FR3117037A1 - Device for combating nosocomial infections by tracing the disinfection of objects carrying pathogens before they enter target areas - Google Patents

Abstract

Device for combating nosocomial infections by tracing the disinfection of target objects carrying pathogens before they enter target areas and ensuring the traceability of target objects, from the decontaminating enclosure to the target area, prohibiting the entry into the target area if it is identified that the target object is not decontaminated.

Description

Device for combating nosocomial infections by tracing the disinfection of objects carrying pathogens before they enter target areas

It is now known that a large number of nosocomial infections are directly linked to mobile phones (smartphones/GSM/pagers) as disseminators of pathogenic germs in care areas (hospitals, clinics, etc.). In medical and paramedical practice, mobile phones are used for essential professional purposes (calls/various medical applications/photos/calendar/torchlight/clocks/alarms, etc.) and by extension for personal misuse (social networks/music/games/ shopping/ calls/ photos/ texting/ mirroring/ dating sites and others…).

In a hospital the reality is that the mobile phone is everywhere. It would be used by 76% of doctors, 56% of nurses and 49% of patients according to a 2016 study [Ref. 1]. This situation is all the more alarming in so-called aseptic areas such as operating theaters or intensive care units.

To enter these areas, authorized medical personnel open a secure changing room, which is mandatory to enter the operating theater (or target area) to change completely daily (operating room outfit/single-use cap/mask/plastic overshoe). Hands should also be washed at this time. During this change, the phone is generally placed on the side, then once the worker has changed and washed, he retrieves the phone to go to work in the operating rooms. In the operating room, the telephone will be used between and during the intervention (nurse holding the telephone to the ear of the surgeon operating, photo of the operation, etc.) and between two operations (operating report made on application , dealing with emergencies, etc.).

• L’asepsie est l’ensemble des mesures propres pour empêcher tout apport d’agents infectieux aux niveaux des surfaces inertes ou biologiques (= lavage main, désinfection, filtrage air, port de sur-chaussure…).
• La stérilisation est une opération qui vise à détruire tous les micro-organismes d’un objet de façon durable sur un milieu inerte.

It is important to differentiate between asepsis and sterilization:

• Asepsis is the set of proper measures to prevent any introduction of infectious agents to inert or biological surfaces (= hand washing, disinfection, air filtering, wearing overshoes, etc.).
• Sterilization is an operation that aims to destroy all the micro-organisms of an object in a sustainable way on an inert medium.

Thus, the operating theater staff works in an aseptic environment and during the operation the direct responders are dressed in sterile gowns and gloves.

Nosocomial infections, or “care-associated infections”, are infections contracted in a healthcare establishment such as a hospital or clinic. Santé Publique France estimates that approximately one hospitalized patient in 20 was confronted with it in France in 2017. The World Health Organization estimates on its website at 1.4 million the number of people who have contracted an infection with 'hospital. The Ministry of Health estimates that nosocomial infections are responsible for 4,000 deaths each year in France.

The French reference for infectiology, the “PILLY” of 2018 [Ref. 2]: “According to a national prevalence survey on a given day, 7.5% of patients hospitalized in CHU/CH have a nosocomial infection. The relative share of urinary tract infections, pneumonia, surgical site infections and catheter-related infections was respectively 30%, 17%, 14% and 10% in 2012”.

According to the 2019 annual public report of the Court of Auditors, the cost of healthcare-associated conditions is difficult to establish, according to a 2006 study [Ref. 3] applying a range of average additional cost of 3,500 to 8,000 euros per infection to the 750,000 annual nosocomial infections in France, we reach an amount of expenditure of 2.4 to 6 billion euros annually.

Nosocomial infections are a major public health issue.

• Dans un article de 2019 [Réf. 4], les téléphones de 25 médecins et 75 infirmiers ont été prélevés et analysés. Il est retrouvé que 88% des téléphones avaient une contamination bactérienne dont 71,2 % des colonies bactériennes retrouvées étaient potentiellement des agents bactériens nosocomiaux (staphylocoque dans 88,9% dont 40% résistant à la méticilline).
• Dans un article de 2016 [Réf. 5], les chercheurs estiment que de 5 à 21 % d’infections nosocomiales seraient directement liés au réservoir bactérien qu’est le téléphone et que 40 à 100% des téléphones sont infectés selon les études (« bactéries pathogènes » : staphylocoque doré souvent résistant à la méticilline).

What would be the role of the mobile phone in these nosocomial infections?

• In a 2019 article [Ref. 4], the telephones of 25 doctors and 75 nurses were taken and analyzed. It was found that 88% of the telephones had bacterial contamination, of which 71.2% of the bacterial colonies found were potentially nosocomial bacterial agents (staphylococcus in 88.9%, of which 40% were resistant to methicillin).
• In a 2016 article [Ref. 5], the researchers estimate that 5 to 21% of nosocomial infections would be directly linked to the bacterial reservoir that is the telephone and that 40 to 100% of telephones are infected according to studies (“pathogenic bacteria”: staphylococcus aureus often resistant to methicillin).

If we take the figure of 4000 deaths per year, we could translate this study [Ref. 5] by a number of deaths between 200 and 840 per year, directly linked to the bacterial reservoir that is the telephone.

• Dans un article de 2015 [Ref. 6], une revue de la littérature étudie 39 études entre 2005 et 2013 traitants du sujet. Sur 39 études, 19 retrouvent une contamination des téléphones par coagulase négative et 26 retrouvent une infection par staphylocoque (à fréquence et taux variant).
• Dans une étude de 2009 [Ref. 7], portant sur la contamination croisée des téléphones portables et des mains du personnel médical. Les auteurs ont échantillonné les mains d'anesthésistes après s’être désinfecté les mains. Puis ils ont simulé un appel téléphonique avec leur téléphone portable durant 1 minute. Ensuite ils ont fait de nouveaux prélèvements sur leurs mains. Les résultats retrouvent que 10% des écouvillons prélevés sur les mains des anesthésistes après contact du téléphone portable pendant 1 minute retrouve une contamination par des `` bactéries pathogènes ''. Ceci démontrant que le téléphone portable peut être une source de bactéries qui peuvent être transférées aux mains des soignants.

If we take the figures from reference 3, we could translate this study [Ref. 5] between a cost of 120 million to 1.26 billion euros, directly linked to the bacterial reservoir that is the telephone.

• In a 2015 article [Ref. 6], a review of the literature studies 39 studies between 2005 and 2013 dealing with the subject. Out of 39 studies, 19 found coagulase-negative contamination of telephones and 26 found staphylococcal infection (with varying frequency and rate).
• In a 2009 study [Ref. 7], dealing with cross-contamination of mobile phones and the hands of medical personnel. The authors sampled the hands of anesthetists after disinfecting their hands. Then they simulated a phone call with their mobile phone for 1 minute. Then they took new samples from their hands. The results find that 10% of swabs taken from the hands of anesthetists after touching the mobile phone for 1 minute find contamination with 'pathogenic bacteria'. This demonstrates that the mobile phone can be a source of bacteria that can be transferred to the hands of caregivers.

Within recent events concerning COVID-19, the spread of the epidemic through a viral reservoir such as the mobile phone is also strongly incriminated. A study published in the " new england journal of medicine in march 2020" [Ref 8] reveals that virus germs remain active on plastic or steel for 2 to 3 days. The smartphone is indeed the object most likely to convey this virus.

• la désinfection du téléphone. Le sulfanios® est le désinfectant et détergent de référence le plus utilisé au bloc opératoire. On peut utiliser des lingettes avec du sulfanios®.

To date, the solutions proposed to fight against the microbial reservoir that is the mobile phone (or other objects carrying pathogenic germs) are insufficient. Here are their limits:

• disinfection of the phone. Sulfanios® is the reference disinfectant and detergent most used in the operating room. We can use wipes with sulfanios®.

In the 2016 study, [Ref. 5], the researchers compared the number of bacterial colonies (CFU: bacterial forming unit) found on telephones before and after disinfection with a diluted sulfanios® wipe, for 30 seconds. They found an average of 258 CFU by telephone before decontamination and 127 CFU after decontamination. That is a reduction of only 50%. This is explained by the authors by an insufficient impregnation of sulfanios® for justified fear of damaging the telephone.

In this same study [Ref. 5] a questionnaire was completed by the 52 study participants (including 24 surgeons). Only 34% of respondents clean their smartphone regularly. Only 7% sanitize their hands after touching their smartphone, despite the fact that 87% of them think their phone contains pathogens. The disinfection of the smartphone is therefore an insufficient means and too little followed to fight effectively against nosocomial diseases.

Disinfection by UV light (ultraviolet pulsed xenon light):

UV light inactivates microorganisms by degrading their nuclide acid. The effectiveness of UV light in inactivating a long list of pathogens such as bacteria, viruses and protozoa is proven by numerous articles. This process is used in the food industry to treat water mainly. In the medical field, a study from the University of Oxford in 2019 [Ref 9] studies the effectiveness of disinfection of patient rooms by standard manual disinfection compared to disinfection by pulsed Xenon UV. In this study UV light disinfects better than standard cleaning. In fact, there is a 99% reduction in methicillin-resistant staphylococci by cleaning with UV light and 91% by standard manual cleaning.

The effectiveness of UV light is therefore known and effective. Its limits are that it does not eliminate 100% of bacteria, and moreover, to be fully effective, the protocols are 3x 15 minutes long compared to the disinfected surface to disinfect large surfaces [Ref 8].

However, there are boxes with UV light concentrated on a smaller surface. These boxes allow 99.9% disinfection of pathogens over shorter periods of time, around 3 minutes.

The provision of plastic pouch with hermetic closure.

In principle, this technique isolates the phone 100% of bacteria from the external environment. These pouches are rarely made available to medical equipment. In France, very few intensive care units or operating theaters take this step. In addition, these pockets are of a single format, often far too large and not very ergonomic, with sharp edges, which interfere with the optimal use of the smartphone. They are therefore not used by the majority of caregivers.

Provision of cling film:

In the same principle, cling film is left at common disposal inside the aseptic areas in certain operating theaters, in a clean non-dedicated space. The problem being an archaic and common manual use, once entering the area.

The total banning of telephones in the target areas.

In view of the studies concerning the dangerousness of telephones, this would seem appropriate. However, in the era of the smartphone, this measure cannot be applied. The smartphone cannot be forbidden to doctors and hardly to the rest of the hospital staff.

Within this reality, a solution seems to be able to be provided by our invention:

The primary goal of this invention is to limit nosocomial infections linked to the use of mobile phones and other personal objects (e.g. car keys, wallets, etc.) in target areas (operating theatres, intensive care, etc.).

Despite a general knowledge of the studies demonstrating the dangerousness of telephones, there is still no way other than that based on the ethics of each caregiver (cleaning his telephone/wrapping it in cling film) to control the disinfection of mobile telephones in the medical staff.

The line that cannot be crossed by the administration of a hospital is due to the fact that the mobile phone is a personal object. The administration could prohibit the introduction of an object in the target area thanks to strict rules. However, in the era of the smartphone, this radical solution is not possible.

• un dispositif aseptisant constitué d’un boitier utilisant la lumière UV -notamment la lumière UVC-, destiné à recevoir au moins un téléphone, permettant une aseptisation de toutes les faces de l’objet en même temps, le dispositif aseptisant étant disposé en amont des zones cibles (vestiaires et ou zones dédiées), et adapté pour permettre une manœuvre de désinfection quotidienne, rapide et n’endommageant pas les objets ;
• un dispositif inventif de traçabilité des objets destinés à séjourner en zone cible, comprenant :
  • un système de marquage de tout objet destiné à séjourner en zone cible, comportant un marqueur physique de type étiquette RFID ayant un code unique permettant d’individualiser chaque objet de manière anonyme ;
  • un système de détecteur de présence par cellule photosensible ;
  • un lecteur courte portée d’étiquette RFID accolé au dispositif aseptisant adapté pour détecter le système de marquage de l’objet uniquement lorsque l’objet est aseptisé en fin de la manouvre d’aseptisation ;
  • un lecteur longue portée d’étiquette RFID accolé au dispositif de contrainte, adapté pour détecter le système de marquage de l’objet à plusieurs mètres ;
  • une base placée à l’entrée des zones cibles contenant le système informatique et le lecteur longue portée et adapté pour communiquer avec un dispositif de contrainte ;
  • un serveur adapté pour permettre une communication entre le lecteur courte portée et la base ;
  • un système informatique comprenant un logiciel de gestion des informations des lecteurs adapté pour élaborer un signal permettant de lever ou de ne pas lever la contrainte ;
  • une carte d’accès sur laquelle est collée de manière indémontable une étiquette RFID, enregistrée dans le système informatique comme permettant une levée de la contrainte à sa détection par le lecteur longue portée, la carte d’accès (ou carte « Pass ») étant délivrée à toute personne n’ayant pas d’objet personnel à introduire en zone cible ;
  • un dispositif de contrainte placé à l’entrée des zones cibles, adapté pour communiquer avec la base et choisi parmi un dispositif de contrainte mécanique (portillon, porte sécurisée) et un dispositif de contrainte sensorielle (alarme/ lumière…) ;

le dispositif de traçabilité étant adapté pour que chaque manœuvre d’aseptisation soit enregistrée dans un réseau et permette une levée de la contrainte pour une durée variable qui peut être définie (24-36h).The invention therefore relates to a device for combating the dissemination in target areas (operating theatres, intensive care, conventional services, etc.) by pathogenic agents (bacteria, parasites, viruses, fungal infections, etc.) carried by target objects (telephones, watches, car keys, etc.) introduced by stakeholders within target structures (hospital-type care structures, laboratories, agrifoods, etc.), based on an indirect method making it possible to ensure the disinfection of target objects intended to stay in the care and on the traceability of the path of the target objects making it compulsory to pass through a disinfectant device before being able to access a care area;
the control device being characterized in that it comprises:

• a sanitizing device consisting of a box using UV light -in particular UVC light-, intended to receive at least one telephone, allowing sanitization of all the faces of the object at the same time, the sanitizing device being arranged upstream of the target areas (changing rooms and/or dedicated areas), and adapted to allow daily, rapid disinfection maneuvers that do not damage objects;
• an inventive device for tracking objects intended to stay in the target area, comprising:
  • a system for marking any object intended to stay in the target zone, comprising a physical marker of the RFID tag type having a unique code making it possible to individualize each object anonymously;
  • a photosensitive cell presence detector system;
  • a short-range RFID tag reader attached to the sanitizing device adapted to detect the object marking system only when the object is sanitized at the end of the sanitizing maneuver;
  • a long-range RFID tag reader attached to the constraint device, suitable for detecting the marking system of the object several meters away;
  • a base placed at the entrance to the target areas containing the computer system and the long range reader and adapted to communicate with a constraint device;
  • a server adapted to allow communication between the short-range reader and the base;
  • a computer system comprising reader information management software adapted to produce a signal allowing the constraint to be lifted or not lifted;
  • an access card on which an RFID tag is stuck in an unremovable manner, recorded in the computer system as allowing a lifting of the constraint on its detection by the long-range reader, the access card (or "Pass" card) being issued to anyone who has no personal item to bring into the target area;
  • a restraint device placed at the entrance to the target areas, adapted to communicate with the base and chosen from among a mechanical restraint device (gate, secure door) and a sensory restraint device (alarm/light, etc.);

the traceability device being adapted so that each sanitization maneuver is recorded in a network and allows a lifting of the constraint for a variable duration which can be defined (24-36h).

There is nothing to prevent a system for disabling the constraint in the event of an emergency from being put in place.

The traceability device is adapted to allow, via a telephone application, a sufficiently precise GPS location of the telephone to allow traceability of the telephone, of its passage through the UV box before presenting itself at the entrance to the target area, in particular at the entrance to an operating room.

This technology uses a dedicated telephone application which would precisely trace the location of the telephone and communicate with the various elements (UV box/base/constraint) via GPS/GSM/radio waves/WIFI/Bluetooth.

The base device detecting the telephone can be a metal detector and/or a wave detector and/or a GPS.

The system is adapted to be able to distribute an RFID tag for daily use when using the box using UV light, the RFID tag being intended to be stuck on the sanitized object, then allowing an opening of the target zone, in particular an opening of an operating room.

The system is adapted to be able to distribute a bar code of the QR code type making it possible to scan the label of the telephone once the object has been analyzed and then to scan this same label at the entrance to the target zone, in particular at the entrance to an operating room.

The marking system is a biometric system. It associates an object with an individual. The individual would be detected at the end of the disinfection process (fingerprint, facial recognition, iris) and then detected again at the entrance to the target areas.

The sanitizing device makes it possible to wrap the target object in marked, shrinkable and/or food-grade plastic and/or having electrostatic properties. The marking would then be drawn according to the invention.

The inventive content of this invention is based on the use of an indirect method making it possible to ensure the disinfection of telephones intended to stay in a care area. Method exploiting the traceability of the journey of the marked telephone from its passage through a device disinfecting it to its control upstream of the target area.

Here is how it works:

Each employee is given by the administration a self-adhesive marking system for any personal item intended to stay in the target zone. If the employee declares that he never introduces any personal object into the target areas, he is then given an access card or “ Pass card ”.

The stickers are stuck at this time on the target objects (on the back of the phone, under the hull for example). The object is then “marked”, it is individualized by a unique and anonymous code.

Thus marked, when the target object is introduced into the sanitizing device upstream of the target areas (in the locker room), its disinfection is detected by the first detector, then the information is recorded and transmitted to a server.

When the worker then moves towards the target area, this same marked object is detected again (by the second detector this time). The information is recorded and transmitted to the server. This information is then analyzed by computer software. If the marked object is detected by the first detector then by the second detector, the object is considered "sanitized" and the passage to the target zone is done without constraints.

is an illustration sheet of the first example.

• 1 : Intervenant est porteur d’un objet marqué « aseptisé » (=l’objet marqué est détecté par le détecteur 1 puis par le détecteur 2).
• 2 : Intervenant porteur un objet marqué « non aseptisé » (= l’objet marqué est détecté par le détecteur 2 mais non par détecteur 1).
• 3 : Intervenant est porteur d’une carte d’accès (ou carte « Pass » (Carte « Pass » détectée par le détecteur 2 uniquement).
• 4 : Intervenant est non porteur d’objet marqué, ni de carte d’accès (Intervenant détecté par détecteur de présence).

The operation of these devices thus makes it possible to differentiate 4 situations at the entrance to the target zones:

• 1: Operator is carrying an object marked "sanitized" (=the marked object is detected by detector 1 then by detector 2).
• 2: Participant carrying an object marked “not sanitized” (= the marked object is detected by detector 2 but not by detector 1).
• 3: Operator is carrying an access card (or “Pass” card (“Pass” card detected by detector 2 only).
• 4: Operator is not carrying a marked object or an access card (Intervenor detected by presence detector).

• Une contrainte mécanique de type porte sécurisée/portillon peut contraindre l’accès en permanence et être levée uniquement dans les situations 1 ou 3 [cf : premier exemple], ou/et ;
• Le passage est libre mais une contrainte sensorielle de type alarme visuelle et/ou sonore peut être déclenchée pour les situations 2 ou 4 [cf : autre exemple].

So :

• A mechanical constraint of the secure door/gate type can constrain access permanently and can only be lifted in situations 1 or 3 [cf: first example], or/and;
• The passage is free but a sensory constraint of the visual and/or audible alarm type can be triggered for situations 2 or 4 [cf: another example].

Each sanitization maneuver is recorded in the network and allows the constraint to be lifted for a variable duration that can be defined (eg: 24-36 hours).

A restraint deactivation system in the event of an emergency can be put in place.

The solutions adopted are illustrated below by examples of achievements meeting this objective by way of non-limiting examples.

In 1855, Louis PASTEUR introduced compulsory hand washing when going from dissection rooms to delivery rooms. In a few months the number of puerperal infections fell from 30% to 0.23%.

We have great hope that in 2020 this invention, which makes it possible to ensure the disinfection of target objects, will allow us to drastically reduce the number of nosocomial infections, thus saving lives.

• Référence [1]: Is your phone bugged? The incidence of bacteria known to cause nosocomial infection on healthcare workers’ mobile phones. J Hosp Infect 2006; 62:123e125:

https://www.ncbi.nlm.nih.gov/pubmed/?term=Is+your+phone+bugged%3F+The+incidence+of+bacteria+known+to+cause+nosocomial+infection+on+healthcare+workers%E2%80%99

• Référence [2]: ECN.PILLY 2018 5e edition. Maladie infectieuses et tropicales-préparation ECN. Paragraphe 4 « épidémiologie » :

http://www.infectiologie.com/UserFiles/File/formation/ecn-pilly-2018/ecn-2018-ue1-004-nb.pdf

• Référence [3]: Rapport de l’assemblé nationale N°3188 , 2006 sur la politique de lutte contre les infections nosocomiales, par M. Alain VASSELLE, Sénateur. Page 9 :

http://www.assemblee-nationale.fr/12/rap-off/i3188.asp

• Référence [4]: The occurrence of nosocomial pathogens on cell-phone of healthcare workers in an Iranian tertiary hospital, dans la revue, infectious disorders: drug targets 2019 (3) : 327-333:

https://www.ncbi.nlm.nih.gov/pubmed/30173654

• Référence [5]: Microbial flora on cell-phones in an orthopedic surgery room before and after decontamination, parue en 2016 dans la revue scientifique Orthopedic & traumatology surgery & research:

https://www.ncbi.nlm.nih.gov/pubmed/27836449

• Référence [6]: Are healthcare workers’ mobile phones a potential source of nosocomial infections? Review of the literature. Journal of infection in developing countries. 2015 oct 29;9(10): 1046-53:

https://www.ncbi.nlm.nih.gov/pubmed/?term=Are+healthcare+workers%E2%80%99+mobile+phones+a+potential+source+of+nosocomial+infections%3F+Review+of+the+literature.+Journal+of+infection

• Référence [7]: Review of mobile communication device as potential reservoir of nosocomial pathogene. Journal of hospital infection (2009) 71-295-300:

https://www.ncbi.nlm.nih.gov/pubmed/?term=Review+of+mobile+communication+devices+as+potential+reservoirs+of+nosocomial +pathogens

• Référence [8]: Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. The new england journal of medicine 2020 Apr 16;382(16):1564-1567 :

https://www.ncbi.nlm.nih.gov/pubmed/32182409

• Référence [9] : Use of Ultraviolet Irradiation in Addition to Commonly Used Hospital Disinfectants or Cleaners Further Reduces the Bioburden on High-Touch Surfaces, Published by Oxford University Press on behalf of Infectious Diseases Society of America 2019:

https://www.ncbi.nlm.nih.gov/pubmed/?term=Use+of+Ultraviolet+Irradiation+in+Addition+to+Commonly+Used+Hospital+Disinfectants +or+Cleaners+Further+Reduces+the+Bioburden+on+High-Touch+SurfacesBibliography:

• Reference [1]: Is your phone bugged? The incidence of bacteria known to cause nosocomial infection on healthcare workers' mobile phones. J Hosp Infect 2006; 62:123e125:

https://www.ncbi.nlm.nih.gov/pubmed/?term=Is+your+phone+bugged%3F+The+incidence+of+bacteria+known+to+cause+nosocomial+infection+on+healthcare +workers%E2%80%99

• Reference [2]: ECN.PILLY 2018 5th edition. Infectious and tropical diseases-ECN preparation. Paragraph 4 “epidemiology”:

http://www.infectiologie.com/UserFiles/File/formation/ecn-pilly-2018/ecn-2018-ue1-004-nb.pdf

• Reference [3]: Report of the National Assembly N°3188, 2006 on the policy for the fight against nosocomial infections, by Mr. Alain VASSELLE, Senator. Page 9:

http://www.assemblee-nationale.fr/12/rap-off/i3188.asp

• Reference [4]: The occurrence of nosocomial pathogens on cell-phone of healthcare workers in an Iranian tertiary hospital, in the journal, infectious disorders: drug targets 2019 (3): 327-333:

https://www.ncbi.nlm.nih.gov/pubmed/30173654

• Reference [5]: Microbial flora on cell-phones in an orthopedic surgery room before and after decontamination, published in 2016 in the scientific journal Orthopedic & traumatology surgery & research:

https://www.ncbi.nlm.nih.gov/pubmed/27836449

• Reference [6]: Are healthcare workers' mobile phones a potential source of nosocomial infections? Review of the literature. Journal of infections in developing countries. 2015 Oct 29;9(10): 1046-53:

https://www.ncbi.nlm.nih.gov/pubmed/?term=Are+healthcare+workers%E2%80%99+mobile+phones+a+potential+source+of+nosocomial+infections%3F+Review +of+the+literature.+Journal+of+infection

• Reference [7]: Review of mobile communication device as potential reservoir of nosocomial pathogene. Journal of hospital infections (2009) 71-295-300:

https://www.ncbi.nlm.nih.gov/pubmed/?term=Review+of+mobile+communication+devices+as+potential+reservoirs+of+nosocomial+pathogens

• Reference [8]: Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. The new england journal of medicine 2020 Apr 16;382(16):1564-1567:

https://www.ncbi.nlm.nih.gov/pubmed/32182409

• Reference [9]: Use of Ultraviolet Irradiation in Addition to Commonly Used Hospital Disinfectants or Cleaners Further Reduces the Bioburden on High-Touch Surfaces, Published by Oxford University Press on behalf of Infectious Diseases Society of America 2019:

https://www.ncbi.nlm.nih.gov/pubmed/?term=Use+of+Ultraviolet+Irradiation+in+Addition+to+Commonly+Used+Hospital+Disinfectants+or+Cleaners+Further+Reduces+the +Bioburden+on+High-Touch+Surfaces

Examples:

Below is a first non-limiting example of embodiment of the invention allowing its interest and operation to be understood. This example is illustrated by the plate.

• Utilisation d’un dispositif de désinfection par lumière UVC. Eliminant 99,9% des agents pathogènes en 3 minutes.
• Un ou plusieurs boitiers de lumière UVC (1), sont installés dans le vestiaire du personnel soignant. Les boitiers sont ouverts lorsqu’ils ne sont pas utilisés. Ils sont alimentés par du 220V. Ainsi l’intervenant peut introduire son téléphone portable marqué (2) destiné à séjourner au bloc opératoire. En fermant le boitier (1), on déclenche la mise en route de la désinfection via la lumière UVC. Cette désinfection se fait en quelques secondes. A la fin de la désinfection le boitier (1) s’ouvre automatiquement permettant ainsi de récupérer son téléphone (2) dit « aseptisé ».
• Durant ce temps l’intervenant se change pour se mettre en tenue de bloc opératoire (tenue propre, chapeau, masque, sabot) et se lave les mains.
• Les boitiers (1) sont étanches et peuvent être nettoyés au sulfanios® plusieurs fois par jour au même titre que les autres surfaces d’un vestiaire.

The device sanitizing the object (1):

• Using a UVC light disinfection device. Eliminating 99.9% of pathogens in 3 minutes.
• One or more UVC light boxes (1) are installed in the nursing staff's changing room. The boxes are open when not in use. They are powered by 220V. Thus the speaker can introduce his marked mobile phone (2) intended to stay in the operating room. By closing the box (1), disinfection is triggered via UVC light. This disinfection is done in a few seconds. At the end of disinfection, the box (1) opens automatically, thus allowing you to retrieve your phone (2) called “sanitized”.
• During this time, the worker changes into an operating room outfit (clean clothes, hat, mask, clog) and washes his hands.
• The boxes (1) are waterproof and can be cleaned with sulfanios® several times a day in the same way as the other surfaces of a locker room.

• Tous les téléphones portables destinés à séjourner quotidiennement au bloc opératoire sont marqués pour permettre leur traçabilité. Ce marquage se fait de manière anonyme par le collage d’une étiquette RFID au téléphone (2) (pouvant être cachée à l’intérieur de la coque).
• L’étiquette RFID du téléphone ainsi passée dans ce boitier fermé a été lue par le lecteur courte portée (3) qui enregistre le code électronique unique de cette étiquette.
• Ce code électronique unique est enregistré et transmis via le réseau wifi de l’hôpital (4) ou Bluetooth indépendant, à un serveur qui est dans une base (5).
• Cette base (5) disposée à l’entrée des zones cibles est composée d’un serveur, d’un lecteur longue portée d’étiquette RFID, d’un système informatique, et est reliée à la contrainte permettant sa levée ou non.
• Ainsi lorsque l’intervenant s’approche de la base (5) à l’entrée de la zone cible, le lecteur longue portée détecte ce même code électronique unique de l’étiquette RFID de l’objet ayant cheminé par le dispositif aseptisant et permet de lever la contrainte (porte sécurisée) (6). Cela fonctionne même avec l’objet dans la poche (7).

The telephone traceability device:

• All mobile phones intended for daily use in the operating theater are marked to allow their traceability. This marking is done anonymously by sticking an RFID tag to the phone (2) (which can be hidden inside the shell).
• The RFID tag of the telephone thus passed through this closed box was read by the short-range reader (3) which records the unique electronic code of this tag.
• This unique electronic code is recorded and transmitted via the wifi network of the hospital (4) or independent Bluetooth, to a server which is in a base (5).
• This base (5) placed at the entrance to the target zones is made up of a server, a long-range RFID tag reader, a computer system, and is connected to the constraint allowing it to be lifted or not.
• Thus when the worker approaches the base (5) at the entrance to the target zone, the long-range reader detects this same unique electronic code of the RFID tag of the object having passed through the sanitizing device and allows to lift the constraint (secured door) (6). It works even with the object in the pocket (7).

There is nothing to prevent a system for disabling the constraint in the event of an emergency from being put in place. (8)

• Les étiquettes RFID peuvent être distribuées par l’administration aux employés autorisés à entrer au bloc opératoire déclarant introduire quotidiennement leur téléphone portable au bloc opératoire.
• Les cartes d’accès ou cartes « Pass » : elles sont marquées d’une étiquette RFID ayant un code spécifique et connu par la base. Elles peuvent être distribuées par l’administration aux employés autorisés à entrer au bloc opératoire et déclarant laisser systématiquement leur téléphone au vestiaire ou n’ayant pas de téléphone.

Prerequisites:

• RFID tags can be distributed by the administration to employees authorized to enter the operating room declaring that they bring their mobile phone into the operating room daily.
• Access cards or “Pass” cards: they are marked with an RFID tag with a specific code known by the base. They can be distributed by the administration to employees authorized to enter the operating room and who declare that they systematically leave their telephone in the cloakroom or who do not have a telephone.

• Dans cet exemple le dispositif de contrainte est une contrainte activée en permanence (porte sécurisée fermée, portillon) qui doit être désactivée pour entrer au bloc opératoire.
• Ainsi la lecture d’une étiquette RFID ayant cheminé par le dispositif d’aseptisation en marche au préalable, devient obligatoire pour entrer au bloc opératoire (pour désactiver la contrainte). La lecture de l’étiquette RFID d’une carte d’accès (carte « Pass ») permet également une entrée au bloc opératoire.
• Un système de sécurité permettant de lever la contrainte en cas d’urgence est à disposition sous un dispositif « brise-glace » (8).
• La durée de levée de contrainte par chaque désinfection peut être défini (24h-36h).

The constraint device:

• In this example, the constraint device is a permanently activated constraint (secure door closed, gate) which must be deactivated to enter the operating room.
• Thus the reading of an RFID tag having traveled through the aseptic device in operation beforehand, becomes mandatory to enter the operating room (to deactivate the constraint). Reading the RFID tag of an access card (“Pass” card) also allows entry to the operating room.
• A safety system allowing the constraint to be lifted in the event of an emergency is available under an “ice-breaker” device (8).
• The duration of constraint lifting by each disinfection can be defined (24h-36h).

• La contrainte devient une alarme sensorielle (visuelle et/ou auditive...).
• Un capteur de présence (capteur photosensible) est ajouté au niveau de la base à l’entrée du bloc. Ainsi lorsqu’un intervenant approche du bloc opératoire, sa présence peut être détectée.
• Dans cet exemple le passage est libre, la contrainte est activée en cas de « fraude ».
• Le passage se fait en règle si l’intervenant détecté est porteur sur son téléphone d’une étiquette RFID ayant cheminé par le dispositif d’aseptisation dans les 24 dernières heures ou s’il détient une carte d’accès ou carte « Pass ».
• L’alarme se déclenche en cas de « fraude » si l’intervenant détecté par le capteur photosensible n’est pas porteur d’étiquette RFID ou s’il a une étiquette RFID non en règle c’est-à-dire n’ayant pas cheminé par le dispositif d’aseptisation dans les 24 dernières heures.

Below, another non-limiting example of embodiment of the invention allowing to understand its interest and its operation:

• The constraint becomes a sensory alarm (visual and/or auditory...).
• A presence sensor (photosensitive sensor) is added at the base level at the block entrance. So when a worker approaches the operating room, his presence can be detected.
• In this example the passage is free, the constraint is activated in the event of “fraud”.
• The passage is done in good standing if the detected speaker is carrying an RFID tag on his phone that has passed through the sanitization device in the last 24 hours or if he holds an access card or “Pass” card.
• The alarm is triggered in the event of "fraud" if the participant detected by the photosensitive sensor is not carrying an RFID tag or if he has an RFID tag that is not in order, that is to say not having not passed through the sanitization device in the last 24 hours.

Claims (7)

Device for combating the dissemination in target areas by pathogenic agents carried by target objects introduced by workers within target structures, based on an indirect method making it possible to ensure the disinfection of target objects intended to remain in the area of care and on the traceability of the path of the target objects making it compulsory to pass through a disinfectant device before being able to access a care area;
the control device being characterized in that it comprises:

• a sanitizing device (1) consisting of a box using UV light, intended to receive at least one telephone (2), allowing sanitization of all the faces of the object at the same time, the sanitizing device (1) being arranged upstream of the target areas, and adapted to allow a daily disinfection maneuver, fast and not damaging the objects;
• a device for tracking objects intended to stay in the target area, comprising:
  • a system for marking any object intended to stay in the target zone, comprising a physical marker of the RFID tag type having a unique code making it possible to individualize each object anonymously;
  • a photosensitive cell presence detector system;
  • a short-range RFID tag reader (3) attached to the sanitizing device suitable for detecting the object marking system only when the object is sanitized at the end of the sanitizing maneuver;
  • a long-range RFID tag reader attached to the constraint device, suitable for detecting the marking system of the object several meters away;
  • a base (5) placed at the entrance to the target areas containing the computer system and the long range reader and adapted to communicate with a constraint device.
  • a server (4) adapted to allow communication between the short-range reader and the base;
  • a computer system comprising reader information management software adapted to produce a signal allowing the constraint to be lifted or not lifted;
  • an access card on which an RFID tag is stuck in an unremovable manner, recorded in the computer system as allowing a lifting of the constraint on its detection by the long-range reader, the access card being issued to any person not having no personal object to bring into the target area;
  • a constraint device placed at the entrance to the target zones, adapted to communicate with the base and chosen from among a mechanical constraint device and a sensory constraint device;

the traceability device being adapted so that each sanitization maneuver is recorded in a network and allows a lifting of the constraint for a variable duration which can be defined. Device according to claim 1, characterized in that the traceability device is adapted to allow, via a telephone application, a sufficiently precise GPS location of the telephone to allow traceability of the telephone, of its passage through the UV box before presenting itself at the entrance to the target area. Device according to Claim 1, characterized in that the device of the base detecting the telephone is a metal detector and/or a wave detector and/or a GPS. Device according to claim 1, characterized in that it is adapted to be able to distribute an RFID tag for daily use when using the box using UV light, the RFID tag being intended to be stuck on the sanitized object, then allowing an opening of the target area. Device according to Claim 1, characterized in that it is adapted to be able to distribute a bar code of the QR code type making it possible to scan the label of the telephone once the object has been analyzed then to scan this same label at the entrance to the target area. Device according to Claim 1, characterized in that the marking system is a biometric system. Device according to Claim 1, characterized in that the sanitizing device makes it possible to wrap the target object in marked, shrinkable and/or food-grade plastic and/or having electrostatic properties.