Lab Matters Summer 2020 | Page 16

FROM THE BENCH from page 13 non-susceptible isolates are shared with CDC for whole genome sequencing and phylogenetic analyses. Future Quality Improvement initiatives MHDL is actively improving and enhancing current GC surveillance by offering patient options for specimen selfcollection, conducting quality assurance reviews to reduce wait times in clinics, and culture-independent molecular analyses. Advanced molecular projects with CDC will aid in understanding strain relatedness, identification of resistance markers, virulence markers, outbreaks, and cluster analysis. In partnership with local, state, and CDC partners, real-time detection of GC resistance, and use of molecular methods for strain typing will contribute to reducing community transmission, and the need for evidencebased modifications to existing antibiotic treatment guidelines and alternate treatment regimens. • References 1. L. Amsterdam, and S. Bhattacharyya. 2020. Strengthening United States Response to Resistant Gonorrhea in Wisconsin. APHL Summer Lab Matters 2. Papp, J.R., et al. (2016). Recovery of Neisseria gonorrhoeae from 4 commercially available transport systems. Diagn Microbiol Infect Dis. http://dx.doi. org/10.1016/jdiagmicrobio.2016.06.019 3. Public Health Partnership in Response to Resistant Gonorrhea: Role of Laboratories in Enhancing Local Capacity Towards Improved Gonococcal Surveillance. 2019. M. Khubbar, R. Gomez, J. Weiner, K. Keuler, N. Leigh, T. Dasu, T. Maher, J. Katrichis, J. Dalby, P. Hunter, J. Pfister, D. Shrestha, L. Amsterdam, and S. Bhattacharyya 4. CDC. Abstract submitted for 2020 STD Conference. Extragenital Cultures from Women and Men with Opposite-Sex and Same-Sex Sexual Exposure Are Important for Antibiotic-Resistant Gonorrhea (ARGC) Surveillance. J. Pfister, L. Amsterdam, D. Shrestha, C. Steward, M. Khubbar, R. Gomez2, J. Weiner, T. Dasu, J. Dalby, H. Hermus, J. Katrichis, S. Bhattacharyya. Acknowledgements: • STD and Non-STD Grant Partners, Milwaukee jurisdiction • WI DPH Program Staff • MHD Clinic and Laboratory Program Staff • CDC Division of STD Prevention SURRG Program Staff • CDC ELC Grant # CK19-1904 Decontamination and Reuse of N95 Masks During Times of Shortage By Mohammad Karim, PhD, Environmental Microbiologist III, City of Santa Cruz Environmental Laboratory and Akin Babatola, MSc, laboratory and environmental compliance manager, City of Santa Cruz Environmental Laboratory Although N95 mask decontamination and reuse are not approved routine standard care procedures, it may be necessary during high-demand periods such as infectious disease outbreaks. During the current COVID-19 pandemic, the N95 mask shortage prompted considerations such as extended use, reuse without decontamination and reuse with decontamination to ensure availability and first responder protection. While waiting for N95 mask supplies to be restocked by commercial and state supplies, the City of Santa Cruz Environmental Laboratory, in collaboration with the city’s emergency officer, developed a procedure to sanitize masks based on US Centers for Disease Control and Prevention (CDC) recommendations to reduce or eliminate risks associated with reuse of untreated, contaminated N95s. Safety and Treatment Efficacy Ultraviolet germicidal irradiation (UVGI) has been shown to effectively inactivate a wide range of human pathogens, including coronaviruses and other human respiratory viruses. According to CDC, mask filtration and fit performance were not affected by up to three cycles of UVGI doses of 0.5 to 950 J/cm 2 . UVGI doses of 0.5 to 1.8 J/cm 2 inactivated at least 99.9% of all the tested respiratory viruses. UVGI can be associated with adverse health effects. Safety precautions are needed to avoid exposure to skin and eyes. With appropriate safeguards, UVGI can be safely administered for mask decontamination. The UVGI treatment efficacy is dose dependent. Not all UV lamps provide the same irradiance intensity and thus treatment times need to be adjusted accordingly. Due to shadow effects produced by the multiple layers of the mask construction, UVGI may not inactivate all the microorganisms on a mask. UV Disinfection of Masks 1. Use appropriate personal protective equipment (PPE) (disposable lab coat, N95 mask, safety goggles, face shield, long sleeve gloves) before handling soiled masks. 2. Place the soiled masks with chain-ofcustody (COC) on a designated cart outside the microbiology laboratory. 3. Receive the soiled masks through the window and place the masks with bags in the cooler on the designated cart inside the microbiology lab. Sign the COC and make a copy for the courier. 4. Bring the cart in the lab next to the biosafety hood (BSL-2). 5. Transfer bags containing masks into the biosafety hood. 14 LAB MATTERS Summer 2020 PublicHealthLabs @APHL