Washing contaminated hospital bedsheets in a commercial washing machine with industrial detergent at high disinfecting temperatures failed to remove all traces of Clostridium difficile (C. difficile), a bacteria that causes infectious diarrhoea, suggesting that linens could be a source of infection among patients and even other hospitals, according to a study published.
"The findings of this study may explain some sporadic outbreaks of C. difficile infections in hospitals from unknown sources, however, further research is required in order to establish the true burden of hospital bedsheets in such outbreaks," said Katie Laird, PhD, Head of the Infectious Disease Research Group, School of Pharmacy, De Montfort University, Leicester, United Kingdom and lead author of the study. "Future research will assess the parameters required to remove C. difficile spores from textiles during the laundry process."
Researchers inoculated swatches of cotton sheets with C. difficile. The swatches were then laundered with sterile uncontaminated pieces of fabric using one of two different methods — either in a simulated industrial washing cycle using a washer extractor with and without detergent or naturally contaminated linens from the beds of patients with C. difficile infection were put through a full commercial laundry where they were washed in a washer extractor (infected linen wash) with industrial detergent, pressed, dried, and finished according to current the National Health Service in the United Kingdom’s healthcare laundry policy (Health Technical Memorandum 01-04 Decontamination of Linen for Health and Social Care (2016).  Researchers measured the levels of contamination before and after washing.
Both the simulated and the commercial laundering via a washer extractor process failed to meet microbiological standards of containing no disease-causing bacteria, the study found. The full process reduced C. difficile spore count by only 40 percent, and this process resulted in bacteria from the contaminated sheets being transferred to the uncontaminated sheets after washing.
Researchers concluded that thermal disinfection conditions currently required by the UK National Health System are inadequate for the decontamination of C. difficile spores. There may be potential to spread C. difficile back into the hospital environment as linens could be a source for outbreaks at other healthcare facilities through businesses that collect, launder and redistribute rented linens to multiple hospitals and care facilities, as is the case at NHS facilities.
SHEA https://tinyurl.com/yxh9aa8j

A new study by biomedical engineering researchers at the University of Arkansas could significantly improve methods for detecting and diagnosing congenital heart disease in infants and small children.
The researchers, collaborating with cardiologists at Arkansas Children’s Hospital in Little Rock, tested a new ultrasound technology called vector flow imaging for the first time on paediatric patients to create detailed images of the internal structure and blood flow of the babies’ hearts. The images can be still or moving, and can be taken from any angle.
“Vector flow imaging technology is not yet possible in adults, but we have demonstrated that it is feasible in paediatric patients,” said Morten Jensen, associate professor of biomedical engineering at the U of A. “Our group demonstrated that this commercially available technology can be used as a bedside imaging method, providing advanced detail of blood flow patterns within cardiac chambers, across valves and in the great arteries.”
Roughly 1 percent of all babies are born with some type of congenital heart defect. Fortunately, the majority of these defects will never have any significant impact as the child grows into adulthood and old age. Paediatric cardiologists detect and diagnose congenital heart disease through multiple processes, including echocardiography. This imaging method is based on ultrasound and assesses the overall health of the heart, including valves and muscle contraction.
Although ultrasound provides essential information about cardiac valve function in babies and small children, it has critical limitations. It cannot accurately obtain details of blood flow within the heart. This is due primarily to the inability to align the ultrasound beam with blood-flow direction.
Using a BK5000 Ultrasound machine with built-in vector flow imaging, the researchers performed successful tests on two pigs, one with normal cardiac anatomy and one with congenital heart disease due to a narrow pulmonary valve and a hole within the heart. The researchers then compared the vector flow images to direct examination of the pigs’ hearts. 
The researchers subsequently used the imaging system to take cardiac images of two three-month-old babies, one with a healthy, structurally normal heart and one with congenital heart disease because of an abnormally narrow aorta. With both patients, the technology enabled total transthoracic imaging of tissue and blood flow at a depth of 6.5 centimetres. Abnormal flow and detailed cardiac anomalies were clearly observed in the patient with congenital heart disease.
All procedures, both animal and human, were performed at Arkansas Children’s Hospital with assistance from Dr. Elijah Bolin, pediatric cardiologist at UAMS.
“We are still getting used to having this great, new information readily available, and we’re excited about the future in both research and direct clinical advancements,” Bolin said.
“This technology will increase our ability to provide the best possible bedside diagnosis and greatly enhances our understanding of what is happening in hearts with complex abnormalities,” Stanford’s Collins said.
University of Arkansas https://tinyurl.com/y47ac996

Infants born to women exposed to high levels of air pollution in the week before delivery are more likely to be admitted to a newborn intensive care unit (NICU), suggests an analysis by researchers at the National Institutes of Health. Depending on the type of pollution, chances for NICU admission increased from about 4% to as much as 147%, compared to infants whose mothers did not encounter high levels of air pollution during the week before delivery. The study was led by Pauline Mendola, Ph.D., of the Epidemiology Branch at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development.
 “Short-term exposure to most types of air pollutants may increase the risk for NICU admission,” Dr. Mendola said. “If our findings are confirmed, they suggest that pregnant women may want to consider limiting their time outdoors when air quality advisories indicate unhealthy conditions.”
Previous studies have linked elevated levels of certain kinds of air pollutants to higher risks for gestational diabetes and preeclampsia, a blood pressure disorder of pregnancy. Earlier research also has shown that infants born to women exposed to high levels of air pollutants are at risk for preterm birth, of being small for their gestational age at birth and of growing more slowly than normal in the uterus. Given these associations, the study authors sought to determine whether prenatal exposure to air pollution might increase the chance for NICU admission.
Researchers analysed data from the Consortium on Safe Labor, which compiled information on more than 223,000 births at 12 clinical sites in the United States from 2002 to 2008. They linked records from more than 27,000 NICU admissions to data modified from the Community Multiscale Air Quality Modeling System, which estimates environmental pollution concentrations in the United States. Researchers matched air quality data in the area where each birth occurred to the week before delivery, the day before delivery and the day of delivery. They then compared these time intervals to air quality data two weeks before delivery and two weeks after delivery to identify risk of NICU admission associated with pollution levels.
The researchers also examined the odds of NICU admission associated with high concentrations of particulate matter (pollution particles) less than 2.5 microns in diameter (PM2.5). These types of particles originate from various sources, among them diesel and petrol engines, power plants, landfills, sewage facilities and industrial processes. Exposure to high concentrations of organic compounds in the air was associated with a 147% increase in risk of NICU admission. Elemental carbon and ammonium ions presented similar increases in risk (35% and 37%, respectively), while exposure to nitrate compounds was associated with a 16% higher risk of NICU admission.
Chances of NICU admission increased significantly with exposures to traffic-related pollutants on the day before and the day of delivery, compared to the week before delivery: 4% and 3%, respectively, for an approximately 300 parts per million (ppm) increase in carbon monoxide; 13% and 9% for an approximately 26 ppm increase in nitrogen dioxide; and 6% and 3% for an approximately 3 ppm increase in sulphur dioxide.
Researchers do not know why exposure to air pollution might increase the chances for NICU admission. They theorize, however, that pollutants increase inflammation, leading to impaired blood vessel growth, particularly in the placenta, which supplies oxygen and nutrients to the developing fetus.
Eunice Kennedy Shriver National Institute of Child Health and Human Developmenthttps://tinyurl.com/y3flll6e