Roles of clinical microbiology in hospital environmental cleaning and disinfection: a narrative review
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Purpose: This narrative review examines the pivotal role of clinical microbiology in environmental cleaning and disinfection within healthcare facilities. With an increasing focus on infection control, particularly regarding multidrug-resistant organisms (MDROs), the review explores disinfection strategies, monitoring methods, and best practices, including recent recommendations from the Korea Disease Control and Prevention Agency. Current content: MDROs such as methicillin-resistant Staphylococcus aureus, vancomycin resistant enterococci, and carbapenem-resistant gram-negative bacteria are significant contributors to healthcare-associated infections (HAIs). These organisms persist on hospital surfaces, posing a risk of transmission. There are various disinfection modalities for non critical surfaces (e.g., bedrails, floors) detailing the advantages and limitations of common disinfectants, including quaternary ammonium compounds, hydrogen peroxide, and sodium hypochlorite. It is efficient to use self-disinfecting surfaces coated with heavy metals and no-touch disinfection technologies, such as ultraviolet (UV)-C light and vaporized hydrogen peroxide. Clinical microbiologists are responsible for monitoring methods, including swab cultures, Replicate Organism Detection and Counting plates, and adenosine triphosphate assays, to assess the microbial load on hospital surfaces. Comprehensive monitoring is needed, which also includes visual inspection, UV-visible markers, and fluorescent tracers for quality control and performance feedback. Conclusion: Environmental cleaning and disinfection are essential in reducing HAIs linked to MDROs. Effective implementation of evidence-based disinfection practices, adherence to guidelines, and collaboration between clinical staff are critical components of successful infection control. The clinical microbiologist's role is vital in evaluating cleaning efficacy and ensuring optimal infection prevention strategies through regular feedback and microbial surveillance.
Abstract
Purpose: This narrative review examines the pivotal role of clinical microbiology in environmental cleaning and disinfection within healthcare facilities. With an increasing focus on infection control, particularly regarding multidrug-resistant organisms (MDROs), the review explores disinfection strategies, monitoring methods, and best practices, including recent recommendations from the Korea Disease Control and Prevention Agency. Current content: MDROs such as methicillin-resistant Staphylococcus aureus, vancomycin resistant enterococci, and carbapenem-resistant gram-negative bacteria are significant contributors to healthcare-associated infections (HAIs). These organisms persist on hospital surfaces, posing a risk of transmission. There are various disinfection modalities for non critical surfaces (e.g., bedrails, floors) detailing the advantages and limitations of common disinfectants, including quaternary ammonium compounds, hydrogen peroxide, and sodium hypochlorite. It is efficient to use self-disinfecting surfaces coated with heavy metals and no-touch disinfection technologies, such as ultraviolet (UV)-C light and vaporized hydrogen peroxide. Clinical microbiologists are responsible for monitoring methods, including swab cultures, Replicate Organism Detection and Counting plates, and adenosine triphosphate assays, to assess the microbial load on hospital surfaces. Comprehensive monitoring is needed, which also includes visual inspection, UV-visible markers, and fluorescent tracers for quality control and performance feedback. Conclusion: Environmental cleaning and disinfection are essential in reducing HAIs linked to MDROs. Effective implementation of evidence-based disinfection practices, adherence to guidelines, and collaboration between clinical staff are critical components of successful infection control. The clinical microbiologist's role is vital in evaluating cleaning efficacy and ensuring optimal infection prevention strategies through regular feedback and microbial surveillance.
참고문헌 (15)
- Protano C, "Hospital environment as a reservoir for cross transmission : cleaning and disinfection procedures", Ann Ig, 31, pp.436~448 (2019)
- Han Z, "Environmental cleaning and disinfection of hospital rooms : a nationwide survey", Am J Infect Control, 49, pp.34~39 (2021)
- Kampf G, "Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs", Clin Microbiol Rev, 17, pp.863~893 (2004)
- Martínez JA, "Role of environmental contamination as a risk factor for acquisition of vancomycin-resistant enterococci in patients treated in a medical intensive care unit", Arch Intern Med, 163, pp.1905~1912 (2003)
- Weber DJ, "Role of hospital surfaces in the transmission of emerging health care-associated pathogens : norovirus, Clostridium difficile, and Acinetobacter species", Am J Infect Control, 38, pp.S25~33 (2010)
- "Best Practices for Environmental Cleaning in Healthcare Facilities: in Resource-limited Settings"[URL]
- Rutala WA, "Disinfection and sterilization in health care facilities : an overview and current issues", Infect Dis Clin North Am, 35, pp.575~607 (2021)
- Fram DS, "Hightouch surfaces disinfection compliance in a COVID-19 intensive care unit", Am J Infect Control, 51, pp.469~471 (2023)
- Lakshminarayanan R, "Recent advances in copper and copper-derived materials for antimicrobial resistance and infection control", Curr Opin Biomed Eng, 24, pp.100408~ (2022)
- Querido MM, "Self-disinfecting surfaces and infection control", Colloids Surf B Biointerfaces, 178, pp.8~21 (2019)
- No-touch modalities for disinfecting patient rooms in acute care settings: a rapid review, "Tsou AY", Agency for Healthcare Research and Quality, ~, pp.20(21)-EHC021 (2020)
- Obenza A, "Microbial contamination on ambulance surfaces : a systematic literature review", J Hosp Infect, 122, pp.44~59 (2022)
- Environmental cleaning for the prevention of healthcare-associated infections, "Leas BF", Agency for Healthcare Research and Quality, ~, pp.15-EHC020-EF (2015)
- "Recommendations for cleaning and disinfection of environmental surfaces in medical institutions"[URL]
- Abubakar U, "Impact of COVID-19 pandemic on multidrug resistant gram positive and gram-negative pathogens : a systematic review", J Infect Public Health, 16, pp.320~331 (2023)