Hygiene

Background: Environmental surfaces are key reservoirs for pathogen transmission, with the survival of bacteria on fomites influenced by factors such as temperature, humidity, and microbial interactions. This study aimed to determine microbial surface contamination and to determine the antimicrobial resistance profile of bacteria isolated from the indoor surface where the presence of cockroaches was observed in households of the Greater Letaba Municipality (GLM), South Africa. Methods: Swab samples were collected from kitchen countertops and food storage areas with visible cockroach activity. Bacteria were isolated and identified using standard microbiological methods, and antimicrobial susceptibility testing (AST) was conducted with the Vitek^® Automated 2 system. Results: Of the 120 samples collected, 82 (68%) showed bacterial growth, resulting in 190 isolates. The majority of isolates (93%) were Gram-negative, comprising Klebsiella, Pseudomonas, Enterobacter, Escherichia, Serratia, Stenotrophomonas, Pantoea, Raoultella, and Salmonella species, with 98% demonstrating multidrug resistance (MDR) to multiple antibiotics. Resistance was particularly high against gentamicin (94%), fluoroquinolones (88%) and amikacin (77%). Among Gram-positive isolates, all belonged to the Enterococcus species, with 22% being resistant to one or two of the tested antimicrobial agents and 78% exhibiting MDR. Conclusions: The study revealed a high prevalence of antibiotic resistance in both Gram-positive and Gram-negative bacteria isolated from household surfaces. The spread of antibiotic-resistant pathogens via environmental surfaces presents a significant risk to human health, safety, and well-being. Full article

Background: The cysts of the protozoan parasite Giardia duodenalis, which targets a broad spectrum of hosts including humans, can withstand environmental conditions for months, making effective disinfectant measures crucial for minimizing the infection burden. Previous investigations concerning disinfection efficacy were based on cysts from fecal/water samples or animal models, which are either unfit for standardized procedures or related to ethical concerns. Methods: To perform standardized in vitro disinfectant testing, four different encystation protocols were compared firstly. The protocol with the highest efficacy in our hands (1.7 × 10⁵ cysts per tube) was used for the production of cysts to establish a disinfectant assay. Therefore, it was used for the production of cysts to establish a dis-infectant efficacy assay. After incubation with a commercial disinfectant (ViPiBaX Giardien Ex^®) or 30% hydrogen peroxide solution (H₂O₂) at 10 °C and room temperature, parasite cyst viability was evaluated by the yield of trophozoites obtained by the applied excystation protocol. Results: Only untreated Giardia cysts, which were used as a negative con-trol, released trophozoites. The protocol established for the evaluation of cyst viability delivered reproducible results and appeared suitable for testing the inactivation of cysts by chemical disinfection. Conclusions: Under the given conditions, the disinfectant ViPiBaX Giardien Ex^® and H₂O₂ inactivated Giardia cysts. Full article

Introduction: The COVID-19 pandemic disrupted social interactions, family dynamics, and economic stability, disproportionately affecting vulnerable populations. Tuberculosis and leprosy perpetuate poverty and, once manifested, hinder socioeconomic development due to their high potential for disability. Methodology: This study analyzed the impact of the COVID-19 pandemic using DATASUS health data and assessed the influence of socioeconomic interventions (SAGICAD data) on tuberculosis and leprosy case notifications in Brazil. A correlation analysis was performed between regional diagnoses and variables such as Bolsa Família (a national social welfare program), BCG vaccination coverage, and COVID-19 immunization rates, applying Pearson’s correlation test. Results: No significant correlations were found between COVID-19 vaccination rates and tuberculosis/leprosy diagnoses. However, a strong negative correlation (p < 0.05) was observed between BCG (Bacillus Calmette–Guérin) vaccination coverage and leprosy incidence in the Northern region. The findings also suggest that social assistance programs such as Bolsa Família play a pivotal role in preventing infectious diseases in vulnerable areas. Conclusions: Understanding the complex interplay between socioeconomic determinants and public health outcomes is essential for guiding future research and informing health policies, including potential revisions to social programs and vaccination protocols. Full article

Medication non-adherence remains a major challenge in healthcare systems worldwide, with significant implications for patient outcomes and healthcare costs. This study explored the perceptions and practices of Key Opinion Creators (KOCs) in Kosovo regarding medication adherence. Using a qualitative approach, 15 participants representing hospitals, pharmacies, academia, pharmaceutical companies, insurance, and professional associations were surveyed through open-ended questionnaires. Findings reveal the absence of clear national policies or guidelines dedicated to adherence, limited monitoring systems, and insufficient institutional support. While KOCs recognize healthcare professionals’ (HPs) role in patient education, counseling, and monitoring, they also stressed that their engagement is often fragmented and lacks standardized reporting mechanisms. Technology and innovation were identified as promising tools to improve adherence, but their application is limited by inadequate infrastructure and resources. Key barriers include a lack of guidelines, financial and human resource constraints, low patient education, and disparities across demographic groups. The study highlights the urgent need for coordinated policies, stronger inter-professional collaboration, targeted interventions, and integration of digital health solutions to strengthen medication adherence practices in Kosovo. Full article

Sustainable aquaculture is increasingly vital to meet global protein demands while ensuring fish product safety and environmental stewardship from a One Health perspective. This review addresses fish hygiene as a comprehensive, multi-stage challenge encompassing water quality management, pathogen control, antimicrobial stewardship, feeding practices, humane slaughter, post-harvest handling, and monitoring systems. We examined current practices and technologies that promote hygienic standards and reduce contamination risks across production cycles. The integration of biosecurity measures and alternative health-promoting agents contributes to disease prevention and reduces reliance on antimicrobials. Responsible drug administration aligned with regulatory frameworks minimizes residues and antimicrobial resistance. Feeding strategies incorporating sustainable and safe ingredients further support fish health and product quality. Critical control points during slaughter and post-harvest processing ensure microbial safety and prolong shelf life. Advanced monitoring and traceability systems enable real-time oversight and enhance food safety assurance. Finally, certification programs and robust regulatory policies are essential to standardize practices and facilitate access to international markets. Collectively, these strategies foster sustainable aquaculture that safeguards public health, maintains ecological integrity, and supports economic viability. This holistic approach positions fish hygiene not as a final quality check, but as an integral, continuously managed component of responsible aquaculture production. Full article

There is a need to develop comprehensive guidelines to encourage the promotion of oral hygiene care among older adults and to assist caregivers in this endeavor, taking into consideration the specific challenges that arise from aging, comorbidities and caregiving. This review was conducted by searching across relevant literature from meta-databases including Academic Google, PubMed, Scielo and Scopus for studies published from 2020 to 2024. PRISMA guidelines were followed. We included articles that described oral hygiene methods, caregiver education and mechanization status of older adults. Common themes, best practices, and gaps in current guidelines were tracked using extracted and analyzed data. The review revealed multiple factors affecting the oral hygiene of older adults, with themes relating to physical impairment, cognitive dysfunction, and caregiver involvement. Highlighted between the approaches are individualized therapy for oral hygiene, caregiver education, and the use of technology to improve adherence to oral hygiene. Barriers like dental care access, underlying medical conditions complicating dental treatments, and cost considerations were identified. The findings emphasize the necessity of clear recommendations that can help caregivers and advance dental care for older adults. Full article

Background: Denture stomatitis (DS) represents an oral fungal infection induced by Candida albicans, impacting approximately 70% of the individuals who use removable acrylic dentures. Researchers suggest that the high level of the Candida species, particularly Candida albicans (C. albicans), is the predominant etiological factor of DS. Consequently, the development of a soft liner with antifungal activity might significantly enhance its therapeutic applicability. This in vitro study evaluates the impact of phosphate bioactive glass reinforced heat-cured acrylic-based soft liner on the candidal activity in this material. Method: Specimens (10 mm × 2 mm disc-like) were required for the selected test; PBG-Sr nano-powder was synthesized and added to the soft liner at percentages of 1 wt.%, 3 wt.%, 5 wt.%, and 7 wt.%. The candidal adherence test was investigated, and characterization was performed by X-ray diffraction analysis, field emission scanning electron microscopy, energy dispersive X-ray spectroscopy mapping, and particle size analysis. The resulting data were analyzed with one-way ANOVA followed by Dunnett’s test. Results: Candidal adherence in the 1 wt.%, 3 wt.%, 5 wt.%, and 7 wt.% PBG-Sr subgroups had decreased values in comparison to the control (0 wt.%), with the 7 wt.% subgroup demonstrating the lowest count of C. albicans (0.027), close to the nystatin group. Conclusions: PBG-Sr can diminish C. albicans adhesion in soft lining materials, and a soft liner containing PBG-Sr (7 wt.%) showed the most effective activity against C. albicans in the soft liner. Soft liners infused with bioactive glass may have the potential to assist those struggling with denture stomatitis, providing patients with enhanced therapeutic qualities. Full article

Healthcare workers, particularly those in training, face significant exposure to biological risks, including needlestick and sharps injuries, which remain a critical occupational hazard. This study examines the incidence and nature of such injuries among young healthcare trainees at the University of Campania “L.Vanvitelli,” with the aim of providing useful information for designing an effective preventive program. From 2014 to 2023, a study population of 14,908 health students was subject to health surveillance, of which 141 workers suffered an occupational injury. Needlestick injuries were most common (67.4%). Surgical residents were the most affected subgroup (24.8%). Injuries occurred more frequently after the first year of training (74.5%). Multivariate logistic regression showed significantly higher odds of injury for nursing students (OR = 8.673; 95% CI: 3.196–35.634) and residents (OR = 50.726; 95% CI: 17.789–214.279) compared to medical students. The findings underscore the urgent need for enhanced risk management strategies, targeted education programs, and stricter adherence to safety regulations to protect this vulnerable population. Full article

Background: With the increasing popularity and diversification of cosmetic products, an expanding number of retail stores are providing in-store testers to allow consumers to try products before purchasing. However, growing concerns have been raised about microbial contamination and the associated risk of infection due to the shared use of these testers. This study aimed to investigate consumer awareness and perceived susceptibility to microbial infection associated with the use of lip cosmetic testers, and to identify major pathogenic bacteria, thereby offering evidence to support the need for improved hygiene management practices. Methods: The survey examined the use of lip cosmetic testers and related side effects, as well as perceptions of product hygiene and microbial contamination. Awareness of microbial infection and consumer sensitivity to product safety were measured using a five-point Likert scale. Microorganisms were detected through PCR analysis of genomic DNA. Results: Among 134 respondents, 95% had previously used lip cosmetic testers, and 90% recognized the potential for microbial contamination. Sensitivity to product safety was not significantly associated with sociodemographic factors. However, susceptibility to microbial infection from tester use was significantly higher among participants of older age and with higher education levels. PCR analysis of lip cosmetic testers revealed frequent detection of Staphylococcus epidermidis and Pseudomonas aeruginosa. Other detected bacteria included Streptococcus oralis, Streptococcus salivarius, Streptococcus pneumoniae, and Escherichia coli, all of which are known to cause oral and respiratory infections. Conclusions: The analysis revealed that the majority of individuals who have used lip cosmetic testers expressed a high level of concern regarding product contamination and the potential for infection. Multiple pathogenic bacteria linked to oral and respiratory diseases were identified in the opened tester products. These findings underscore the necessity of establishing regulatory guidelines for the management of lip cosmetic testers and highlight the importance of enhancing consumer awareness regarding hygiene practices. Full article

Breastfeeding is a complex biological system and a bidirectional physiological dialogue in which the infant may contribute to maternal breast health. This review synthesizes current evidence, clearly separating established findings from emerging hypotheses, to examine the possible infant-driven mechanisms that influence hormonal and immune homeostasis in the mammary gland. We evaluate how neonatal suckling coordinates interconnected hormonal reflexes and immune activity, and we explore the hypothesis that the retrograde flow of infant saliva to the breast tissue could activate maternal enzymatic defenses, particularly the xanthine oxidase and lactoperoxidase systems. We also consider the activation of antimicrobial peptides through direct contact at the nipple and areola, including cathelicidin and defensins, as well as the potential roles of fetal microchimerism and microbial transfer from the infant’s mouth in strengthening breast resilience. Although much of the evidence remains indirect and based on in vitro and animal models, the convergence of data supports a reformulated conceptual model that presents the infant as an active physiological partner rather than a passive recipient of milk. Recognizing this shift has important clinical implications for the prevention of inflammatory conditions such as mastitis, the improvement of breastfeeding support strategies, and the optimization of maternal and infant health outcomes. The review also identifies significant gaps in current knowledge and cautiously proposes hypotheses to explore these mechanisms. While preliminary, this framework offers an original perspective that may guide future research and open new paths in the study of human lactation biology. Full article

Oral hygiene protocols and basic oral care (BOC) are paramount for patients undergoing cancer treatment, although based upon limited evidence from clinical trials. There are a range of oral care guidelines proposed in the literature mainly focusing on oral mucositis prevention. This systematic review aimed to define the best procedures and practices in the scope of oral hygiene protocols and BOC interventions for the prevention and/or treatment of oral complications in patients under cancer treatment. This systematic review was conducted according to the PRISMA guidelines, and the methods were previously established and registered in PROSPERO (CRD42022319455). A systematic search was completed in six databases (PubMed, Scopus, Web of Science, LILACS, and the Cochrane Library, and gray literature). Eleven studies were included in the qualitative analysis including non-randomized (n = 1) and randomized clinical trials (n = 6), and cohort studies (n = 4). The included studies showed the effectiveness of soft brushes for daily oral hygiene with topical fluoride, and the use of mouthwashes with 0.12% chlorhexidine, doxepin, and benzydamine and saline solutions, as well as dental scaling/prophylaxis in decreasing the severity of oral toxicities. Although not well-explored by well-designed clinical studies, BOC protocols may be effective in prevention oral toxicities from cancer therapy and are supported in multiple guidelines. This review synthesized available evidence on BOC in head and neck cancer patients, focusing on the effectiveness of hospital-based dental protocols during cancer treatment. Full article

Artificial intelligence (AI) is progressively being utilized in the healthcare sector to enhance efficiency, alleviate administrative burdens, and improve patient care outcomes. In the secondary healthcare sector, AI presents a range of opportunities as well as challenges. This study investigates the viewpoints of healthcare professionals regarding the adoption of AI in Greece, emphasizing the anticipated advantages and apprehensions associated with its integration. A cross-sectional descriptive study was carried out to collect responses from healthcare professionals at the General Hospital of “Evangelismos”, which is the largest hospital in Athens, Greece. A questionnaire was utilized and distributed over a period of four months, involving 513 registered healthcare professionals (comprising 136 physicians, 235 nursing staff, and 142 other healthcare personnel). Each participant had a minimum of one year of clinical experience and was selected using a convenience sampling method. The questionnaire comprised two parts: one focused on evaluating the AI knowledge and attitudes of healthcare professionals, and the other collected demographic data. The overall comprehension of knowledge pertaining to AI among healthcare professionals was evaluated as moderate, resulting in a mean score of 3.39. A distinction exists among different personnel categories, with physicians (M = 3.73) demonstrating a greater understanding of AI and a firm conviction that AI cannot supplant human positions. Conversely, nursing personnel appear to express apprehension regarding the implications of AI on the human experience, with a notable concern about potential replacement and job loss (M = 2.63), which was identified as the lowest-ranked issue. This latter concern is also echoed by other healthcare personnel (M = 2.90). Nevertheless, the majority of participants regard the prospective use of AI favorably, demonstrate confidence in its application, and contend that the benefits outweigh the possible risks. Sufficient training and ongoing updates would enhance employees’ comprehension of AI and their awareness of its potential benefits within the healthcare sector. Full article

This study aimed to explore psychosocial factors in a sample of Peruvian workers, examine their convergence with the PROPSIT model, and identify the emergence of new or idiosyncratic psychosocial dimensions. At the same time, the quality and efficiency of the categorization process were evaluated. n = 48 workers were contacted by a non-probabilistic sampling method and asked to fill out a form with open-ended questions that explored negative stressors and positive engaging factors. Some strategies were used to assess the quality and efficiency of the categorization process. The results showed that the quality, speed, and reliability of the categorization procedure were satisfactory, and several categories were aligned with the PROPSIT model and other literature, both in their negative aspects (workload and rhythm, working hours, shifts, etc.) and positive aspects (rewarding tasks, atmosphere of unity, etc.). The emerging new categories were confined to aspects of teamwork and conflict climate, as well as topics such as order, cleanliness, and recreation. These findings underline the need to adapt existing models and instruments to capture idiosyncratic aspects of the Peruvian work environment. In conclusion, this study validated an efficient mixed approach for categorizing psychosocial work factors in Peru, revealing both PROPSIT-aligned and novel context-specific categories, and highlighting the need for culturally adapted tools and broader validation. Full article

Background: Dental offices and clinics utilize a variety of dental materials that are delivered in reusable containers and dispensers. However, many of these materials, including NeoPutty, BC Putty, Flowable, and Diapex, may be subject to bacterial contamination and microbial exposures from the surrounding dental office environment. Objectives: The aim of this study was to quantify and identify microbial contamination, specifically in regard to these reusable dental materials. Methods: Surfaces of new and used reusable and resealable tubes where the material dispenses and the interior surfaces of the cap were swabbed and cultured. DNA was isolated from each sample and quantitative polymerase chain reaction (qPCR) was performed to determine the presence or absence of microbial contamination, as well as the relative abundance. Results: Microbial contamination was observed among all of the “in use” samples from both the dispensing end and the interior surfaces of the cap and was strongly associated with the amount of usage. Conclusions: These data suggest that environmental contamination may be present in measurable and quantifiable amounts on reusable and resealable dental materials, which suggest the need to create protocols for sanitizing the surfaces of reusable materials to reduce the presence of microbial contamination identified in similar clinical settings. Full article

Biofilms are the source of numerous issues in the food, pharmaceutical, and production industries, making their control a major component of economic and public health. Among anti-biofilm strategies, enzyme-based products that target the biofilm matrix have proven effectiveness against multiple bacterial species. We tested the efficacy of a commercial product, Baso Bionil SL40^® (SL40; Stockmeier France, Saint-Jacques de la lande, France), against biofilms of Pseudomonas aeruginosa under various conditions of temperature, concentration, pH, and incubation time. SL40 contains two enzymes: a subtilisin protease and an α-amylase glycosidase. Our results showed that SL40 removed up to 85% of the biofilm biomass compared to tris solutions. SL40’s efficacy was strongly influenced by the presence of the enzymes and both temperature and concentration. Enzymatic activity was maintained from 20 °C to 60 °C and at pH values ranging from 5 to 9, with effective concentrations corresponding to SL40 dilutions from 3/200 to 1/200 in 50 mM tris solutions. Additionally, we observed that the P. aeruginosa biofilm biomass after pH 9 tris solution treatment was twice compared to a H₂O washing. Our results confirm the potential of enzymes against biofilms, highlight the need to define optimal application conditions, and support their integration into combined strategies for complete biofilm removal. Full article

In cemented endoprosthetics, closed prepacked mixing systems represent the most advanced generation of cementing technology. (1) Background: The purpose of the present study is to evaluate four approved prepacked systems—Palacos^® R+G pro, SmartMix™ Cemvac GHV, Optipac^® Refobacin and Cemex^® System Genta—with a focus on practical handling and intraoperative hygiene. (2) Method: The systems were evaluated according to established standard test methods for bone cements (ISO 5833), including dough time, setting time, additional mechanical tests and the level of system closure. (3) Results: The results show that all systems are safe to use and meet the general requirements, but there are relevant differences in terms of intraoperative hygiene. The Palacos R+G pro system shows significantly shorter doughing and setting times, which helps to minimize wound exposure during surgery and thus significantly reduces the overall operating time and the risk of bacterial contamination. Two of the systems cannot be classified as completely closed “pre-packaged systems.” In two cases, the system must be temporarily opened before mixing to insert the mixing element, which may result in a temporary but clinically relevant impairment of sterility and a corresponding potential risk of contamination. (4) Conclusion: From a hygienic point of view, systems that remain completely closed throughout the entire preparation process can offer advantages in terms of infection prevention. This was the case for all systems tested. Short handling times, reduced exposure of the surgical site and a shorter overall duration of the procedure could further improve intraoperative safety and reduce the risk of contamination. In terms of intraoperative hygiene, the Palacos R+G pro system achieved the best results compared to the three other systems tested due to its rapid readiness for use and comparatively short setting time (according to ISO 5833). Cemex System Genta performed worst in this respect due to its late doughing time and setting time. Full article

Hand hygiene (HH) is universally recognized as a pillar of infection prevention and control (IPC), both in hospitals and long-term care facilities such as nursing homes (NHs). An annual national survey based on the voluntary notification of purchased alcohol-based hand rubs (ABHRs) has been set up in France since 2019 to appraise the compliance to HH in NHs. The results pertaining to the Hauts-de-France (HdF) region were analyzed over the 2018–2023 period. The impact of factors such as the year, structure status, availability of an infection control link (ICL) nurse and/or an IPC team as well as constant participation in the survey was evaluated. A clear rise in the consumption of ABHRs was witnessed in 2020 followed by a progressive return to the 2018 baseline by 2023 for most NHs. This decrease was significantly less marked in NHs constantly participating in the survey. The ABHR indicator’s annual values were significantly higher in public NHs than in associative ones and in NHs with available ICL nurses/IPC teams. Finally, even though less than 50% of regional NHs reached the target of four daily ABHR uses per resident, they more frequently met it than French ones as a whole. This result underscores the need for ceaselessly reiterating the importance of HH and for pursuing training efforts in NHs with the help of ICL nurses and IPC teams. Full article

Gingivitis is a common and reversible inflammatory condition caused by dental plaque accumulation, which, if left untreated, can progress to periodontitis. Conventional oral care products like chlorhexidine (CHX) and fluoride are effective in plaque control but are often associated with adverse effects such as dental staining and mucosal irritation. This systematic review aimed to compare the efficacy and safety of natural versus conventional toothpastes and mouthwashes in managing plaque-induced gingivitis. The review followed PRISMA guidelines and was registered in PROSPERO (No. 1008296). A systematic search was conducted across PubMed, Web of Science, and Scopus for English-language clinical studies published between 2015 and 2025. Eligible studies included randomized controlled trials and clinical trials on human subjects with plaque-induced gingivitis. Exclusion criteria were studies on animals, in vitro experiments, review articles, and studies lacking control groups. Data extracted included intervention type, sample characteristics, clinical indices (PI, GI, SBI), inflammatory biomarkers, adverse events, and patient adherence. A narrative synthesis was conducted due to study heterogeneity. Fifteen studies were included. Natural products such as neem, green tea, aloe vera, and propolis demonstrated comparable effectiveness to CHX and fluoride in reducing gingival inflammation and plaque indices, with a lower incidence of side effects. In particular, natural formulations showed superior tolerability and better patient compliance, especially in long-term use. However, variability in concentration and the formulation of natural products limits their clinical standardization. In conclusion, natural oral care products appear to be effective and better-tolerated alternatives to conventional agents in managing gingivitis. Nonetheless, further long-term, standardized clinical trials are needed to confirm their efficacy and define optimal formulations. Full article

Growing concern for environmental sustainability has resulted in the implementation of sanitization methods that respect ecological principles. This research evaluates a “green” sanitizing protocol that uses CAM (Minimum Environmental Criteria)-compliant products against a traditional protocol within two ASL Roma 1 facilities. The study performed a Life Cycle Assessment (LCA) following ISO 14040, ISO 14044, and ISO 14067 standards to measure greenhouse gases emissions. Microbiological sampling was conducted according to established protocols across three different risk zones utilizing contact plates and surface swabs. The Life Cycle Assessment showed that CO₂ emissions reduced by 49.6% to 53.3% at different sites due to reduced energy use together with concentrated detergents and improved washing cycles. Microbiological testing revealed notable decreases in contamination rates across both cleaning systems yet demonstrated the “green” system achieved superior results specifically within high-risk zones. The “green” protocol matched traditional cleaning methods hygienically but delivered significant environmental advantages which positions it as a sustainable hospital cleaning solution. Full article