This is an era when the antimicrobial resistance is rampant and awareness for hygiene and sanitation is picking up. As a country, we are passing through and witnessing the change. If we consider the healthcare sector, there are manifold changes happening around as lot of capital investment is pumped in various sectors and so as many new products and services are easily available and accessible due to technological revolution.
Now when we are expanding, and the expansion is exponential, there is competition between the providers and also every company is trying to bring out best suitable for a given era and breakthrough technologies are transformed in marketable products which is benefitting overall society at large. In this article, I am about to discuss for new nanotechnology product which has been recently introduced in India and has application in many industries but preferably in healthcare, pharmaceutical and food industry.
Burden of healthcare infections1
Infectious diseases are challenging especially in this era where there are multi drug resistant organisms around and there are no new antimicrobial agents available. At any given time, the prevalence of health care-associated infection in developed countries varies between 3.5% and 12%. At any given time, the prevalence of health care-associated infection varies between 5.7% and 19.1% in low- and middle-income countries. Among hospital-born babies in developing countries, health careassociated infections are responsible for 4% to 56% of all causes of death in the neonatal period, and 75% in South-East Asia and Sub-Saharan Africa1,2.
There are several factors which are independent of resources which are prolonged and excessive use of antibiotics and invasive devices, high risk and sophisticated procedures, immune-suppression and other comorbid conditions and insufficient application of isolation forms. There are other determinants which are more specific to resource limited settings include inadequate hygiene and waste disposal, poor infrastructure, insufficient equipment, understaffing, overcrowding, poor knowledge of application of basic infection control techniques, lack of procedure, lack of transfusion and safe injection practices and lastly absence of national guidelines and policies to address same1.
Addressing the need for reducing burden of HAIs
The problem though huge can be addressed with simple solution as effective as hand hygiene and also taking utmost care to prevent infections during procedures carried out at healthcare organization.
Following points are needed to be considered while addressing issue of healthcare associated infections1.
- Identify local burden of healthcare associated infections
- Improving reporting and surveillance systems
- Ensure that minimum resources are available to address the issue including strengthening of microbiology laboratory.
- Ensure that core components of infection control are in place
- Implement standard precautions and hand hygiene
- Staff training and accountability
- Conducting further research for same.
However apart from above mentioned efforts, the efforts required for resource poor organizations which have multiple issues at multiple levels and they must be given priority. A simple example is maintaining basic hygiene and cleanliness in the general hospitals. Providing adequate infrastructure to avoid overcrowding and if there is, there should be proper way in which air handling should be done so that airborne illnesses do not spread especially in OPD blocks of pulmonary medicine where MDR and XDR tuberculosis patients frequently visit.
Environment is a key link in transmission of pathogens as the reservoir is present in environment so also susceptible host is present in environment. Also some of modes of transmission are through environment for e.g. airborne diseases, water borne diseases, food borne diseases. Also critical areas like ICU may harbor MDRO (multidrug resistant organisms) which may be transmitted from patient to patient through contact or through inanimate surfaces which may be notorious to treat as well as causing high mortality and morbidity and increase cost of healthcare organization.
Environmental cleanliness is given priority in healthcare organization and there are disinfectants and surface cleaning agents which are used. Processes such as fogging also are used since age old time however agents have been modified.
The new breakthrough in technology is making possible to have products which are useful, economic and also add value.
It’s a revolutionary formula from New Zealand that has been demonstrated effectiveness in laboratory, clinical and field test trials. The product has been approved by Food and Drug Administration / Environment Protection Agency (US), UK and European Union, New Zealand and Australia.
One of such breakthrough technology is now available in India with residual effect lasting as long as a month and its effectiveness is best when it is dry. Most of currently used disinfectant solutions loose effectiveness once they are dried or they have minimum residual effect which necessitates frequent application. Another advantage of this technology is water based, non toxic compound which do not require any additional precautions which are required by other products like corrosive effect, toxic effect and irritation to eyes and hands.
The product for surface application is named as Zoono Microbe Shield (Z- 71®). It works by formation of mono molecular layer of covalently bound biocidal molecules based around silicone polymer chemistry. The simple way to explain is that it forms spikes which are positively charged which when combined with negatively charged surface of microorganism causes fluidization (membrane lysis) and this process continues till the interaction continues.
To summarize the technology, it is a breakthrough technology where in the advances of nano technology are combined to bring out new product which work on physical principles, with residual effect which can last for a month, non toxic and water based compound which is easy to use and in turn product is environmental friendly, effective even in dry state, in textiles can remain effective up to 30 washes, on intact skin can stay up to 24 hours.
The product has been validated by over 100 third parties and shown to inactivate all viruses tested which includes MERS, H1N1 (swine flu), norovirus, influenza A virus and against bacterial pathogens such as E. coli, Staphylococcus aureus including Methicillin resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, M. tuberculosis, Legionella species, Salmonella cholera-suis, Listeria species including L. monocytogenes (ACM 98), Neisseria species, Haemophilus speices, Cryptosporidium parvum (oocysts), Citrobacter freundii (MS2), Vancomycin resistant Enterococcus (VRE), C. difficile and fungi in clinical and field research trials in Australia, Turkey, Germany, China, Dubai, United Kingdom, New Zealand and United states of America with extraordinary effectiveness. The product is also approved for food contact and has food safety approvals.
Considering its properties, proposed uses are in healthcare, facilities like old age centers, child care centers, veterinary, dental, food industry (manufacturing as well as processing), pharmaceutical industry, poultry, dairy, bottling plants, corporate markets, military, agriculture, horticulture and many more where such environmental hygiene products are used.
As an infection control practitioner, cleaning is a primary basic requirement which can never be substituted. It is important to have best and appropriate products as per available guidelines to aid in attaining purpose of getting surfaces cleaned. Zoono is no exception to that as all testing required prior cleaning and followed by application with this compound and post test evaluation by ATP bioluminescence also needs appropriate cleaning and visible dust free environment. Cleanliness has to be maintained as per the cleaning protocol of facility in which the product is applied.
Company provides R &D for new product development to meet current and future demand of emerging breakthrough technologies.
Dr Dhruv K. Mamtora, (MBBS, MD, EPGDHA, NYSIC). Member: IAMM, IATP, ISID, HIS-MF (Inst.), SCM, IMA. Faculty – Infection Control Academy of India (IFCAI); Consultant Microbiologist and Infection control officer, S. L. Raheja (A fortis associate) Hospital, Mumbai
World Health Organization. Report on the burden of endemic health careassociated infection worldwide.
Ling ML, Apisarnthanarak A, Madriaga G. The burden of healthcareassociated infections in Southeast Asia: a systematic literature review and meta-analysis. Clinical Infectious Diseases. 2015 Feb 12;60(11):1690-9.