Enhanced Decontamination to Reduce Healthcare-Associated Infections. Is New Technology the Answer?

Professor Hilary Humphreys1

1Department of Clinical Microbiology, RCSI, Smurfit Building, Beaumont Hospital, Dublin D09 YD60 hhumphreys@rcsi.ie


Conventional decontamination with detergent, water and disinfectants is often sub-optimal despite recent efforts to improve hygiene services.  Consequently, there has been much interest in alternative approaches, in particular those that are “walk away” technologies.  These include altering the surface components, coating or incorporating antimicrobial compounds into the surface, or alternatively the use of hydrogen-peroxide or ultra-violet light.  Silver-coated surfaces and copper have been shown to reduce surface counts but there is limited evidence of their impact on rates of healthcare-associated infections (HCAI).  It is unclear whether they provide added benefit to conventional cleaning.  Both hydrogen peroxide and ultraviolet light require the vacating of clinical areas by both patients and staff.  Both reduce surface bacterial counts and quasi-experimental studies have shown a possible impact on either reducing HCAI rates or bringing outbreaks to an end.  Despite a cluster randomised study of ultra-violet light showing a reduction in the acquisition of multi-drug resistant organisms, there remains some caution in recommending these for routine use.  However, better designed interventional studies which allow for the many variables involved are required to evaluate their potential contribution or otherwise to preventing HCAI.

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