Cleaning and Surgical Disinfection: New Insights and Strategies
By DR. MARTIN EXNER, Institute of Hygiene and Public Health, University of Bonn

 Recently, new insights into the persistence of pathogens, their transfer from inanimate surfaces to humans, and the risk of contamination and dissemination of pathogens by detergents have been gained.

Furthermore, new experimental data on the interruption of chains of infection by disinfectants as well as results of outbreak-control studies are now available. Hence it has become necessary to reassess the potential benefits of using disinfectants to prevent and control nosocomial infections. 

Based on the new findings and in view of the increasing incidence of nosocomial infections and antibiotic resistance, the German Robert-Koch-Institute has issued completely revised recommendations on cleaning and surface disinfection. 

With respect to these recommendations, a new test method was developed, which allows comparison of the efficacy of disinfection in reducing the microbial loads and their dissemination with that of cleaning procedures under practical conditions. 

In a multi-factor approach, mechanical properties (wet mop technique), utensils (different mop materials) and active agents (disinfectant, detergent) were taken into consideration. We found that under the given conditions, dissemination of the test organism (itals)Staphylococcus aureus(enditals) did not take place when using aldehydes and peroxides, it did take place, however, when water, surfactants, and the disinfectant glycol derivatives, quaternary ammonium compounds and alkylamines were used.