The Role of Contaminated Surfaces in the Transmission of Nosocomial Pathogens - Use of Biocidal Surfaces for Reduction of Healthcare Acquired Infections - page 28

3.8 Environmental Cleaning, Disinfection and Infection Control . . . . . . ...................... 45
3.8.1 Improving the Efficacy of Cleaning and Disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
3.8.2 Evaluating and Implementing New Technology .................................. 46
3.8.3 Reducing and Controlling the Extent of Environmental Contamination . . . . . . . . . 47
3.8.4 Antimicrobial Surfaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
3.8.5 Improving the Quality of the Evidence ............................................ 49
3.9 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

Abstract Studies in the 1970s and 1980s suggested that environmental surface
contamination had a negligible role in the endemic transmission of healthcare-
associated infections. However, recent studies demonstrate that several major
nosocomial pathogens are shed by patients and contaminate hospital surfaces at
concentrations sufficient for transmission, survive for extended periods, persist
despite attempts to disinfect or remove them and can be transferred to the hands
of healthcare workers. Evidence is accumulating that contaminated surfaces make
an important contribution to the epidemic and endemic transmission of C. difficile ,
vancomycin-resistant enterococci, methicillin-resistant Staphylococcus aureus ,
Acinetobacter baumannii , Pseudomonas aeruginosa and norovirus and that
improved environmental decontamination contributes to the control of outbreaks.
Efforts to improve environmental hygiene should include enhancing the efficacy of
cleaning and disinfection and reducing the shedding of pathogens. Further high
quality studies are needed to clarify the role of surfaces in nosocomial transmission
and determine the effectiveness of different interventions in reducing associated
infection rates.

Keywords Environmental contamination • Cleaning • Disinfection • MRSA
• VRE • Acinetobacter baumannii • Pseudomonas aeruginosa • Clostridium difficile
• Norovirus

List of Abbreviations

aHP Aerosolized hydrogen peroxide

CDC Centers for Disease Control and Prevention

CDI Clostridium difficile infection

CFU Colony forming units

CPE Carbapenemase-producing Enterobacteriaceae

ESBL Extended spectrum beta-lactamase

GNRs Gram-negative rods

HAI Healthcare-associated infections

HCPs Healthcare personnel

HPV Hydrogen peroxide vapor

ICU Intensive care units

QAC Quaternary ammonium compounds