Disinfection of Virtual Reality Devices in Health Care Settings: In Vitro Assessment and Survey Study.

BACKGROUND: Virtual reality (VR) devices are increasingly used in health care settings. The use among patients has the potential to unintentionally transmit pathogens between patients and hospital staff. No standard operating procedure for disinfection exists to ensure safe use between patients. OBJECTIVE: This study aims to determine the efficacy of disinfectants on VR devices in order to ensure safe use in health care settings. METHODS: Three types of bacteria were inoculated onto porous and nonporous surfaces of 2 VR devices: the Meta Oculus Quest and Meta Oculus Quest 2. Disinfection was performed using either isopropyl alcohol or alcohol-free quaternary ammonium wipes. A quantitative culture was used to assess the adequacy of disinfection. A survey was separately sent out to VR device technicians at other pediatric health care institutes to compare the methods of disinfection and how they were established. RESULTS: Both products achieved adequate disinfection of the treated surfaces; however, a greater log-kill was achieved on nonporous surfaces than on the porous surfaces. Alcohol performed better than quaternary ammonium on porous surfaces. The survey respondents reported a wide variability in disinfection processes with only 1 person reporting an established standard operating procedure. CONCLUSIONS: Disinfection can be achieved through the use of either isopropyl alcohol or quaternary ammonium products. Porous surfaces showed lesser log-kill rates than the nonporous surfaces, indicating that the use of an added barrier may be of benefit and should be a point of future research. Given the variability in the disinfection process across health care systems, a standard operating procedure is proposed.

Nebulizer cleaning and disinfection practices in families with cystic fibrosis: The relationship between attitudes, practice and microbe colonization.

BACKGROUND: The daily burden of health maintenance for children and families with cystic fibrosis (CF) is immense with respect to time and complexity of care. Infection control practices, specifically nebulizer cleaning and disinfection, are a recommended component of home health care for CF families due to colonization of home respiratory equipment with lung pathogens. To better inform education interventions at our center, we were interested in studying how families' views on infection prevention and awareness of CF Foundation infection prevention and control (IP&C) guidelines correlate with actual home nebulizer care and the presence of microorganisms on their nebulizers. METHODS: Twenty families who have children with CF were surveyed to better understand attitudes toward infection prevention, awareness of CFF IP&C guidelines and nebulizer cleaning and disinfection practices in the home. Their nebulizers were also cultured for microbes to correlate recovery with infection control behaviors. RESULTS: A subset of families recognizes the importance of germ avoidance but do not recognize nebulizer cleaning and disinfection as very important for infection control practices. Decreased frequency of disinfection, but not cleaning, was correlated with the recovery of organisms on the nebulizers. CONCLUSIONS: The study questionnaire results identify a gap between recognizing the importance of infection prevention and consistently implementing CFF IP&C guidelines in the home. This demonstrates the need at our center for new educational interventions to promote cleaning and disinfection of home nebulizers after each use as recommended by the CFF.

Epidemiology and management of infectious diseases in international adoptees.

International adoptees represent a group of children with unique health care needs. Data from published studies, along with the recent experience of the Yale International Adoption Clinic, suggest that the risk of serious infections in adoptees is low, although infections associated with institutionalization still occur commonly. Interpretation of these data must be undertaken with caution, however, since many, if not most, international adoptees are not evaluated in specialty clinics. Thus, prospective studies designed to minimize selection and referral bias are needed in order to accurately define the risk of infectious and noninfectious diseases in all international adoptees.