INF ECTION P R EVENTION
The science of safe surfaces
Dr. Kayleigh Cox-Nowak provides an insight into effective disinfection protocols, aimed at reducing the risk of transmission of healthcare-associated infections.
Effective disinfection protocols are essential to support infection prevention strategies in hospitals. Environmental surfaces contaminated with pathogens have the potential to become sources of infection. Cleaning and disinfection are key interventions to reduce contamination levels on surfaces. However, the efficacy of these interventions is determined not only by the methods used but also by the type of surface being cleaned and where it is situated.1 Therefore a risk stratified approach should be considered when determining protocols, based on a number of factors which are examined in this article.
Viruses and bacteria are the most common causes of infectious diseases acquired in hospitals and cause a considerable negative impact on the health of patients. Healthcare associated infections (HCAIs) also known as “nosocomial”
infections are defined as infections that occur in patients during the process of care in a hospital or other healthcare facility, which was not present or incubating at the time of admission. Such infections increase morbidity and mortality, as well as presenting significant extra costs.2 data3
The most recent UK
estimates a prevalence in hospitals in England of 6.4%. Although a recent study estimated that 5%-15% of hospitalised patients in high-income countries acquire an HCAI.4
In hospitals, the direct transmission of pathogens generally occurs from person to person, but indirect transmission through
Although wipes may look similar, their composition and subsequent ability to clean and disinfect critical surfaces shows considerable variation. The size, thickness, material composition, layering, formulation, and degree of absorbency of the wipe will determine the quantity of disinfectant retained in and released from it.
SEPTEMBER 2021
contaminated surfaces is also recognised.1 Surfaces can become contaminated by hands, objects, and the settling of virus containing aerosols or contaminated fluids.5
Therefore, these surfaces can
play an important role for transmission of pathogens in healthcare settings.5 Transmission of pathogens by a person touching a contaminated surface has been demonstrated to be possible.6
Microorganisms including gram-positive and gram-negative bacteria can persist on inanimate surfaces for prolonged periods of time.7
Viruses may remain on surfaces for between a few hours and a few months; generally non-enveloped viruses are more stable on environmental surfaces than enveloped ones.7
A recent report on the
persistence of various coronaviruses on different surfaces showed viral survival from 2 hours to 9 days.8
A study specifically
examining SARS-CoV-2 found the virus, which causes COVID-19, is stable on plastic and stainless steel for up to 72 hours, on copper for up to 4 hours, and cardboard up to 24 hours under laboratory conditions.9 Noroviruses are found on different types of surfaces including floors, tables, doorknobs, handles, bed rails, carpets, and curtains in healthcare facilities. Along with many other enteric viruses like poliovirus
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