Hospital Disinfection: Efficacy and Safety Issues
By DR. MARKUS DETTENKOFER, Freiburg University Hospital, Germany

 The key question as to whether the use of disinfectants on environmental surfaces, or whether cleaning with detergents only reduces nosocomial infection rates still awaits conclusive studies. 

New disinfectants, mainly peroxygen compounds, show good sporicidal properties and will probably replace more problematic substances such as chlorine-releasing agents. 

The safe reprocessing of medical devices requires a well-coordinated approach, starting with proper cleaning. New methods and substances show promising activity for preventing the transmission of prions. 

Various different aspects of virus inactivation have been studied, and the transmissibility – e.g. of norovirus – shows the need for sound data on how different disinfectant classes perform. 

Biofilms or other forms of surface-adherent organisms pose an extraordinary challenge to decontamination. Although resistance to biocides is generally not judged as yet to be as critical as antibiotic resistance, scientific data support the need for proper use, notably including the avoidance of widespread application, especially in low concentrations and in consumer products. 

Chemical disinfection of heat-sensitive instruments and targeted disinfection of environmental surfaces are established components of hospital infection control. To avoid danger to staff, patients and the environment, prudent use as well as established safety precautions are required. 

New technologies and products should be evaluated with sound methods. As emerging resistant pathogens will challenge healthcare facilities in the future even more than at present, there is a need for well-designed studies addressing the role of disinfection in hospital infection control.

 

- reprinted from Volume 11 of the Virox Solutions newsletter.