Cleaning schedule

I develop maintenance program for my clients and the question that comes up most often is:
“How often should I clean this or that?”

clean

How often should I clean this?

Here is a non-exhaustive list of 16 surfaces to clean regularly at home.

Item Frequency Tips
1. Cellular phone

Daily Wipe with a microfiber glass cloth to remove any greasy substances and germs
2. Kitchen Counter

Daily Use a mild all purpose cleaner. When using a disinfectant cleaner, rinse the surface.
3. Dishwasher

Monthly Use specially designed capsules or a little bit of baking soda and vinegar and the trick is done.
4. Refrigerator

Quarterly To avoid the appearance of mold and other undesirable contents, empty and clean the shelves and containers.
5. Kitchen floor

Weekly Use a broom after each meal and a good damp mopping every week.
6. Carpets

Weekly Vacuuming carpets every week will even reduce allergies. Remove the dog and the baby before to do so!
7. Furniture

Monthly Vacuum furniture and fabrics every month and steam clean annually
8. Remote control or joystick

Weekly Remove the batteries, clean the remote control surface by rubbing the buttons and gaps.
9. Ceiling fans

Quarterly With an all purpose cleaner, wipe the blades. Do not forget to turn off the fan!
10. Window blinds

Quarterly Dust and clean batten by batten with soapy water and a soft cloth.
11. Toilet

Daily Brush daily and thoroughly clean once a week.
12. Towels

After some use After the shower or the bath, hang to dry and use a few times (3 or 4 times), then machine wash. Note: If you have teenagers, this thing may not work!
13. Shower curtain

Monthly Spray a bathroom cleaner to remove residual accumulated soaps and limescale.
14. Bed linen

Weekly Wash in warm water to remove bacteria and mites. Avoid eating in your bed!
15. Mattress

Biannual Vacuum the mattress twice a year to remove dead skin cells and mites.
16. Air filter

Monthly Changing air filters every month or as recommended by the manufacturer contributes to a healthy environment.

We have the tools to clean

At Lalema, we serve a large industrial and institutional clientele with an online catalog of more than 18000 products ! Come and have a look!

www.lalema.com

 

Source :

inspired from http://www.webmd.com/a-to-z-guides/ss/slideshow-how-often-clean-this.

Photos are owned by me or from various talended photographs via unsplash.com

Clean this or that? How often?

I develop maintenance program for my clients and the question that comes up most often is:
“How often should I clean this or that?”

clean

How often should I clean this?

Here is a non-exhaustive list of 16 surfaces to clean regularly at home.

Item Frequency Tips
1. Cellular phone

Daily Wipe with a microfiber glass cloth to remove any greasy substances and germs
2. Kitchen Counter

Daily Use a mild all purpose cleaner. When using a disinfectant cleaner, rinse the surface.
3. Dishwasher

Monthly Use specially designed capsules or a little bit of baking soda and vinegar and the trick is done.
4. Refrigerator

Quarterly To avoid the appearance of mold and other undesirable contents, empty and clean the shelves and containers.
5. Kitchen floor

Weekly Use a broom after each meal and a good damp mopping every week.
6. Carpets

Weekly Vacuuming carpets every week will even reduce allergies. Remove the dog and the baby before to do so!
7. Furniture

Monthly Vacuum furniture and fabrics every month and steam clean annually
8. Remote control or joystick

Weekly Remove the batteries, clean the remote control surface by rubbing the buttons and gaps.
9. Ceiling fans

Quarterly With an all purpose cleaner, wipe the blades. Do not forget to turn off the fan!
10. Window blinds

Quarterly Dust and clean batten by batten with soapy water and a soft cloth.
11. Toilet

Daily Brush daily and thoroughly clean once a week.
12. Towels

After some use After the shower or the bath, hang to dry and use a few times (3 or 4 times), then machine wash. Note: If you have teenagers, this thing may not work!
13. Shower curtain

Monthly Spray a bathroom cleaner to remove residual accumulated soaps and limescale.
14. Bed linen

Weekly Wash in warm water to remove bacteria and mites. Avoid eating in your bed!
15. Mattress

Biannual Vacuum the mattress twice a year to remove dead skin cells and mites.
16. Air filter

Monthly Changing air filters every month or as recommended by the manufacturer contributes to a healthy environment.

We have the tools to clean

At Lalema, we serve a large industrial and institutional clientele with an online catalog of more than 18000 products ! Come and have a look!

www.lalema.com

Source :

inspired from http://www.webmd.com/a-to-z-guides/ss/slideshow-how-often-clean-this.

Photos are owned by me or from various talended photographs via unsplash.com

Are technological devices a source of hospital-acquired infections?

Source: Air Force Medical Service

You’ve already seen on this blog just how dirty cellphones can get, but did you know that cellphones and other electronics such as tablets and laptops can also cause contamination in a healthcare setting, potentially making them a source of HAIs? Hospital staff use technology throughout their workday, whether it be to enter patient information in a computer or for personal use on their breaks. If they don’t wash their hands before and after using the device, it can become contaminated causing those workers to spread the bacteria all throughout the hospital.

According to Kelly M. Pyrek (2019),

“A casual online poll of ICT readers shows that 83 percent of survey respondents use their personal mobile technology devices within the hospital, and just 68 percent said they clean/decontaminate these devices regularly. Fifty-seven percent of respondents indicated they use a hospital-issued mobile technology device in the course of their workday; 56 percent report cleaning the device themselves, while 7 percent let someone else clean the device.”

Kelly M. Pyrek, Infection Control Today, 2019

Many hospitals are now realizing that technological devices are a potential source of the spread of infection within a healthcare setting and some of them are beginning to implement protocols regarding the use and disinfection of electronics.

That being said, the cleaning and monitoring of technological devices can be complicated. As James Davis, MSN, RN, explains to Infection Control Today (2019), tech companies such as Apple only tell people to wipe down their devices with a damp cloth. However, that recommendation does not take into consideration the use of devices in a healthcare setting, where bacteria and infection are everywhere.

Some recommendations that Davis and Shivek, Phd, senior product engineer, give include:

  • Always washing your hands before and after using your device
  • Placing a layer between the device and the environment is key
    • Phone covers are becoming increasingly popular, however must be replaced frequently
    • Placing the mobile device in a ziploc bag is another option, especially if it’s being brought into an isolation room
  • No matter what, always wipe down the device before and after using it. Even if it was in ziploc bag or had a cover over it, wiping your device is key to ensuring that harmful bacteria are eliminated.

The cleaning and monitoring of technological devices is a daunting task for healthcare facilities, especially if it is an employee’s personal device. Davis (2019) stresses that because of this, employees should be personally responsible for the cleaning and disinfecting of their mobile devices. Although a complicated task, the recommendations provided by Infection Control Today allow us to understand how to better prevent the contamination of our mobile technology, which may in turn help prevent the spread of infection.

Sources:

https://www.infectioncontroltoday.com/transmission-prevention/contaminated-mobile-technology-making-it-part-your-institutions-cleaning-and

https://www.infectioncontroltoday.com/transmission-prevention/mobile-technology-disinfection-contaminated-devices-pose-threat-patients

The Prevention of Waterborne Hospital-Acquired Infections

Source: Flickr

On this blog, we have already learned that healthcare-associated infections can be spread through the water and plumbing systems of hospitals. There are many possible reservoirs for the growth and spread of harmful pathogens; including potable water, sinks, faucets, showers, bathtubs, toilets, etc. It is therefore crucial that healthcare facilities develop water-management programs, in order to reduce the risk of infection.

In a recent article from Infection Control Today 2019, it is stated that:

“facilities must develop and adhere to policies and procedures that inhibit microbial growth in building water systems that reduce the risk of growth and the spread of Legionella and other opportunistic pathogens in water.”

Kelly M. Pyrek, Infection Control Today, 2019

Infection Control Today (2019) discusses many different policies that should be adopted by healthcare facilities.

In terms of potable tap water and hospital water systems, recommendations include:

  • Hot water temperatures at the outlet should be at the highest temperature allowable, preferably >51C.
  • In the case of water disruptions, signs should be posted and the drinking of tap water should be prohibited.
  • Standards for potable water must be maintained (<1 coliform bacterium/100 mL).
  • Equipment should be rinsed first with either sterile water, filtered water or tap water and an alcohol rinse should follow.
  • Periodic monitoring of water samples should be done in order to test for Legionella growth.

In terms of sinks in hospitals, recommendations include:

  • The use of separate sinks for handwashing and disposal of contaminated fluids.
  • The decontamination or elimination of sinks if epidemic spread of gram-negative bacteria via sinks is suspected.

In terms of showers in hospitals, recommendations include:

  • Prohibit the use of showers in neutropenic patients.
  • Control Legionella colonization of potable water.

The article discusses many more recommendations for other water-related reservoirs that are potential sources of infection. For more information on these other reservoirs, please refer to Infection Control Today’s website.

In addition to this, it is recommended by Tim Keane, a consultant with Philadelphia-based Legionella Risk Management Inc, that healthcare facilities hire engineers that are “building water system expert(s) who specialize in risk management for building water systems” (Infection Control, 2019). This will provide healthcare facilities with the expertise needed to develop a concise water-management program.

Preventing the spread of infection is no easy task, especially when there are constantly new sources of HAIs in healthcare facilities. That being said, with the help of very specific programs and procedures, such as the recommendations described above, it is possible to reduce the risk of infection and the spread of bacteria.

Source:

Infection Control Today. Vol. 23. No. 3. March 2019.

Hospital Privacy Curtains: A Harbour for Infectious Agents

Source: Wikimedia Commons

On this blog, we have already reviewed many of the sources of a major health problem: hospital-acquired infections (HAIs). And yet, every day, researchers seem to discover new sources of HAIs. One of the latest discoveries is that hospital privacy curtains in hospital rooms are extremely contaminated with pathogens. A study conducted in Winnipeg, Canada, revealed that freshly hung hospital curtains with minimal contamination became more contaminated each day that they hung in the hospital rooms. Furthermore, after 14 days of being in the room, 87.5% of the curtains were tested positive for methicillin-resistant Staphylococcus aureus (MRSA).

Kevin Shek (Bsc), the leader of the study on hospital privacy curtains carrying pathogens, writes,

“We know that privacy curtains pose a high risk for cross-contamination because they are frequently touched but infrequently changed.”

Kevin Shek (2018)

Healthcare facilities have been placing a great amount of effort in reducing the risk of HAIs in terms of hand-washing and the cleaning of equipment and high-touch surfaces, however, other things such as curtains, mattresses, and bedsheets have often been overlooked. A survey that was conducted to determine how hospital privacy curtains are cleaned/changed revealed frightening results. Only about half of the hospitals had a written policy which specified how often the curtains needed to be changed. 37% of respondents answered that hospital curtains were changed only when visibly soiled. 13% of respondents answered that the curtains were changed only once per year. Considering the results obtained from the Winnipeg hospital study, where curtains became increasingly more contaminated with each day that they remain in a patient’s room, the responses from the survey are alarming.

In terms of controlling the spread of infection, hospitals really need to consider that almost anything in the facility could be contaminated. Hospital cleaning is becoming increasingly complicated, as there are so many places where harmful pathogens can be found. It will be increasingly important that healthcare facilities develop new protocols and policies to prevent HAIs.

Sources:

https://www.infectioncontroltoday.com/transmission-prevention/new-study-says-hospital-privacy-curtains-may-harbor-infectious-pathogens

https://www.infectioncontroltoday.com/transmission-prevention/hospital-privacy-curtains-and-bed-sheets-soft-surface-contamination-and

Hospital floors, yet another source of Hospital-Acquired Infections

The list of potential areas of contamination in hospitals seems to keep growing, leading us to identify more sources of hospital-acquired infections (HAIs) and making hospital cleaning continuously more complicated. To add to this, researchers are now finding that hospital floors are a significant source of hospital-acquired infections. Every day, hospital and clinic floors are flooded by thousands of people. Shoes soles, wheels from equipment, such as monitors or stretchers and bodily fluids all contribute to the contamination of hospital floors.

It seems so obvious; floors are dirty in general. Hospital floors must be even dirtier. However, as Koganti, et. al. (2016) describes,

“… hospital floors are often heavily contaminated but are not considered an important source for pathogen dissemination because they are rarely touched. However, floors are frequently contacted by objects that are subsequently touched by hands (e.g., shoes, socks, slippers). In addition, it is not uncommon for high-touch objects such as call buttons and blood pressure cuffs to be in contact with the floor.”

(Koganti, et. al. (2016).

In addition to this, shoe soles and wheels on equipment also frequently touch hospital floors. Shoes of healthcare professionals can lead to the spread of infection since these workers are visiting many different patient rooms. Similarly, equipment such as monitors, stretchers or infusion pumps all have wheels which touch the floors of multiple hospital rooms.

Now you might be thinking, ‘but surely hospital floors are routinely cleaned?’ While that is true, researchers are now finding that much of the floor cleaning that is done is relatively ineffective since the bacteria is able to reproduce so quickly. So, what can be done to help reduce the risk of hospital floor contamination?

A good hygiene program for hospital floors, to reduce the risk of contamination

The cleaning and the disinfection of floors are essential elements of an effective hygiene program for hospitals. Regular floor maintenance implies the systematic elimination of hidden bacterias, which can be achieved by using vacuums, mopping and other elimination processes.

A good floor disinfection program consists of using effective disinfectants/detergents and procedures that are notable for reducing the risk of contamination. It is also important that cleaning equipment be properly cleaned and maintained, so that bacteria doesn’t spread when cleaning.

Cleaning hospital floors seems like a daunting task, especially since bacteria has been able to reproduce and spread itself so quickly. Healthcare facilities will need to become more exigent with their floor cleaning programs, if they are going to seriously tackle the threat of hospital-acquired infections.

Source : 
https://www.infectioncontroltoday.com/environmental-hygiene/shoe-sole-and-floor-contamination-new-consideration-environmental-hygiene

How to Prevent Cross-Contamination

Our last post discussed how janitors may contribute to the cross-contamination of different environments. As a follow up, this post will discuss different methods for preventing cross-contamination.

Cross-contamination can happen so easily that many people do not even realize it. A simple example would be that a janitor cleans a toilet with a wipe, and then uses that same wipe to clean the bathroom sink. Whichever viruses were present on that toilet have now been transmitted to the sink. This is why it is crucial that organizations develop cleaning programs that will prevent cross-contamination from happening.

Source: Flickr

Steps for preventing cross-contamination

Cleaning and Maintenance Management (CMM) makes three simple recommendations for the prevention of cross-contamination: (1) color code and categorize, (2) upgrade your tools, (3) clean from top to bottom. (2017).

The first recommendation is to color code and categorize. Organization is crucial in preventing cross-contamination. CMM recommends the use of a color-coded system, more specifically, the use of microfibre cloths and mop heads which come in a minimum of four colors: red, green, blue and yellow.
The British Institute of Cleaning Science recommends the following color chart for the cleaning of specific items and rooms:

  • Red: sanitary appliances, restroom floors, toilets, urinals
  • Yellow: restroom surfaces – sinks, towel dispensers, hand dryers, soap dispensers
  • Green: general food and bar cleanup in non-preparatory food areas, such as lunchrooms
  • Blue: areas of low-risk of contamination, such as hallways, offices and classrooms

Furthermore, it is recommended that cleaning tools are kept separate within the janitor’s closet. This is because if these items touch each other in the closet, then it defeats the purpose of having different colors for different areas and does not solve cross-contamination.

The second recommendation is to upgrade your tools. Having the best tools for cleaning will ensure that most of the bacteria is removed. Microfibre cloths and mops are highly recommended, since they are the best material for trapping dirt and bacteria. Once the dirt and bacteria are trapped in the microfibre, the particles will remain trapped in the material.

The third recommendation is to clean from top to bottom. Cleaning from top to bottom allows the cleaner to avoid missing any areas. By starting from the top, any dust or dirt that may fall to the bottom, or the floor, will be picked up afterwards, since the cleaner will then move on to the lower areas.

CMM provides the following methodological approach for top to bottom cleaning:

  • Wipe Down surfaces first. Make sure to wipe down surfaces before applying products.
  • Disinfect second. Spray disinfectant on areas that have been wiped down and let sit for 5-10 minutes before wiping it off.
  • Tackle the floor last. Mopping or vacuuming the floors last will ensure that anything that may have fallen onto it will be picked up.

Preventing cross-contamination may seem like a daunting task, but the steps recommended by CMM definitely help simplify it!

As you have read on this post, microfibre is one of the best cleaning tools that you can use because it has the ability to trap dust and dirt particles, and does not release them. Having microfibre cleaning products will provide you with optimal results in cleaning. Here at Lalema Inc, we offer all types of microfibre products. Feel free to consult our website for more details 🙂

http://www.lalema.com/search?q=microfiber

Source:
https://www.cmmonline.com/articles/preventing-cross-contamination-is-as-easy-as-1-2-3?utm_medium=email&utm_source=cmm&utm_campaign=CM+e-News+Daily&omid=


How Janitors contribute to cross-contamination

Source: Wikimedia Commons

Janitors are responsible for the cleanliness and maintenance of many types of establishments, including hospitals, schools and restaurants. In most places, there are procedures and regulations to be followed in order to achieve optimal cleanliness and, ultimately, prevent the spread of harmful bacteria.

But did you know that janitors can also spread infection through cross-contamination, if there aren’t proper cleaning protocols in place?

According to Infection Control Today (2019),

“Cross-contamination is defined as the spread of germs from one surface or object to another and frequently occurs when performing janitorial tasks.”

Robert Shor, Infection Control Today, 2019

Infection Control Today describes several possible causes of janitorial cross-contamination, which include mop heads, towels, and gloves. While it is known that these sources are associated with the spread of infection, there is one which is often overlooked: the gloves worn by the janitor. While cleaning many different rooms, and even different buildings, the janitor usually keeps the same gloves for the duration of the cleaning. When changing rooms and buildings, he is spreading the bacteria that are on his gloves.

Infection Control Today suggests the following protocol for janitors’ use of gloves:

  • Don gloves before performing cleaning tasks (use gloves that are appropriate for the task being performed).
  • Change gloves in the following situations:
    • When they become soiled, torn or punctured
    • After cleaning areas with high concentrations of germs (restrooms)
    • When going from building to building or floor to floor
    • After cleaning each classroom (room), restrooms, kitchen areas
  • Avoid contaminating your hands when removing gloves by following CDC guidelines.
  • Wash hands and/or use hand sanitizers after janitorial tasks are completed.

Janitors play a very important role when it comes to keeping establishments sanitary and safe. That is why it is crucial to develop protocols to ensure the highest quality of cleaning.

Source: Infection Control Today, Vol. 23, No. 3, March 2019

Handwashing really is important…

February 2019. We have all learned time and time again about the importance of handwashing, and how it can reduce the risk for harmful infections and, ultimately, save lives. Then, along comes Pete Hegseth, co-host of Fox & Friends, with the statement that he has not washed his hands in 10 years. He stated the reason for this as being “germs are not a real thing – I can’t see them, therefore they’re not real.” Whether he was joking or not is still under debate, but one thing is for sure, his statement is far from being correct.

Hegseth’s statement no doubt created a lot of publicity, but many are now concerned that people will be influenced by him in not washing their hands. And they have every right to be.

The Guardian (2019) quotes Professor Val Curtis, from the London School of Hygiene and Tropical Medicine, where she states that:

“Hands are the most important vector of infectious diseases.”

Val Curtis, 2019. Retrieved from the Guardian

She adds to this that not washing your hands or improper handwashing puts everyone at risk, and that it is a moral issue above all. If, for example, you go to the washroom and don’t wash your hands, everything you touch afterwards will be contaminated. Everyone who touches the same surfaces that you did will be touching the bacteria that you have spread, putting them at high risk for infection.

Even though the risks are significant from improper handwashing, many people rarely put in the extra little effort needed in order to reduce these risks. According to Sandoz (2019), 1 in 20 people fail to wash their hands properly after using the washroom. Also, the average time that people take to wash their hands is 7 seconds, which is far below the recommended 20 seconds (Sandoz, 2019).

How to properly wash your hands

So what is considered proper handwashing and how can we achieve it in order to prevent infection? The Centre for Disease Control and Prevention (CDC) provides us with detailed steps in order to maintain ultimate hand hygiene. The steps are as follows:

  1. Wet your hands with clean, running water (warm or cold), turn off the tap and apply soap.
  2. Lather your hands by rubbing them together with soap. Be sure to lather the backs of your hands, between your fingers and under your nails.
  3. Scrub your hands for at least 20 seconds.
  4. Rinse your hands well, under clean, running water.
  5. Dry your hands using a clean towel or air dry them

Proper handwashing is necessary to prevent the spread of infection and to ultimately save lives. It doesn’t take a lot of time or effort to do, and it can make all the difference. So do your part for yourself and society; wash your hands 🙂

Sources:

https://www.theguardian.com/lifeandstyle/shortcuts/2019/feb/12/hands-hadnt-washed-10-years-peter-hegseth

https://www.sandoz.com/stories/access-medical-information/washing-hands-saving-lives-surprising-health-benefits-clean-hands

https://www.thestar.com/entertainment/television/opinion/2019/02/11/fox-news-host-pete-hegseth-shouldve-kept-his-dirty-secret-to-himself.html

https://www.cdc.gov/handwashing/index.html

Candida auris : A new threat ?

Candida auris

After the coming of hospital’s contracted diseases such as C. difficile or MRSA (Methicilin-Resistant Staphylococcus Aureus), another difficult to treat bug seems to emerge. This time, it is a fungus: Candida auris.

This fungus or more precisely this yeast, has first been discovered by scientists in 1996. Then, a first infected human case has been reported in Japan in 2009. 1,2 To this date, Candida auris has been detected in hospitals of more than 20 countries such as the United States of America, England and many Europe countries. The first case in Canada has been reported in 20173.

Candida auris poses a specific threat because of the following characteristics4:

  • Infections by this microorganism have a high mortality rate.
  • The microorganism resists antifungal agents.
  • The microorganism is difficult to identify in clinical microbiology laboratories which results in wrong diagnostic. The identification is important in the choice of antifungal treatment.
  • The microorganism is known for its virulence.
  • The microorganism colonizes surfaces such as catheters used for healthcare.

Among recommended precautions by American and Canadian governments, disinfection of surfaces plays an important part. However, specific disinfectants are to avoid: this is notably the case for quaternary ammonium-based disinfectants which are ineffective5. The following procedure is rather recommended:

« Healthcare facilities that have patients with C. auris infection or colonization should ensure thorough daily and terminal cleaning and disinfection of these patient’s rooms with hospital-grade disinfectant effective against Clostridium difficile spores. »6

Sporicidal sodium hypochlorite-based disinfectant against C. difficile are for example great disinfectants to prevent and control contact transmission of Candida auris. In other words, scientists are only starting to understand and study this recently discovered microorganism. More studies will allow the discovery of effective treatment.

Until that time,in need of sporicidal products against C. Difficile to face Candidaauris new threat? Get our products right now!

References:

 1) Lee WG, Shin JH, Uh Y, Kang MG, Kim SH, Park KH, et al., (2011), First three reported cases of nosocomial fungemia caused by Candida auris. J Clin Microbiol, 49:3139-3142.

2) Satoh K,Makimura K, Hasumi Y, Nishiyama Y, Uchida K, Yamaguchi H., (2009), Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canalof an inpatient in a Japanese hospital. Microbiol Immunol., 53:41-44.

3) Schwartz IS, Hammond GW., (2017), Premier cas de Candida auris multirésistant au Canada. Relevé des maladies transmissibles au Canada., 43(7/8):168-72.

4) Anuradha Chowdhary, Cheshta Sharma et Jacques F. Meis., (2017), Candida auris : A rapidly emerging cause of hospital-acquired multidrug-resistant fungal infections globally, PLoSPathogens, 13(5):e1006290

5) Institut National de Santé Publique du Québec, (Janvier 2018), Mesures de prévention et de contrôle dans les milieux se soins, Comité sur les infections nosocomiales du Québec, 2377 :1-11

6) Relevé des maladies transmissibles au Canada, (juillet 2017), Premier cas de Candida auris déclaré au Canada, Agence de santé publique du Canada, 43-7/8

Will “good” viruses replace antibiotics in the future?

A major health concern for the future

Antibiotics have been around for almost 100 years now, and have proven to be very effective against fighting harmful bacterias. However, during this time, these bacteria had time to evolve and many of them are now becoming “drug-resistant”, meaning that these bacteria have developed a resistance to antibiotics. There are even some bacteria, known as “superbugs”, that have become resistant to nearly every existing antibiotic. If a person is infected with a “superbug”, this means they cannot seek treatment from antibiotics and will have to rely solely on their immune system to fight the disease. This could result in death by diseases that were once treatable. According to the United Nations World Health Organization, “By 2050, estimates indicate that more people could die from antibiotic resistant infections than those who currently die from cancer” (2016), making drug-resistant bacteria one of the most serious health concerns that we face. 

Source: Wikimedia Commons

So if antibiotics are becoming ineffective, then what can be done? Researchers are now turning towards a “good virus” called a “bacteriophage”, or simply phage, that kills bacteria, which was previously overlooked by researchers and scientists.

Phages: The Virus that kills drug-resistant superbugs

First of all, what is a phage? Simply put, phages are viruses that infect specific bacteria (Motherboard, Vice). This means that bacteriophages do not infect human or animal cells. There are more phages on earth than any other living specimen, and they can be found almost anywhere. There are also many different kinds of phages, and each phage does not fight the same bacteria.

Phages kill bacteria by binding themselves to the membrane of the bacteria when they come in contact with it and then releasing an enzyme that drills a hole in the bacteria cell. The phage then injects its own DNA into the cell and reproduces more phages inside of it. This causes the bacteria cell to explode (Motherboard, Vice). Phages can therefore be used as a natural alternative to antibiotics, and may prove to be even more effective.

 

Source: Wikimedia Commons

 

In the early 1900s, phages were studied by many researchers and scientists all over the world, however, after the invention of antibiotics, Western countries became less interested in phages and any research about the viruses were put to a halt. The Soviet Union, on the other hand, kept investing in phage research and Russia, Georgia and Poland are among the only countries that use phage therapy today as a bacteria-fighting technique. Research scientist Benjamin Chan (Yale University) explains that the United States has been “hesitant to use bacteriophages because they’re a virus.” However, he goes on to explain that there are many types of viruses and virus does not always mean that there is a disease involved.

Will phages replace antibiotics in the future?

Maybe. It will take some time, as much research still needs to be done by Western countries. Many science researchers believe that they will begin to be used out of desperation. One thing is for sure though: our current antibiotics will no longer be a sustainable option and we need to find another alternative and fast!

For more information on the subject, watch the video below by Vice:

 

SOURCES:

https://motherboard.vice.com/en_us/article/9kdbqa/bacteriophages-phage-therapy-antibiotic-resistant-bacteria?utm_source=mbfb

http://www.lemonde.fr/sciences/article/2012/06/14/les-phages-des-virus-guerisseurs_1718745_1650684.html

https://en.wikipedia.org/wiki/Antibiotics

http://www.un.org/apps/news/story.asp?NewsID=54928#.WnikApM-cWo

Water, a source of hospital-acquired infections?

Hospital-acquired infections are a serious threat in healthcare facilities today and researchers keep finding new sources of these infections. We know that sources of HAIs include surfaces, high-touch objects, hands and medical devices, but did you know that these infections can also occur due to the water and plumbing systems in healthcare facilities?

Source: Public Domain Pictures

According to Infection Control Today (2018), “Potable and utility water systems in healthcare settings are reservoirs and vectors of Hospital-acquired infections, resulting in pneumonias, bacteremias, skin infections, surgical site infections, eye infections and others.”

Hospitals are major users of potable water, whether it be for drinking, bathing, hand-washing or rinsing medical devices. It is therefore important that healthcare facilities realize that the water entering their facilities is not considered sterile.

Why is the water in plumbing systems infected? The design of and water use patterns in premise plumbing creates biofilms, which provide shelter and food for harmful bacterias. According to Infection Control Today (2018), “Biofilms in premise plumbing systems are complex ecosystems, and it is within these biofilms that bacteria, fungi and amoeba find the food, water and shelter they need.” Many bacteria develop in the biofilms, such as Legionella, Ancinetobacter aumanniii, Aspergillus flavus, etc.

Legionella – what is it and how does it affect patients in a healthcare setting?

Legionella colonies

Hospital-acquired infections

       Source: Wikimedia Commons

Legionella is one example of a bacteria that is found naturally in water. This bacteria is known for causing Legionnaires’ disease: a severe form of pneumonia. This disease is one of the most significant waterborne infections. Legionnaires normally has a mortality rate of only 10%, however, if acquired in a hospital, this rate goes up to anywhere between 25-50% (Infection Control Today, 2018)! Hospitals experience the highest number of outbreaks of Legionnaires disease (compared to other types of buildings) due to having a large number of patients with weakened immune systems or that have chronic diseases. It is important to note that the majority of Legionnaires cases in hospitals are due to the drinking water system.

How to reduce the risk of wHAIs: education and water management programs

So now that we are aware of waterborne hospital acquired infections (wHAIs), is there a way to reduce the risk that potable water poses to healthcare facilities? Infection Control Today (2018) suggests both education and water management programs as possible solutions to reducing the wHAI risk. Firstly, through education, it is important that healthcare workers know that potable water does carry bacteria and does cause an increase in HAIs. Second, once this idea of water carrying bacteria is understood, it will be important to implement water management programs. There can be no standardized water management programs, as all facilities differ in factors such as age of establishment and system, overall design of plumbing system, populations served, etc. Some hospitals have already tried different methods of water disinfection. Examples of these methods used to reduce risk include the use of sterile water in high-risk patient areas, engineering controls and point-of-use water filters.

To summarize, healthcare facilities must realize the risk that water and plumbing systems pose to their patients and employees. Hospital-acquired infections are one of the leading causes of death in North America and it is therefore crucial that hospitals take action against any source that could spread these infections. Education and water management programs are the best ways to help reduce the risk of wHAIs, according to Infection Control Today (2018).

Learn more about Hospital-acquired infections in this free webinar

Source: Infection Control Today. Vol. 22. No. 2. February 2018. 

Medical hygiene monitoring badges: how new technology is helping to prevent the spread of microorganisms

Hygiene and cleanliness are already monitored closely in hospitals and healthcare facilities. Hand sanitation is a crucial hygiene practice for both medical professionals’ well-being, as well as their patients. However, according to TrendHunter (2014), hand hygiene compliance in US hospitals is only achieved 50% of the time. And this is only an example of hand hygiene in the US. Studies would probably show similar, if not worse, percentages in countries across the globe. That is why Biovigil invented a medical hygiene monitoring badge.

Source: Pixabay

The Biovigil monitoring badge is specifically made for hand sanitation. The badge can be clipped on to a scrub or lab coat. It reminds healthcare workers to clean their hands when they leave or enter a patient’s room. It also works by telling either healthcare professionals or patients if their hands have been properly sanitized by turning green when the worker places their hand over the monitor. The badge also collects data on hand sanitation and sends it to be analyzed. While these badges are not heavily used yet, they could prove to be very efficient in eliminating the spread of hospital-aqcuired infections.

It is not, then, unreasonable to ask what other sort of technology could be developed in order to better monitor hygiene and sanitation in healthcare facilities. With the technological resources we have today, it is highly possible to create new products such as this. For now, most hygiene monitoring technologies revolve around hand sanitation. But as we’ve seen in other posts, there are way more sources of contamination and spread of bacteria than just hands; hospital bed mattresses, marked medical instruments, surface damages on medical equipment, etc. Why not create a technology that monitors the hygiene of these things as well? Similarly to the hand sanitation monitor, there could be monitors for other medical equipments that alert healthcare cleaners to check if they are clean and safe to use.

 

Source: https://www.trendhunter.com/trends/biovigil

How certain medical instrument marking methods can enable the growth of microorganisms – and what to do about it

In order to make it easier to identify a medical instrument, many doctors use different marking systems.The methods in which medical instruments can be marked are quite strict, in order to prevent the spread of bacteria. For example, instruments cannot be engraved because bacteria can get stuck in the small holes and grow. The article “Instrument Marking Methods Must be Maintained Properly”, by Nancy Chobin, describes three different methods of marking medical instruments and how these methods still have disadvantages and need to be maintained.

medical instrument

Source: Wikimedia Commons

First method for marking a medical instrument

Firstly, instruments are often marked by different colored tapes, however, many healthcare professionals fail to realize that the tape on the instruments can harbour bacteria and must be very carefully maintained. The tape should be replaced as soon as it begins to chip, as those small tears in the tape could allow for microorganisms to grow. According to Chobin “All tape and adhesive residues should be completely removed and the instrument washed before it is re-taped.” It is also stressed that a sharp object should not be used to remove tape, as this could simply create small fissures on the instrument where bacteria could grow.

Two other methods for marking a medical instrument

There are two other methods for marking instruments that are considered “acceptable”; chemical etching and color-bonding. These methods also come with some disadvantages, such as color-bonded instruments also chipping sometimes, however, seem to be more “sanitary” than using tape.

Why is this important? The general goal of healthcare facilities is to improve the health of its patients, while at the same time controlling and preventing the spread of infections and contamination. This means that healthcare facilities should aim to prevent, at all costs, the growth of bacteria. In order to be able to do so effectively, healthcare workers must know where all sources of bacteria may come from.

Source: Infection Control Today. Vol. 21. No. 12. December 2017.

Infection control in schools

Every parent knows it: when kids are in school, they are way more likely to get sick than when they are not. From sharing toys, chairs, desks, computer keyboards, water fountains and door handles, kids are the most prone to getting sick. Elementary and preschool students are the most prone to getting sick at school, mostly because their immune system is not fully developed yet. On average, elementary students will have 12 colds per year (yikes!). And let’s not forget that many school staff also end up getting sick from their students. So what can be done to help stop the spread of infection among students and staff?

Source: Pixabay

Sure, you can remind kids to wash their hands, cover their mouths when they cough, etc, but how effective will it really be? Schools must play a very important role in the cleaning and disinfection within their buildings in order to protect both employees and students. The primary person responsible for the upkeep of the school building is the custodian, and, as such, he should be trained in infection control methods.

The Centers for Disease Control and Prevention (CDC) makes the following recommendations on how to properly clean and disinfect schools and what procedures to follow:

  1. Knowing the difference between cleaning, disinfecting and sanitizing
    The CDC stresses the difference between the three methods of “cleaning”. While cleaning involves the removal of dirt and germs, it does not necessarily kill the bacteria. Disinfection, on the other hand, uses chemicals to kill bacterias, and does not focus on a clean surface, but rather a bacteria-free one. Finally, sanitization is the process of lowering the number of bacteria to a safe level.
  2. Clean and disinfect surfaces that are touched often
    This point speaks for itself; many schools already have a specific procedure regarding what should be cleaned more often, such as desks, compared to something that does not have to be cleaned often.
  3. Do routine cleaning and disinfecting.
  4. Clean and disinfect correctly.
    It’s simple to say, however, many people and institutions are not trained to know exactly what “correctly” means. It is important to pay close attention to the detailed instructions provided on the label of product.
  5. Use products safely.
    Pay attention to warnings and hazards on the label of product. Make sure that proper equipment (gloves, masks, etc.) are used when necessary.
  6. Handle waste properly.
    Avoid touching tissues/napkins when emptying waste baskets. Wear gloves, if possible. Wash hands after handling waste.
  7. Learn more.
    CDC provides more follow up information on their website about disinfection and cleaning for schools.

Let’s prevent staff and students from getting unnecessary illnesses and work together for a more clean and safe learning environment!


SOURCES: https://www.cdc.gov/flu/school/cleaning.htm

http://www.standard.net/Health/2015/09/24/Everyone-gets-sick-when-school-starts

Surface Damage and its implications for healthcare facilities

Preventing and controlling the spread of contamination and infection is of very high importance for healthcare facilities, and it is safe to say that many measures have already been taken in order to reach these goals. However, like many things, there is still much room for improvement moreover when it is about surface damage.

medical equipment surface damage

Source: Shaw Air Force Base

Evidently healthcare facilities use a wide variety of equipment, from monitors to surgical instruments to cleaning tools, and over time, this equipment wears down. Sometimes, equipment will break completely and be unusable, however sometimes there will only be a few scratches or other small damage.  But what happens when these scratches or other forms of damage become shelters and areas of growth for microorganisms? This is an example of how surface damage may not only impede the prevention of bacteria growth, but also provide the microorganisms with a place to grow.

What is surface damage?

According to Infection Control Today, surface damage is defined as:

a quantifiable physical or chemical change from the original manufactured state of an object (surface or device).

While it is recognized that surface damage of medical equipment poses a potential threat in the spread of bacteria in healthcare facilities, there is no standardized method for healthcare workers to determine what is considered surface damage, and at what point the damage is likely to cause the spread of bacteria. In a later blog post, I will discuss the ideal surface damage testing protocol, proposed by Peter Teska et al. in “Infection Control Today.” In this article, the authors discuss ideal methods of avoiding the problems that surface damage presents.

Are your surfaces damaged?

At Lalema, when we talk about hygiene and cleanliness, we offer a wide range of technical and consulting services. Find out more.

You can also read this article about The complete guide for hospital cleanliness.

Source: Infection Control Today. Vol. 21. No. 12. January 2018.

Would we be ready to face an epidemic of bubonic plague?

Would we be ready to face an epidemic of bubonic plague?

In Madagascar, the government has recently imposed two days ago new emergency measures to stop a plague epidemic. It has been declared 24 dead since 1 month1.

black_death

What is the bubonic plague?

The plague is a bacterium Yersinia pestis, present in rodents as rats are often passed to humans by infected fleas.

According to Health Canada:

The incubation period of the plague varies from one to ten days.

Whatever the form, the illness always starts with flu-like symptoms (fever, chills, muscle aches, weakness and headaches) and can also cause nausea, vomiting, diarrhea and abdominal pain.

If left untreated, the mortality rate can reach 50%.

Bubonic plague smear demonstrating the presence of yersinia pest

SURFACES DISINFECTIONS

According to Health Canada2, in the event of a spill or contaminated surfaces:

Let the aerosols fall; wear protective clothing, carefully cover the spilled material with paper towels and apply 1% sodium hypochlorite from the periphery to the center; allow to act for a sufficient period (30 minutes) before cleaning

Plague is affected by many types of surface disinfectants such as:

MATERIAL SAFETY DATA SHEET: PATHOGENIC AGENTS, AND RISK ASSESSMENT

You are dealing with a bacterium, virus or other pathogen and you want to know more about it. Health Canada has launched an application and a website:

LAST CASE REPORTED IN CANADA

Cases of plague in humans are very rare in Canada; the last case was reported in 1939.

 

References:

1 http://www.lapresse.ca/international/afrique/201709/30/01-5138249-madagascar-durence-measures-to-tenter-delight-pidemic-epidemia.php

2 https://www.canada.ca/en/public_health/services/biosururity-biosurete-laboratory/technical-sheets-health-security-agents-pathogenes-risk-assessment/yers-in-the-health-technical-files -Security-ftss.html

How often should I clean this or that?

I develop maintenance program for my clients and the question that comes up most often is:
“How often should I clean this or that?”

clean

How often should I clean this?

Here is a non-exhaustive list of 16 surfaces to clean regularly at home.

Item Frequency Tips
1. Cellular phone

Daily Wipe with a microfiber glass cloth to remove any greasy substances and germs
2. Kitchen Counter

Daily Use a mild all purpose cleaner. When using a disinfectant cleaner, rinse the surface.
3. Dishwasher

Monthly Use specially designed capsules or a little bit of baking soda and vinegar and the trick is done.
4. Refrigerator

Quarterly To avoid the appearance of mold and other undesirable contents, empty and clean the shelves and containers.
5. Kitchen floor

Weekly Use a broom after each meal and a good damp mopping every week.
6. Carpets

Weekly Vacuuming carpets every week will even reduce allergies. Remove the dog and the baby before to do so!
7. Furniture

Monthly Vacuum furniture and fabrics every month and steam clean annually
8. Remote control or joystick

Weekly Remove the batteries, clean the remote control surface by rubbing the buttons and gaps.
9. Ceiling fans

Quarterly With an all purpose cleaner, wipe the blades. Do not forget to turn off the fan!
10. Window blinds

Quarterly Dust and clean batten by batten with soapy water and a soft cloth.
11. Toilet

Daily Brush daily and thoroughly clean once a week.
12. Towels

After some use After the shower or the bath, hang to dry and use a few times (3 or 4 times), then machine wash. Note: If you have teenagers, this thing may not work!
13. Shower curtain

Monthly Spray a bathroom cleaner to remove residual accumulated soaps and limescale.
14. Bed linen

Weekly Wash in warm water to remove bacteria and mites. Avoid eating in your bed!
15. Mattress

Biannual Vacuum the mattress twice a year to remove dead skin cells and mites.
16. Air filter

Monthly Changing air filters every month or as recommended by the manufacturer contributes to a healthy environment.

We have the tools to clean

At Lalema, we serve a large industrial and institutional clientele with an online catalog of more than 18000 products ! Come and have a look!

www.lalema.com

 

Source :

inspired from http://www.webmd.com/a-to-z-guides/ss/slideshow-how-often-clean-this.

Photos are owned by me or from various talended photographs via unsplash.com

An enzyme to destroy biofilms

One can not stop the progress. The discovery of an enzyme capable of preventing the production of a biofilm, this polymeric protective layer produced by bacteria that prevents antibiotics and surface disinfectants from functioning well, could ultimately revolutionize the fight against nosocomial infections.

perturbation-biofilm

The team at the McGill University Health Center, which includes Dr. Donald C. Sheppard, has published a study in the journal Proceedings of the National Academy of Sciences (PNAS). Their hope is that this technology will be the subject of human clinical trials in Canada within 5 years and be used in hospitals within 10 years.

From the abstract:

We demonstrate that glycoside hydrolases derived from the opportunistic fungus Aspergillus fumigatus and Gram-negative bacterium Pseudomonas aeruginosa can be exploited to disrupt preformed fungal biofilms and reduce virulence.

What is a biofilm?

My colleague Rémi Charlebois described biofilms as follows:

Biofilms found on surfaces are often derived from a complex colony of microorganisms producing polymers that allow them to adhere better to the surface and facilitate colony life. In short, a biofilm is like a city for microbes. Man has learned to tame these biofilms and can use them to treat wastewater or produce certain molecules such as natural plastics. However, the presence of unwanted biofilms could be harmful and can lead to infections.

Biofilms are also found on the skin and medical devices. Thus, according to the article of Le Devoir:

Biofilms, a highly sticky matrix of proteins and sugar polymers made by bacteria to protect themselves, are attached to the skin, mucous membranes or the surface of biomedical materials, including catheters, tubing, heart valves and other prostheses Which become preferred entry points for infection.

In the same article, Dr. Sheppard quotes:

Biofilms are produced by molecules that defend against our immune system or against antibiotics with this shell that is 1000 times more resistant than the organisms that produce and proliferate in these biofilms.

An enzyme that acts as a “destructive machine” for biofilms

In short, the enzyme discovered was modified to destroy the biofilms instead of forming them. This is a new strategy that can reduce nosocomial infections in healthcare centers.

Watch this video about biofilms (25 minutes, french)

Sources:

http://www.ledevoir.com/societe/sante/501939/des-chercheurs-percent-le-secret-de-la-resistance-de-certaines-bacteries

http://www.lapresse.ca/sciences/medecine/201706/27/01-5111114-avancee-majeure-contre-les-infections-dans-les-hopitaux.php

Free Webinar: Fighting Healthcare Associated Infection with Environmental Hygiene

Fighting Healthcare Associated Infection with Environmental Hygiene.


The main objective of this webinar is to review the basics of cleaning and disinfection:

  • The updated burden of HAI’s in Canada
  • Why do we disinfect
  • Best practices in cleaning and disinfection
  • Using the right product
  • Validation technique

This 40 minutes long webinar was originally broadcast on December 15th, 2016. Watch it now on replay for a limited time!

Beware, microbes can survive in hospital environment

microbes

For a long time, cleaning has been all about the look; fresh smell and the absence of stains or dirt were the criteria to determine that a place is clean. Today, these criteria are still generally accepted in environments such as offices and classrooms.

It’s common knowledge, however, that microbes (bacteria or viruses) invisible to the human eye represent a risk for spreading infections. Take the example of the influenza virus: it can survive for up to 48 hours on a hard surface!

Without cleaning and disinfection procedures or a quality check procedure, microbes can survive in hospital environment.

Three key elements have to be considered in order to perform an infective risk analysis:

  • Is the patient carrying a disease agent? Disease agents are classified based on their spreading capacity and their virulence. The choice of a disinfectant will be based on this.
  • Do the functional activities of a sector represent a risk of spreading infections from the environment? E.g.: food service, offices, Intensive Care, etc.
  • The intensity of contact is related to the traffic and the surfaces that are more likely to be touched. E.g.: bathroom fittings.

Have you already performed an infective risk analysis? We can help, make sure to visit our unique offer for Diagnostic Analysis of Hospital Housekeeping Service. My next post is going to explain how cleaning allows reducing risks of infection among patients.

Robots to destroy Ebola?

xenex-robots

Credit photo: Xenex website

Robots are soldiers in a war againt HAI’s

Two Canadian hospitals have recently acquired a machine enabling surface disinfection in health institutions.

The Juravinksi hospital in Hamilton has started a year trial of a robot that costs 95 000 $ that burns the bacteria with UV rays: the Xenex Robot System. The general hospital of Vancouver has also started a trial of a UV robot that is 1.65 meters tall, called the Tru-D Smart UVC, working with UV rays as well. The effectiveness of these machines relies on the properties of the UV rays, or rather on the xenon UV rays, to sterilize and kill microscopic contaminants.

Ebola outbreak

Recently, with the Ebola Outbreak, the Texas Health Presbyterian Hospital in Dallas, where 42-year-old Thomas Eric Duncan, the first person to be diagnosed with Ebola in the US, was being treated, also uses such device. But was it enough? See this other blog post from my collegue: The Dallas case rises a question: Should protocols for infection control be revised?

What about your hospital?

The goal of these robots is not to replace the cleaning staff, nor the products employed for critical disinfections, but rather to complete their work, and to avoid that a single microscopic bacteria could take the life of a person whose immune system is weak.

Is your plan ready? Is your staff trained well enough? Do you have a stabilized chlorinated cleaner disinfectant in stock?

Do not miss our next post, which is going to explain how UV disinfection works!

More about Ebola Virus

There are a lot of ramblings about Ebola in 2014 on the web, you will find these articles interesting:

Ebola, How to disinfect surfaces

Ebola virus, Are we Ready?

Cleaning in Hospitals (part 2)

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source: http://tvanouvelles.ca/lcn/infos/lemonde/archives/2014/10/20141007-174935.html

A virus transmitted from computers to humans

virus-norwalk-norovirus

Virus on my keyboard, really?

Did you know that your keyboard and mouse are covered with bacteria and viruses? This may sound obvious when we think about it. Using computers is very common and the risk to be infected seems banal. However, in certain environments such as hospitals this contamination could reveal critical.

In fact, many bacteria and virus breaks have been associated with computers. It’s the case for a hospital in Great Britain, where a study revealed that 42% of tested keyboards were contaminated with the MRSA bacteria, which was directly related to higher MRSA infections as compared to other hospitals where keyboard contamination was lower (1). Another study carried out in Great Britain found that keyboards had been a breeding-ground for the norovirus, which then lead to a break of gastro-enteritis. A virus transmitted from computers to humans… who would’ve thought about that!

Don’t panic, solutions exist!

First and unforgettable is hand washing. In order to limit bacteria and virus spreads, hand washing is essential. Then, to avoid washing our hands every time we use a computer, an alcohol-based antiseptic liquid would do the trick. If our hands are dirty, washing hands before touching the keyboard is also recommended. Finally, it is wise to disinfect your keyboard and mouse from time to time. A renowned researcher named William Rutala, or Bill for his friends, has demonstrated that computer keyboards do not seem to deteriorate after being cleaned 300 times with different disinfectant solutions.

Long story short, we often forget daily objects as being a breeding-ground for viruses and bacteria. For example, mobile phones are often neglected as well despite the fact that we touch them and constantly put them on our face.

But no need to become hypochondriac, it’s enough to follow basic preventive measures. In other words, make little changes and set frequent disinfections based on the risk associated with your environment.

 

(1). Devine J., Is methicilin-resistant Staphylococcus aureus (MRSA) contamination of ward-based computer terminals a surrogate marker for nosocomial MRSA transmission and handwashing compliance? J Hosp Infect. 2001;48:72-5

(2). Morter S., et coll. Norovirus in the hospital setting: virus introduction and spread within the hospital environment. J. Hosp Infect. 2011 Feb;77(2):106-12

A Wednesday Tale: Romans used to say: Automate your restrooms

roman_legionaire_restrooms

This is not really that the Romans would tell each other after a rough battle against the Gallic, but nowadays the battle is never ending and merciless against the irreducible microbes!

Certain bacteria are good for us

And yet, most of bacteria are good for us, simply think of yoghurts or biological products and you’ll see that not all bacteria must be eliminated!

In certain environments such as at home, it’s not necessary to eradicate all microbial activity on the surfaces. It’s still better do it in an operating room though!

Let’s talk about public restrooms

Whether it is in a clinic, at school, in a shopping mall, a restaurant, or even at the office, certain people are a bit reluctant to touch surfaces. And you?

Conceive the ideal restroom

In this room, you will find accessories that have been conceived based on 3 fundamental criteria:

  • Infection spread risk reduction
  • Consumption reduction (environment protection)
  • Comfort and well-being of the user

Among these items, you’ll find:

The best way to discover the ideal restrooms is to visit our web site at www.lalema.com. 

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