Survival of Microorganisms on Inanimate Surfaces - Use of Biocidal Surfaces for Reduction of Healthcare Acquired Infections - page 19

During outbreaks, the role of the patients' environment is particularly evident, as
suggested by observed evidence for Acinetobacter baumannii , C. difficile , MRSA,
P. aeruginosa , VRE, Adenovirus, SARS virus, Rotavirus, and Norovirus [ 64 , 65 ,
54 , 55 , 99 , 9 , 123 , 83 , 58 ]. The role of contaminated surfaces is also underlined by
the observation that after environmental disinfection, significant decrease of trans-
missions and HAI have been shown, i.e. for C. difficile [ 73 , 126 ], for VRE [ 50 ], for
MRSA [ 32 ], for multidrug-resistant A. baumanii [ 84 ], for S. marcescens [ 3 ], and for
other multidrug-resistant Gram-negative rods [ 86 ].
If performed correctly, also the burden of microbial airborne transmission can be
significantly decreased by surface disinfection. This again may have an impact on
healthcare organisations, resulting in i.e. higher clean room class of drug
manufacturing areas [ 8 ] by elimination of critical bacterial and fungal contamina-
tion [ 63 ]. As consequence for the successful interruption of cross contamination
and infections a multi-barrier approach is required with the key points of hand
hygiene and surface disinfection, appropriate used of antisepsis, barrier nursing,
and safe reprocessing of contaminated medical devices. Within such multi-barrier
strategy, environmental disinfection policies should be based on risk assessments
for surfaces with different risks for cross contamination such as high- and
low-touched surfaces with appropriate standards for adequate disinfection mea-
sures. Generally, surface disinfection is indicated in the following situations:
- Frequently touched surfaces adjacent to patients
- Surfaces with assumed or visible contamination
- Terminal disinfection in rooms or areas where infected or colonized patients
with easily transferable nosocomial pathogens are cared for, and
- in outbreak situations.
The purpose of preventive or targeted disinfection on inanimate surfaces is the
killing or irreversible inactivation of pathogens to an extent which prevents subse-
quent infection transmission [ 41 ]. In order to ensure the success of environmental
disinfection, education, training [ 52 ], and targeted microbiological control are impor-
tant measures and have been shown to improve both, cleaning performance and
infection prevention [ 50 ]. Increasingly, novel technologies are introduced, which
may be used additionally to cleaning. Such technologies may include antimicrobial
surfaces on basis of different antimicrobial compounds and are provided for hospital
door handles, alarm knobs, curtains, and other objects with high frequencies of hand
contact. However, such technologies must be used appropriately and as an adjunct
measure to meaningful cleaning and disinfection processes.
References
1. Aviles B, Klotz C, Eifert J, Williams R, Ponder M (2013) Biofilms promote survival and
virulence of Salmonella enterica sv. Tennessee during prolonged dry storage and after
passage through an in vitro digestion system. Int J Food Microbiol 162:252-259