revealed greater bacterial presence on the skin surface (11,661±5,181 copies/±L) than fungal presence (87±35 copies/μL), and the microbial load was greater in the swab samples (16S: 11,661±5,181; 18S: 87±35 copies/μL) than in the biopsy samples (16S: 76±56; 18S: 8±5 copies/μL). Notably, the use of CAG reduced the microbial load in biopsy samples by 3.7-fold. 16S and ITS sequencing analysis revealed slightly greater alpha diversity in swab samples than in biopsy samples, particularly in areas treated with CAG. Beta diversity revealed distinct clustering of swab and biopsy samples, with shorter distances between CAG-treated samples and untreated samples. Fewer bacterial (n = 8) and fungal (n = 1) genera were detected in CAG-treated biopsies compared with untreated (n = 21, n = 9, resp.) and IPA-treated (n = 45, n = 7, resp.) biopsies. These results demonstrate a high probability of biopsy contamination with microbial DNA originating from the skin surface. They also confirmed that CAG effectively reduces such contamination and can serve as a practical decontamination step before biopsy. Although based on a nonhuman wildlife model, this feasibility study provides methodological insights that can inform the design of future human hair follicle microbiome investigations.
Healthcare-associated infections (HAIs) pose a significant threat to patient safety, particularly for vulnerable populations such as critically ill patients, the elderly, and individuals with multiple comorbidities. Hospital surfaces often act as reservoirs for pathogens, including multidrug-resistant strains, yet conventional disinfectants frequently lack sustained activity. We evaluated the real-world effectiveness of a novel disinfectant wipe combining low-concentration didecyldimethylammonium chloride (DDAC) and organosilane quaternary ammonium compound (Si-QAC) for its immediate and persistent antimicrobial properties across multiple hospitals. A multi-center, paired-design study was conducted at five university-affiliated hospitals between March and April 2025. Eight high-touch surfaces were categorized into dry zones (e.g., bed rails, nurse station desks) and wet zones (e.g., ward sinks, toilet lids). We compared the disinfection effectiveness of DDAC+Si-QAC wipes (experimental group) against each hospital's standard disinfection protocol (control group). Microbial samples were collected at baseline and at 1, 6, and 24 hours post-disinfection. Effectiveness was measured by the change in microbial load (Δ colony-forming unit/mL) from baseline. A total of 640 specimens were analyzed from 160 surfaces. To ensure rigorous analysis, pairs containing "zero-point" baseline surfaces were excluded, resulting in 39 pairs (78 surfaces) for final evaluation. The experimental group showed significant reductions from baseline at 1, 6, and 24 hours (P<0.001), whereas the control group failed to exhibit significant changes. In comparative analysis, the experimental group demonstrated superior effectiveness over the control group at 1 hour (P=0.041) and 6 hours (P=0.042). Although the difference at 24 hours (P=0.276) was not statistically significant, the experimental group maintained a lower median microbial load. Sub-group analysis revealed that the experimental group's potency was most pronounced in wet zones at 1 hour (P=0.004), where the bioburden was highest. The DDAC+Si-QAC wipe provides superior and sustained antimicrobial activity compared to standard hospital protocols, particularly in challenging high-bioburden wet environments. While the statistical advantage diminished at 24 hours, the persistent coating effect of Si-QAC offers a robust alternative to conventional point-in-time disinfection. Integrating these wipes into routine environmental management may help prevent the formation of microbial reservoirs and contribute to reducing HAIs.
Individuals with diabetes remain at high risk for diabetic foot ulcers (DFUs) even after ulcer healing. Dysbiosis of the skin microbiome has been associated with ulcer formation. Topical chlorhexidine gluconate (CHG) is a broad-spectrum antiseptic commonly used to reduce microbial burden. In a prior randomized clinical trial comparing daily CHG foot treatment with soap-and-water treatment, no statistically significant reduction in new DFUs was observed, prompting evaluation of whether CHG produced durable changes in the skin microbiota. To compare changes in foot skin microbiota (including bacterial bioburden, diversity, and community composition) associated with daily CHG versus soap-and-water use over one year in people with diabetes and prior foot complications. In a single-center, double-blind, placebo-controlled randomized trial, 87 participants were randomized to daily CHG wipes or soap-and-water wipes for 12 months. Foot swabs were collected at baseline, 3 and 12 months, and 4 weeks post-treatment. Bacterial bioburden was quantified. Microbiota composition was assessed using 16S rRNA and ITS amplicon sequencing. CHG treatment significantly reduced bacterial bioburden, increased microbial diversity, and altered community composition, including sustained reductions in Staphylococcus abundance. Several microbiota changes persisted more than 4 weeks after treatment cessation. Soap⍰and⍰water treatment showed similar but smaller and largely nonsignificant trends. Daily CHG use durably modifies foot skin microbiota in high-risk individuals with diabetes. However, this alone may be insufficient to prevent new foot complications, highlighting the need for additional interventions. These findings have implications for long-term CHG use in populations at risk for staphylococcal infections. Long-term daily chlorhexidine foot cleansing in adults with diabetes reduces Staphylococcus abundance and overall bacterial burden more effectively than soap-and-water, with microbiota effects persisting for up to one month after treatment cessation, demonstrating durable pathogen suppression.
Mobile phones are integral to modern clinical workflows and increasingly bridge clinical and private environments. Yet, their role as portable high-touch surfaces in infection prevention remains insufficiently characterized. We hence assessed prevalence and molecular epidemiology of multidrug-resistant organisms (MDRO) on mobile phones used by healthcare workers (HCWs) at a German university hospital and compared them with devices used by non-HCWs. In this 30-month cross-sectional study, 232 HCW and 241 non-HCW mobile phones were analyzed to determine MDRO prevalence and overall bacterial count. A subset of devices was examined before and after disinfection with alcohol-based wipes. Whole genome sequencing with subsequent core genome multilocus sequence typing (cgMLST) was applied to identify clonal clusters. MDRO prevalence was significantly higher on HCW phones compared to non-HCW phones (15.1% vs. 0.4%, p < 0.001), with particularly high rates on intensive care unit devices and shared phones (23.4% and 23.0%, respectively). Vancomycin-resistant Enterococcus faecium, predominantly the endemic ST117/CT71 clone, and methicillin-resistant Staphylococcus aureus were detected on 11.2% and 4.7% of devices, respectively. In contrast, no multidrug-resistant Gram-negatives (MDRGN) were identified, despite contamination with susceptible Enterobacterales or nonfermenters. cgMLST analyses revealed clonal MDRO strains mainly within wards and only rarely across wards, consistent with both local clustering and possible cross-ward dissemination. Total bacterial count did not predict MDRO detection. Alcohol-based wipes reliably eliminated MDRO from all tested devices. Given the high MDRO burden on HCW mobile phones and genomic clustering across wards, mobile phones may represent a relevant reservoir with potential to facilitate in-hospital MDRO dissemination. Standardized mobile phone disinfection routines - particularly for shared and ICU devices - should be considered in infection prevention strategies to reduce potential phone-associated MDRO transmission risk and may represent a conceptual "Sixth Moment" complementing the WHO "Five Moments for Hand Hygiene".
Chlorinated paraffins (CPs), specifically short-chain (SCCPs) and medium-chain (MCCPs), are widely used industrial chemicals of concern due to persistence, bioaccumulation, and toxicity. This study assessed integrated personal exposure (dermal and inhalation) to SCCPs and MCCPs using silicone wristbands (SWBs) and hand wipes (HWs) in 20 volunteers over five days. Participants wore two SWBs simultaneously: a non-removable wristband (N) worn continuously and a removable wristband (R) taken off during sleep and hygiene. SCCPs and MCCPs were detected in all SWBs. Median concentrations in SWBs(N) were 1566 ng/g SWBs for SCCPs and 1808 ng/g SWBs for MCCPs; SWBs(R) showed 1262 ng/g for SCCPs and 2321 ng/g for MCCPs, suggesting minimal contribution from bedding or hygiene. HWs (n = 84) showed median values of 210 ng/participant for SCCPs and 283 ng/participant for MCCPs, with both CP groups present in 96% of samples. Dermal exposure doses were estimated from both matrices and compared with toxicological reference values, including tolerable daily intake (TDI) and margin of exposure (MOE). For MCCPs, MOE never fell below 1000 in SWBs(N), whereas for SCCPs, it was below 1000 in 80% of cases. The TDI value for MCCPs was exceeded in 5% of SWBs(N) samples. For HWs, the TDI value was not exceeded, and MOE values were well above 1000. These findings highlight the importance of considering integrated exposure pathways in CP risk assessment. The combined use of SWBs and HWs provides complementary insights, with SWBs reflecting longer-term exposure and HWs capturing recent skin contamination, improving the overall assessment of personal CP exposure.
Fragrance and preservative chemicals in cosmetic and household cleaning products are recognised causes of allergic contact dermatitis. To identify fragrance and preservative ingredients with potential contact allergenicity in Turkish market products. Labels of 245 products, including predominantly rinse-off cosmetic products and household cleaning products obtained during on-site visits to chain supermarkets were reviewed. Fragrance and preservative ingredients were scored (0-2) for reported allergen potential and summed as an 'allergen load' per product. Cosmetics had significantly higher number of fragrance ingredients and fragrance loads than cleaning products. The most frequent fragrance substances were linalool, limonene and hexyl cinnamal. Paediatric products contained fewer fragrance and preservative ingredients than adult products. Sodium benzoate, methylisothiazolinone (MI) and methylchloroisothiazolinone (MCI) were the most common preservatives; laundry detergents had the highest preservative load, wet wipes and surface cleaners the lowest. Anti-dandruff shampoos had higher allergen loads than regular shampoos. Fragrance-free/preservative-free claims conflicted with labels in 21.2%. Fragrance and preservative loads were weakly correlated (Spearman's rho = 0.260, p < 0.001). Fragrance and preservative allergens are common in cosmetic and cleaning products in Turkey. More frequent MI and MCI in domestic products suggests limited substitution and possible regulatory gaps; anti-dandruff shampoos warrant caution.
Evaluating the virucidal efficacy of surface disinfectants under practical conditions with mechanical action remains a major challenge. Current standards primarily rely on suspension tests and carrier tests without mechanical action, whereas mechanical, surface-based methods are not yet sufficiently validated for virucidal testing. This methodological validation study reports the results of an interlaboratory ring trial on the 4-field test for viruses with hard water. The objective of the present study was to validate a practical test method aligned with European standards and to support the development of a new Work Item within the Working Group 1 of CEN Technical Committee 216 activities. Thirteen European and international laboratories tested three human pathogenic model viruses - Adenovirus type 5, Modified Vaccinia Virus Ankara, and Murine Norovirus - on non-porous surfaces in the 4-field test using hard water. Virus recovery was assessed across multiple contact times, and repeatability and reproducibility were calculated according to ISO 13528. All viruses were reliably recovered on test field 1. The method was largely robust across laboratories, although variations in physical parameters affected interlaboratory consistency, underscoring the relevance of mechanically driven application factors. The virucidal 4-field test demonstrates promising applicability as a phase 2/step 2 method and represents a valuable candidate for incorporation into future European standards. The method is particularly relevant for assessing ready-to-use wipes as virucidal efficacy depends on the combined effects of wipe material, released liquid, and mechanical action, which may substantially differ from results obtained in the absence of mechanical application. Representative-of-use validation methods are therefore essential for assessing disinfectant efficacy in hospitals, long-term care facilities, and public spaces.