During its cleaning processes, B+N Referencia Zrt. collects information on changes in the microbial community of an area over time. Dr. Ágnes Ősz, biologist and Zsuzsanna Nagy, Director of Hygiene, told imeonle.hu how this could revolutionise the cleaning of healthcare institutions.
Testing microorganisms for effective intervention
“The methods we use allow us to optimise cleaning processes by monitoring the microbial community in a given area over time. Quantitative detection of microorganisms can be done in different ways. There are biochemical (adenosine triphosphate, ATP measurement) and culture methods, or nucleic acid analysis by qPCR and metagenome sequencing.” – tells Dr. Ágnes Ősz, biologist and senior researcher at B+N Reference Zrt.
We also learn from Zsuzsanna Nagy, Director of the Hygiene, that the company is currently conducting pilot studies in a designated ward of a hospital. Based on samples taken from wipes and mops the microbiological community in the area is continuously monitored. This allows detection of pathogens and immediate intervention like changing chemicals, increasing the concentration of the chemical, or using the in-house developed UV disinfection equipment.
The benefits of next-generation sequencing
“Continuously monitoring the hygiene of a hospital is a major challenge for the institutions. Genomic sequencing analysis during the monitoring provides an opportunity to analyse many species simultaneously. While traditional (Sanger) sequencing could only target a single DNA sequence, next-generation sequencing can handle many samples at once and can detect a wast variety of species within a single sample. This allows us to gain more information about the diversity and taxonomic composition of the community. We can even use this method to identify new species or viruses.” – Dr. Ágnes Ősz outlines adding: “The difficulties of metagenome sequencing are the more complex processing due to a large amount of data and a complex laboratory preparation.”
Another molecular method is the so-called qPCR (quantitative PCR), which provides faster results, but only allows the tracking of marker species. With the right sampling, logistics and data analysis system, samples can be processed within 24-48 hours, depending on the test.
Other methods are also being tested
Two additional methods are being tested as part of the hygiene analysis system. One is the ATP hygiene wand, which is widely used in food hygiene but is also used in hospitals to check the cleanliness of surfaces. ATP is found in all living organisms and its quantity can be used to infer the number of microorganisms. The quantity of ATP is monitored to assess the quality of cleaning and to establish a baseline of hygiene for the area. In case of outstanding quantities, comprehensive hygiene measurement (testing for common pathogens by qPCR or metagenome sequencing) and additional disinfection is carried out if justified.
Also in food hygiene, a device called Microtester is widely used to detect the total bacterial count. Like the traditional culture method, it detects live micro-organisms. Since it measures microbial growth based on the oxygen depletion of the culture, it is faster and more accurate in detection, up to 1 cell/ml in 1-12 hours on site. The Microtester is a patented and accredited method that can be developed for automated measurement.
“We also research if resistance develops to different disinfectants. This is of particular importance because as antibiotic resistance increases, bacteria can become resistant to the active ingredient, or even the carrier of surface treatment products.” – Zsuzsanna Nagy points out. According to the expert, the chemical industry will not be able to change the composition of these agents so quickly that they cannot be tracked down by pathogens. That is why the team at B+N also pays close attention to avoiding the development of resistance to disinfectants. If this does happen, the product is immediately replaced.
Alarm system for the safety of patients and healthcare workers
B+N intends to set up an IT platform and an alert system in the near future to notify regional managers immediately if there is a risk of infection. The aim is to inform the hygienist of the institution concerned in good time of the risk of infection.
“We are building a complex system from the combination of methods we use, which allows us to optimise cleaning processes based on the microbial community in a given area over time. Ultimately, our goal is to increase the safety of patients and healthcare workers.” – stresses Dr. Ősz.