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Viruses and Bacteria: A Talk

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A recent talk with Carl Zimmer, a noted lecturer and author on science subjects, is filled with interesting information on the good and bad of viruses and bacteria in our bodies. Worth a half an hour.
http://www.npr.org/player/v2/mediaPlayer.html?action=1&t=1&islist=false&id=150003129&m=150723111
A summary of the interview :
The Race To Create The Best Antiviral Drugs

EnlargeC. Goldsmith, P. Feorino, E. L. Palmer, W. R. McManus/CDC Public Health Image Library
The HIV-1 virus cultivated with human lymphocytes.
April 17, 2012
If you’ve ever had a bacterial infection like staph or strep throat, your doctor may have prescribed penicillin. But if you’ve had the flu or a common cold virus, penicillin won’t work. That’s because antibacterials only kill bacteria, and both the flu and the common cold are viruses. So for illnesses like the flu, doctors prescribe antiviral drugs, which target the mechanisms that viruses use to reproduce.
“For example, there are antivirals for the flu that interfere with the virus as it tries to get out of its host cell,” says science writer Carl Zimmer. “So this molecule latches on to that particular protein that the virus uses to escape, and interferes with it so that the virus is trapped inside.”
Zimmer’s latest piece for Wired magazine profiles the scientists who are developing antiviral medications, and examines the new ways medicine is working to attack viruses.
“There are some really amazing antivirals that have been invented over the last 40 years,” he says. “There are antivirals for herpes. There are antivirals for HIV. … Now, if you were to get Ebola and you tried to take HIV drugs, they’d do you no good at all because that HIV drug only works for HIV. It’s a narrow-spectrum drug, and really, there are no broad-spectrum antivirals, at this point.”
But scientists are now working to create a “penicillin-like” drug that will target viruses more broadly. In San Francisco, a company called Prosetta is working on a drug that doesn’t affect a virus directly. Instead, it works by affecting the proteins that are naturally in cells that help viruses replicate.
“The basic idea behind it is that viruses need help to build themselves,” says Zimmer. “What happens is quite amazing: [Viruses] get lots of different proteins in our cells and cooperate to push their own proteins into place. And so the viruses need these groups of host proteins to form.”
Prosetta created a drug that prevents the host proteins from performing their cooperative jobs and helping the viruses out. Preliminary studies have shown that targeting these host proteins — and not the virus itself — can stop Ebola, influenza, rabies and other viruses.
Other researchers are working to replace or help interferons, our body’s own natural virus-fighting system. Eleanor Fish, a researcher at the University of Toronto, is heading a project to create synthetic interferon, in order to accelerate the body’s virus-fighting response.
“Today, people with Hepatitis C can get interferon treatment, but it doesn’t work all that well. It has some benefit, but not as much as Eleanor Fish would like,” says Zimmer. “So she has been essentially tweaking the interferon molecule to make it more effective, to make it last longer, to make it safe and to make it cheap. Because what she wants to do is deploy interferon all over the world where there isn’t fancy refrigeration. She wants to help people who are dealing with viruses in very remote places.”
A third approach, says Zimmer, involves creating an artificial protein that would latch onto viruses and then instruct them to literally self-destruct. Spearheaded by Todd Rider at MIT, the project has been tested in cells and in mice.
“Rider’s basically hot-wiring your cells so that as soon as they get infected by a virus, that trips a switch,” says Zimmer. “This doesn’t exist naturally, but if you were to take a pill, the thinking is, then this molecule would go into your infected cells, and as soon as it detected the virus, it would kill the infected cell, and you would recover from your disease.”
But successfully eradicating viruses may bring a host of other problems, says Zimmer. He points to broad-spectrum antibiotics, which wipe out good bacteria in addition to bad bacteria.
“Eventually your body may recover, and it can take awhile, and there may be some bad consequences of the antibiotics themselves,” he says. “So it’s going to be interesting to see what happens in the future if we are, in fact, knocking out lots of viruses. Because we don’t understand the full ecology of the viruses that get into our bodies.”
There are trillions of viruses that live in our bodies, even when we’re not sick, says Zimmer.
“Some are harmful, some may not be harmful,” he says. “Some may even help us defend against other viruses. It’s very complicated in there, and we don’t really understand it very well yet.”
Transplanting Gut Bacteria
Physicians are now using bacteria to combat other diseases. Zimmer points to an example of a patient infected with theClostridium difficile bacteria, which causes severe diarrhea and can frequently return, even when treated with antibiotics. The patient was treated with a transfusion of gut microbials from a healthy individual’s fecal material to restore the bacterial flora in her intestinal tract.
“Literally two days later she started feeling better, and a couple weeks later, when they went to sample the bacteria that was there, they couldn’t find the C. difficile anymore. It was just gone,” he says. “The only thing they had done was essentially restore her ecology, essentially like restoring a wetland.”
Zimmer says fecal transplants have only been performed on patients when all other options fail — but they are seemingly quite effective.
“The problem is, as some other journalists have reported, is that the FDA has a very difficult time figuring out how to come up with regulations for this,” he says. “Before it’s going to become a widespread practice, the FDA is going to have to move beyond its old paradigm of giving people regular drugs to being able to give people tailored concoctions of living things — of bacteria, of maybe even viruses — as medical treatments.”
These bacteria and viruses work in conjunction with other bacteria and viruses in the body, but scientists still know very little about their mechanisms, says Zimmer.
“There’s this whole ecosystem of interactions going on inside our own bodies that we do not understand — barely at all,” he says. “Scientists are just starting to figure it out with very big projects where they’re sequencing all the genes these microbes have. But they’re just at the beginning of understanding it.”

Applicator Traction

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We continue to enjoy watching as our applicators of OxiTitan products get more and more publicity. We enthusiastically congratulate folks like Mike King of OxiArmor Antimicrobial Services for their success.

Here is Mike on TV in Kansas City.Mike King on Kansaa City TV

http://youtu.be/Nyn5nwUgNd0

Oh, Canada!

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Unfortunately, healthcare acquired infections know no geographical boundaries. This investigative report on the problems with environmental services ( ‘cleaning’ to us laymen) is instructive. With increasing cost constraints, short cuts are taken. All the more reason to have self-cleaning surfaces provided by OxiTitan working continuously 24/7 to reduce the bio-burden in between routine cleaning.

See the story here:

http://www.cbc.ca/marketplace/2012/dirtyhospitals/

ALL ABOUT QUATS

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LET’S TALK ABOUT ORGANO SILANE QUATERNARY AMMONIUMS.

A broad subject with decades of history, so I’ll just hit some of the high points for now and let you dig further should you be curious.

In the antimicrobial coatings industry we constantly see much touting for ammonium chloride based silane ‘coatings’ with lots of wonderful claims about kill rates, uses and durability and such. Hard to keep track of them all since the marketers are diverse and ever-changing, and sometimes less than forthright. But we’ll address that in a minute.

First some background.

Back in 1971 a couple of researchers at Dow Corning discovered the adding of silane (simply silicon + hydrogen, SiH4) to quaternary ammonia compounds (QACs or quats), which is a longer name for the ordinary ammonia you use in your household cleaning ( usually the alkyl benzyl ammonium chlorides or BAC). They made the father of silane quats, 3-(trimethoxysilyl)-propyldimethyloctadecyl ammonium chloride. The key is that the silane makes the ammonia chloride salt stick to a surface better giving a longer service time than the quat alone, which was useful for just minutes as a sanitizer. We’ll use their shorthand for these compounds, Si-QACs. This is their paper about it, for those of you who like these historical documents.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC380687/pdf/applmicro00052-0033.pdf

There are many versions of the basic chemistry, but all share similar key ingredients: ammonium chloride variant (the active antimicrobial), silicon as a binding agent ( the silyl part) and an alkane chain. More about that alkane chain later, but first let’s talk about the antimicrobial part of the chemical.

Quats are very useful in healthcare setting because they are much less caustic that the more effective bleach (sodium hypochlorite). From Wikipedia:
Quaternary ammonium compounds are lethal to a wide variety of organisms except endospores, Mycobacterium tuberculosis and non-enveloped viruses… Quaternary ammonium compounds are not very effective in the presence of organic compounds. ..Quaternary ammonium compounds are deactivated by soaps, other anionic detergents, and cotton fibers. Also, they are not recommended for use in hard water. Effective levels are at 200 ppm.

As with any toxic chemical, QACs can be hazardous with prolonged and /or intense exposure. Again Wiki:
Quaternary ammonium compounds can display a range of health effects, amongst which are mild skin and respiratory irritation up to severe caustic burns on skin and gastro-intestinal lining (depending on concentration), gastro-intestinal symptoms (e.g., nausea and vomiting), coma, convulsions, hypotension and death.

And while effective as an antibacterial, QACs have been shown to do something very disturbing: cause resistance in microbes. Here is one recent study, but others have been done as well.

http://jac.oxfordjournals.org/content/62/5/1160.full

This seems to be more prevalent when the antimicrobial is used at less than optimal ppm (like when used as a thin surface coating as opposed to sanitizing use in liquid form). This is not an issue with broad spectrum oxidizers like hydrogen peroxide and the hydroxyl radicals produced by OxiTitan.

Now, about those alkanes (or alkyds). These are the methyl, dimethyl parts of the compounds we are describing. Alkanes examples are paraffins, waxes, or saturated hydrocarbons. They consist only of hydrogen and carbon atoms and are bonded exclusively by single bonds. Most of the manufacturers use a very dramatic image of the alkyd chain as little “swords” which puncture the threatening microbe, and therefore destroying it. There is no evidence of this, and in fact, if the alkyd chains were doing the microbial killing we would be in a different chemical world (and we wouldn’t need the ammonium chloride!).

Here is our friend Wiki on the biological power of alkanes:
Alkanes are not very reactive and have little biological activity. Alkanes can be viewed as a molecular tree upon which can be hung the more biologically active/reactive portions (functional groups) of the molecule.

That is, the alkyd chains do not have biological activity, either beneficial or adverse effects, on living matter. So forget that cute ‘sword’ metaphor, it is the chloride salts doing the heavy lifting, antibacterially speaking.

Here are the major Si-QACs, although they sometimes change the order of the chemicals to sound different:

3-(trimethoxysilyl) propyl dimethyl octadecyl ammonium chloride and these related compounds:
Octadecyldimethyl trihydroxysilyl propyl ammonium chloride
Decyl-N-methyl-N-(3-trimethoxysilyl)propyl)-1-decanaminium chloride
Dimethyltetradecyl [3-(trimethoxysilyl)propyl]ammonium chloride

So who sells Si-QACs? Well, they are tell you how different and new they are, but they have been making them for decades (Dow Corning sold the formula) are made by a handful of companies with many sub registrants, variants and licensees. These are some of the brand names, so no commercial claim in this list, just taken from EPA records:

Aegis 5700, et al, AM 3651, AM 7, Bioshield 75 et al, Proshield 5000, HM 4100, Goldshield, Marquat, Monfoil, Mpale, Protect’n Shield, Requat, SiS 7200 et al, Sports-Aide 1000, Tile Doctor Shield and Zooncide.

Some other notes on some of these products. The marketing may not match the label, as allowed by the US EPA. Mostly, these Si-QACs are operating under the Treated Article Exemption in FIFRA.
In order for an article or substance to qualify for the treated article exemption, the incorporated pesticide must be registered for use in or on the article or substance and the sole purpose of the treatment must be to protect the article or substance itself. As a result, reliance on the treated article exemption is misplaced if you make public health claims (e.g., “fights germs” or “controls fungus”) for the product, or otherwise suggest that the product produces a pesticidal effect apart from the article itself. Names or claims that imply or express protection that extends beyond the treated article or substance itself are not allowed. In general, carefully worded mold- and mildew-resistant claims, as well as odor-resistant claims are permitted. Also, a claim to inhibit microorganisms that may cause spoilage or fouling of the treated article or substance is acceptable.

Then there are claims as to how long the Si-QAC lasts on the treated article. Assuming it is not washed with soaps or detergents, it can last a while. Recommendations vary for recoating, from 1 to 3 months, but there are no manufacturer assurances it will function even that long. Unfortunately, the very reason to use the Si-Quat is for protection on touch points, and those are usually frequently washed.

As always, compare the marketing claims to the actual US EPA approved label claims. This is an example of a Si-QAC label. Note the treated article reference from the” *” after Microbiostatic Agent.

http://www.azpharm.com/images/BioShield_Images/BioShield%2075%20Insert%20rev091808.pdf

So, there is a primer on the Si-QAC. There is much more to this subject of course, and we can go on for a bit, but like a Si-QAC, I’m wearing out.

WHERE THE GERMS ARE

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Some factoids: your keyboard (not mine! It has OxiTitan on it!) has 60 times as many germs as your toilet seat. Light switches may have 217 bacteria per square inch. And yes, that hotel TV remote is the dirtiest thing in the room.

Now go wash your hands!

http://8.mshcdn.com/wp-content/uploads/2011/11/tech-germs.jpg

http://8.mshcdn.com/wp-content/uploads/2011/11/tech-germs.jpg

‎8.mshcdn.com

ABOUT SMELL & ODOR

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Without going into a deep discussion of the science of smell and how we detect odors, some overview is necessary as odors relate to our products ability to reduce the volatile organic compounds(VOCs) and other odorants like hydrogen sulfides.

First, our sense of smell is not like measuring the absolute concentration of a single odor causing molecule, as we can do in scientific air sampling. Smell is a two part process. The molecules which we smell contact our olfactory receptors, which are strictly physiological, and then are sent on to our brains for ‘analysis’, which varies widely according to age, gender, habituation, previous memory, and even menstrual cycle. Our sense of smell is a fantastic gift, useful for finding food, a mate, detecting dangers or predators. However, it is not a measuring device.

We don’t smell a single compound, but the complete odorous mixture. And even then, we easily get used to an odor, and our ability to detect an odor diminishes with exposure and if it is mixed with others. Thresholds for detection by our sense of smell vary widely and intensity is a perceived strength and affected by psychological factors. You may smell something and someone else doesn’t and your intensity is arbitrary as well. You can read more about this at the great Wikipedia link posted below, but in sum, your sense of smell is subjective and not the best way to measure whether the actual odor causing molecules are reduced or removed.

For example, a odorous molecule like hydrogen sulfide(H²S), which is what we smell as the ‘rotten egg’ odor. Humans are extremely sensitive to H²S. Less than five parts per billion in air or, 0.0047 ppm, is the recognition threshold, the concentration at which 50% of humans can detect the characteristic odor.

So, let’s say your air has just one (1.0) ppm, so just one molecule of hydrogen sulfide in a million parts air. Up to 10 ppm of H²S is acceptable by OSHA. The air would smell of rotten eggs. Now, if you use OxiTitan™, which is fantastically effective at reducing hydrogen sulfide by photo-oxidizing the hydrogen from the sulfur, you can easily reduce that by 99% and more!

http://www.oxititan.com/lab_tests/Hydrogen_Sulfide_test.pdf

So now the air is much, much cleaner, down to just 0.01 parts per million! Very, very good, and much healthier to be breathing. But guess what, you still might smell the remaining few molecules of H²S. We need to reduce the concentration down another 50% or more to not smell it anymore!

Complicating this is the ability of many molecules like H²S to adsorb into the environmental substrates and out gas over a long time, presenting a detectable odor despite multiple log reduction of it in the air. So while OxiTitan™ is busy continuously reducing the odor, more is either being leached into the air from the within the substrate like in happens in defective drywall, or is actually coming free from the surface from air disturbance or changes in temperature or humidity.

The only true measure of challenge odor causing compounds is chemical air sampling, for either specific VOCs or other odorous compounds like H²S. Sniffing the air is not a quantitative measuring device!

I smell pizza (I can’t tell what size it is), so I’ve got to go, but read more here:
http://en.wikipedia.org/wiki/Odor

Clostridium Difficile Is Rampant in Healthcare

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A recent NPR story on C. diff in an interview with the CDCs Clifford McDonald.

http://www.npr.org/player/v2/mediaPlayer.html?action=1&t=1&islist=false&id=148072242&m=148072294

If you have trouble with the audio link to the renowned Dr. McDonald’s short interview, here is a text version:

http://www.npr.org/blogs/health/2012/03/06/148072242/deaths-from-dangerous-gut-bacteria-hit-historic-highs

C. diff endospores are a huge challenge in healthcare due to its nearly ubiquitous and highly virulent nature, and the fact that it is both aerosoled and remains viable for up to 5 months on dry inanimate surfaces ( floors ,walls, ceilings and other surfaces not routinely disinfected and often unaffected by routine cleaning).

Some good reads here:
http://www.initiatives-patientsafety.org/Initiatives4.pdfhttp://www.biomedcentral.com/1471-2334/8/7/

Most Infection Control Professionals recognize that the use of strong oxidizers such as chlorine bleach (with sufficient exposure time) suggests is effective on bacterial endospores. Patient isolation, contact precautions, hand hygiene and environmental cleaning should all be adjusted. Hand washing and cleaning in particular because alcohols and quats are not effective against endospores.

As a commercial entity we, of course, feel that the addition of continuously self-cleaning coatings on noncritical surfaces is an appropriate adjunct to more intense hand hygiene protocols and improved temporal cleaning. As a recent technology in this arena, we do not as yet have in vivo studies to show a direct corollary between continuous, low level but safe, microbial photooxidation on surfaces and reduced HAIs, However, we feel our logic is compelling and point to our independent lab tests regarding C. diff endospore deactivation.

http://www.oxititan.com/lab_tests/C._diff_spores_test.pdf

ATP Meters, Again!

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Just in the interest of corroborating my earlier statements concerning the inaccuracy of ATP meters in measuring microbial contamination, there is this from the INFECTION CONTROL JOURNAL, written by Ecolab, a major player in healthcare hygiene:

Ecolab: The measurement of ATP by a bioluminescence reaction has been successfully used in the food industry as an alternative method of monitoring environmental contamination for many years. Within the healthcare industry, the use of ATP as an educational and training tool may have some merit because there is some relationship between RLU readings and environmental cleanliness. However, the use of ATP as a hygiene audit tool is not recommended because the relationship between RLU and environmental cleanliness it is not directly equivalent to microbial monitoring, as both living and recently killed organisms “spill” ATP on surfaces at various rates. Consequently, there is no known correlation between ATP level and numbers of microorganisms, and therefore potential pathogens, present on a surface. Additionally, ATP is not produced in certain microbes, most notably viruses, and ATP-based systems will not detect the presence of these organisms on a surface. A study conducted by Ecolab, presented at APIC 2009, demonstrated that used, but laundered, microfiber cloths may give a false positive reading for ATP as evidenced high RLU readings with no viable bacteria present. Finally, because there are significant differences in the sensitivity and reproducibility of results of ATP systems offered by different manufacturers, its application within the healthcare environment should be approached with caution and awareness of the limitations of the system.

Honey Badger Noroviruses

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Honey Badger Noroviruses
Some stats are out from surveys of hospital infection outbreaks the last two years show 18.2 % were attributed to noroviruses, according to a recent survey published in the AJIC. Noroviruses also accounted for 65% of ward closures in US hospitals surveyed.
Just four pathogenic organisms caused nearly 60% of all outbreaks:
17.5% were Staph. Aureus, 13.7% due to Acinetobacter and 10.3% were Clostridium difficile outbreaks.
There were an average of 10.1 cases in each of the outbreaks, and the outbreaks lasted over 58 days. These outbreaks resulted in unit closures causing an average of 16.7 bed closures for 8.3 days. Big dollars.
Good news, OxiTitan kills these organisms ( see our independent lab results on RNA type virus reduction on our website). What are we waiting for? Obviously normal hand hygiene and environmental services are not getting the job done. We need all hands on deck, and a persistent, continuously self-cleaning surface may help in driving down the exposure and cross contamination of this pathogens.

From the American Journal of Infection Control:
Frequency of outbreak investigations in US hospitals: Results of a national survey of infection preventionists

http://www.ajicjournal.org/article/S0196-6553(11)01210-7/fulltext

UV Disinfection In Hospitals

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Here is an article on the use of UV lighting for disinfection and some comments on it.

http://hpac.com/departments/design-solutions/oklahoma-ultraviolet-germicidal-irradiation-0212/#.T1JUZ_aIJoA.mailto

Oklahoma Hospital Takes Ultraviolet Germicidal Irradiation to the… hpac.com
Muskogee Community Hospital, a rural, 45-bed hospital in Muskogee, Okla., may seem to be an unlikely place for ultraviolet germicidal irradiation (UVGI) to take an evolutionary leap. However, the unassuming, 2-year-old,…

1 day ago


There are though a couple of important points to consider in the reading the article. First is an inaccurate statement concerning the upcoming Medicare HAC penalty. It is one percent (1%) not the ten percent (10%) stated. As Medicare dollars are a huge component of hospital income, this is still a significant figure but the number is wrong.
Secondly, the conclusions made concerning reduction of health care acquired conditions are questionable in this particular case as the HAC information supplied only addresses two actual infections in the comparative data, both catheter related. The remaining 6 HACs, such as falls and trauma and air embolisms, would not be affected by UV disinfection. The lowered HAC rate is to be applauded, but the data does not necessarily point to the UV-C in surgical suites as the causative factor.
That said, we are strong believers in the germicidal effects of UV light and have studied it extensively as it is an energy source ( along with visible light) for our light powered antimicrobial coating. However, UV, and in particular UV- C, has a few flaws. This subject can be followed in peer reviewed studies such as that by Donskey, Cadnum et al here. More research is needed and is being conducting to accurately assess the reduction of HAIs by the use of UV light sources

http://www.biomedcentral.com/1471-2334/10/197

One critical issue not discussed is the destructive power of UV light and particularly UV-C on virtually all surfaces in a room. The costs of accelerated ‘weathering’ of capital goods in a surgical suite could be immense. Equipping a typical operating room costs from about $1/2 million for general operating on up toward $2 million for a partially automated endoscopic surgery room. Let’s be clear: UV light, whether from sunlight or artificial UV lighting, degrades plastics, textiles, paints and coatings. Yes, just about every surface other than uncoated metals in an operating room. Also, care must be taken that the artificial UV systems do not produce in the UVV range, generating harmful ozone.
As it is destructive to microorganisms and human tissue, UV is likewise breaking down the exposed surfaces of any products made of natural and synthetic polymers. Just as we need sunscreen to protect our skin from UV burn, many surfaces need this protection as well, and it is why UV inhibitors are used in products to be in sunlight and why UV is used to rapidly simulate years of sun exposure.
Since most products used in operating rooms are not engineered to be continuously exposed to UV, protecting that equipment is important, and fortunately, possible.
The use of OxiTitan™ is suitable both as a stand-alone antimicrobial in normal lighting, and also is complimentary to UV-C use. OxiTitan™ is activated by both UV and visible light and, as demonstrated in research literature, coated surfaces would be more rapidly disinfected than by UV-C alone. Additionally, OxiTitan™ is a highly effective UV absorber and works as a ‘sunscreen’ across the entire destructive UV wavelength range. OxiTitan can be easily applied to virtually any substrate to be exposed to UV, and will both accelerate the bio-burden reduction and protect the substrate from accelerated degradation.

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