Evaluation of a shoe sole UVC device to reduce pathogen colonization on floors, surfaces and patients

T. Rashid, K. Poblete, J. Amadio, I. Hasan, K. Begum, M.J. Alam, K.W. Garey, University of Houston College of Pharmacy, Houston, Texas; University of Texas Schoolof Public Health, Houston, Texas; University of Edinburg, Edinburg, Scotland

Background: An ultraviolet C (UVC) decontami-nation device that delivers germicidal UVC radiation to the soles of shoes has become available recently

Aim: To demonstrate that shoe soles can be vectors for healthcare-associated infection, and to investigate if a UVC shoe sole decontamina-tion device would decrease this risk effectively.Methodology: Three bacterial strains (Staphylo-coccus aureus, Enterococcus faecalis and Escherichia coli) and a non-toxigenic strain of Clostridium difficile were spiked on to standard-ized rubber-soled shoe soles and then selected at random for UVC exposure or no UVC exposure. Experiments were performed to test the efficacyof the UVC device to decontaminate shoe soles and flooring

Results: The UVC device decreased shoe sole contamination significantly for all tested bacterial species, and decreased floor contamination significantly for all floor types and species tested (P<0.01 for all experiments). The log10 reduction was the highest for E. coli (mean standard deviation 2.6 0.79), followed by E. faecalis (2.19 0.68), S. aureus (1.74 0.88) and C. difficile (0.42 0.54) (P<0.0001 for all analyses). Exposure of shoe soles to the UVC device decreased contamination significantly (mean log10 reduction 2.79 1.25; P<0.0001). Proportions of samples from furniture, bed and patient dummy samples decreased from 96-100% positive in controls to 5-8% positive in UVC device experiments (P<0.0001 for all analyses).

Conclusion: A UVC decontamination device was shown to reduce the colony-forming unit counts of relevant pathogenic organisms from shoe soles with subsequent decreased colonization of floors, healthcare equipment, furniture, beds and a patient dummy

Evaluation of Hospital Floors as a Potential Source of Pathogen Dissemination Usinga Nonpathogenic Virus as a Surrogate Marker

Sreelatha Koganti, Heba Alhmidi, Myreen E. Tomas, Jennifer L. Cadnum,Annette Jencson and Curtis J. Donskey Journal of Infection Control and Hospital Epidemiology

Hospital floors are frequently contaminated with pathogens, but it is not known wether floors are a potential source of transmission. Wed demonstrated that a nonpathogenic virus inoculated onto floors in hospital rooms disseminated repidly to the hands of patients and to high-touch surfaces inside and outside the room


Shoe Soles as a Potential Vector for Pathogen Transmission

Rashid T, V onVille H, Hasan I, Garey KW Journal of Applied Microbiology

Shoe soles are possible vectors for infectious diseases. Although studies have been performed assess the prevalence of infectious pathogens on shoe soles and econtamination techniques no systematic review has ever occurred. The aim of this study was to perform a systematic review of the literature to determine the prevalence of infectious agents on shoe bottoms and possible decontamination strategies. Thirteen studies were identified that supported the hypothesis that show soles are vector for infectious pathogens. In conclusion, a high prevalence of microbiologic pathogens was identified from shoe soles studied in the healthcare, community, and animal worker setting. An effective decontamination strategy for shoe soles was not identified.

Prevalence and Characteristics  of Toxigenic Clostridium Difficile, C. Perfringens, and Enterococcus on Shoe-Bottoms from a Hostpital System

In: American Society for Microbiology (ASM) Texas Branch Fall Meeting, (poster presentation) Oct 29-31, 2015 (SAM HOUSTON STATE UNIVERSITY, HUNTSVILLE, TX) M. Jahangir Alam , Jacob K McPherson, Julie Miranda, Sangeetha S. Fernando, Lynn Le, Jonathan Amadio, Kevin W. Garey University of Houston College of Pharmacy


Background:Healthcare associated infections (HAI) are common everywhere in the world. Environmental surfaces are cleaned regularly, but can be re-contaminated from shoes. Shoe-bottom surfaces could be highly contaminated with pathogenic bacteria from diverse sources. Our recent studies on community house shoe-bottom surface swab samples were found to be frequently contaminated with toxigenic C. dificile. Our objectives of this pilot study were to investigate the prevalence C. dificile, C. perfringens, and Enterococcus of shoe-bottom surface swab samples from a large hospital source.

Materials and Method:

Materials and Method: We collected 20 shoe-bottom swab samples from a hospital system and cultured for the bacteria using standard methods. Isolates were characterized by molecular methods. C. dificile and C. perfringens were cultured anaerobically by enrichment and selective agar plates (CCFA and Perfringens agar). Enterococcus counts were determined by an Enterolert kit.


All the samples (20/20; 100%) were positive for C. perfringens, and 9 (45%) for toxigenic C. dificile (tcdA and tcdB genes). Enterococcus counts were between 25 and >12000 cells/swab for all the samples. Vancomycin resistant Enterococcus species were recovered from 90% (18/20) the samples by selective culture using Enterococcus agar.


Overall, hospital shoe-bottom samples were highly contaminated with potential human pathogens.

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