Believe it or not, there’s a war being waged all around us – every day – that we don’t see. For the most part, the “balance of power” is maintained and we are at peace. However, with the simple shake of a hand, or the opening of a door, that balance of power can shift with the war potentially becoming very personal. The war we are referring is against germs – all kinds of germs that surround us every day. Most of us have come to terms with this and live normal, healthy lives.
But what you may not know is that the battleground has been evolving gradually and the balance of power has shifted. The germs with which we have had a “relative détente” have been mutating below our radar screen and are now in position to literally threaten our lives. Today, what were once pathogens over which we had control have become resistant to our antibiotics and become deadly MRSA (“Methicillin-resistant Staphylococcus aureus“) or VRE (“Vancomycin-resistant enterococci “), for instance. Outside the body, similar mutations are occurring and those germs we dealt with on our hands and surfaces are now evolving with the ability to survive our once-effective cleaning and disinfecting protocols.
Because the situation described above is such a significant issue, the White House has issued a national action plan to slow the emergence of resistant bacteria, prevent associated infections and pursue innovative solutions to address this issue.
The Disinfection ‘Rollercoaster’
The disinfection practices currently used today are limited by the technology they employ. Specifically, even if you assume the labor to clean and disinfect a surface is ideal, the products really are only effective while they are wet. In other words, they are useful only for a few minutes, at most. Once dry, the cycle of contamination resumes, until the next disinfection event. The aforementioned describes the typical intermittent cleaning paradigm that characterizes all of our current cleaning/disinfecting behavior. As Figure 1 below indicates, there are gaps of exposure to both dirt buildup and germs.
When we clean, we also typically enjoy the highest levels of disinfection. However, just because it is clean, it does not ensure it is disinfected. Cleaning and disinfecting are two very different activities. Just because it looks clean, that does not mean it is disinfected!
Between disinfection events, microbial contamination increases and one’s risk of infection grows quickly during cleaning/disinfecting intervals. Currently, one’s only option to increase the sanitary condition of surfaces is to clean/disinfect more frequently. This solution is not only logistically impractical and cost-prohibitive, but the improvement to overall hygiene is still only temporary. More of the same is just not the answer.
Antimicrobial Nanotechnology Provides a Quantitatively-Superior Solution
The optimal solution to the “disinfection rollercoaster” is to use/develop a technological solution that offers persistent efficacy. The harnessing of molecular technology to coat and protect surfaces from re-contamination for extended periods of time is available in a High Performance Bonded Quaternary Ammonium Compound (“HPBQAC”). This newly available (and field-tested) technological solution re-purposes well-understood “quat” molecules with an aggressive bonding capability which, potentially attached to an incredibly broad spectrum of substrates, provides a protective “barrier” that inhibits the colonization of micro-organisms between disinfection events. See Figure 2.
The HPBQAC is a water-based, non-toxic, and long-lasting antimicrobial technology-based solution that forms a bacteriostatic barrier on surfaces to which it is applied, providing a long-lasting defense against a broad spectrum of microbes.
This new tech-based solution is vastly different from other products available in the market today because no other antimicrobial technology provides the persistent efficacy against a wide range of pathogens and it is a non-toxic, non-corrosive, water-based formula that has proven efficacy for up to 30 days.
It is important to note that this type of HPBQAC was designed specifically for medical facilities as a product to use “in addition to,” as opposed to a replacement for current best practices. This allows facilities to maintain cleaning regimens they are comfortable with and augment their efforts by adding a protective barrier that will keep surfaces “cleaner longer” (i.e., free from germs).
The best and longest-lasting results achieved with this HPBQAC are observed when the product is applied to clean, dry surfaces. In this manner, the product can augment and maintain the germ-free condition achieved immediately after cleaning for an extended period of time, by disallowing the re-colonization of germs on cleaned and protected surfaces.
It is also important to note that by being a Ready-To-Use (“RTU”), water-based formula that requires no mixing, its toxicity is very low (equivalent to Vitamin C) and will not damage surfaces to which it is applied such as mattresses, fabrics or equipment. Being RTU also relieves, for example, a maintenance staff from making judgments about mixing various ingredients, or other complications that can arise if a concentrate is mixed with contaminated water.
Test and Evaluation (“T and E”) Lead the Way:
It is well-recognized in both governmental and commercial arenas that test and evaluation results are paramount in determining the efficacy and effectiveness of a proposed solution. In that vein, we are pleased to describe actual studies that elucidate how this simple-to-use, yet effective HPBQAC solution fared in real-world environments for the reader to appreciate this technologically advanced and environmentally friendly solution to a well-known problem:
In the summer of 2015, in recognition of the persistent and growing challenge presented by Healthcare Associated Infections (“HAIs”) that plagued the healthcare industry, a major New Jersey Hospital undertook the challenge of quantifying the impact of a novel antimicrobial technology.
This study was performed within the (non-surgical) Intensive Care Unit (“ICU”). Several locations within the ICU were benchmarked before treatment, and then re-evaluated at 8-hour / 7-day intervals across a total of 10 weeks. Samples were cultured for total bacteria CFU (“Colony Forming Units”) and compared with non-treated, control locations. The product was applied both by trigger spray and via fogger, and was used in addition to existing hospital and ICU disinfection protocols. This test was conducted with a high degree of clinical rigor, tracking chain-of-custody of all data with independent, third-party lab recording and evaluation of results. See Figure 3 (a) and (b) below:
The solution assessed in this study was found to have demonstrated statistically significant efficacy and persistence across the 10-week period of the study in reducing the total number of pathogens (TPC) on surfaces within the ICU.
Airport Study – Major International Airport in Texas
This particular airport had long recognized the high volumes of traffic through their facility and, in particular, the impact of that volume of people on the conditions in their restrooms. Odor was also a persistent reminder of the adverse environmental conditions. Their best efforts to clean and sanitize were felt to be insufficient to adequately handle the volume of use and they were in search of new practical solutions.
Purpose of Test:
The rationale of airport officials was to execute a test vs. controlled environment using ATP (Adenosine triphosphate is a common building block in all forms of life and is used as a standard measure of environmental hygiene) to measure the ability of HPBQAC to preserve the hygienic state of restroom surfaces under normal-use conditions. If the HPBQAC technology in the restroom test environment (which is deemed to be one of the most challenging) could deliver a meaningfully quantitative benefit, as compared to current sanitation best practices, the facility would consider the use of this technology on a large-scale basis for the benefit of their customers and staff. See Figure 4 below:
The performance of HPBQAC in these studies showed that not only would the addition of the HPBQAC improve the overall level of sanitation in treated areas, this compound shows that bio-loads are reduced, with evidence supporting continued mitigation of contamination over time, improving the overall sustained hygienic state of treated environments.
There are three (3) primary benefits to the application of a technology like an HPBQAC:
- Ensuring Consistently Hygienic Environment
“Protect the clean”- By applying a protective layer on one’s clean surfaces, you are ensuring they stay cleaner, germ-free longer with no gaps in hygiene (typical cleaning and disinfecting delivers a periodic decrease in pathogen load that decays exponentially until the next cleaning interval).
With an HPBQAC, surfaces are protected following one’s best-practice cleaning interval, as well as stay protected from germs for up to 30 days. What’s more, with each successive application, one’s pathogen loads will continually decrease and be persistently mitigated, creating a sustained hygienic environment that is better for both patients and staff.
- Reducing Costs
Reducing cost is only viable if you can maintain or improve the end result. So how can adding an additional step reduce costs? The persistent efficacy of an HPBQAC cuts down on re-application labor and product costs. If surfaces stay in a higher state of hygiene longer, less disinfectant is required and the associated labor to apply it is reduced.
How much cost and labor might there be if you attempted to deliver a consistently clean result for 30 days with a typical product, when you consider that they only are effective while they are wet (~10 minutes)? Let’s perform the math:
- If a traditional disinfectant only is effective for 10 minutes while it is wet, how many more times does one have to apply it before it compares to a single application of an HPBQAC, if the HPBQAC controls germs for up to 30 days consistently?
- Even if a single application of a typical disinfectant killed germs consistently and worked for 24 hours (which they do not!) and a single application of an HPBQAC lasted for 30 days, the HPBQAC is 30 times more effective – and that does NOT include the labor to apply the product.
- Takeaway: Traditional disinfectants can’t provide the persistent efficacy that an HPBQAC does by providing its antimicrobial nanotechnology barrier.
So, not only is it impractical to apply other products with the incremental frequency required to deliver a more consistent clean state, it quickly becomes cost-inefficient. Plus, there is no comparison when you look at the benefit of persistently hygienic surfaces. No other tech-based solution can deliver this kind of assurance and protection from the impact of germs. An HPBQAC delivers a superior result with a single application than virtually all competitive products do even with multiple repeated applications – while saving on costs and labor. See References 1-4 for more information about disinfection technologies.
- Staff Health, Well-being and Absenteeism
What is the cost of absenteeism? What is the impact to your cost of healthcare? What is the burden of employees’ absence on the remaining healthy employees? Using an HPBQAC on surfaces mitigates germ transmission, protecting your most valuable asset: personnel.
We undertook to explain in simple language how all disinfection is not created equally. Take time to understand, in a systematic way, with robust Tand E, how and why a certain solution may be preferred over others.
Gasch, A., ed., “Hospitals Warring With Microbes Have a Powerful New Weapon!”, Medical Strategic Planning, Inc., 2018. See: https://www.medsp.com/publications.html
Poster Session (University of Arizona), “Estimating the effect of a unique hand sanitizer on norovirus infection risk” –at The 6th Food and Environmental Virology conference (FEV), October 7-10, 2018.
Escudero-Abarca, B., Goulter, R. and Jaykus, L. ( Department of Food, Bioprocessing, and Nutritional Sciences, North Carolina State University), “Evaluation of a hand sanitizer having evidence of residual activity against human norovirus” See: https://iafp.confex.com/iafp/2018/meetingapp.cgi/Paper/17992
University of Arizona, “Comparative norovirus infection risk reductions for a residual and non-residual hand sanitizer”, Am J Infect Control.2019 Oct 29. See: https://www.sciencedirect.com/science/article/abs/pii/S0196655319308466