Surface cleaning and disinfection: insight into the situation in Germany and Europe

IntroductionRoutine disinfection of frequently touched environmental surfaces and floors has been a controversial issue in hospital hygiene strategies. In view of the rise in multi-resistant micro-organisms and with more attention being paid to nosocomial infections and outbreaks occurring in community settings, environmental disinfection is being increasingly recognised as an important contribution to infection prevention.DiscussionEnvironmental concerns regarding the use of chemical disinfectants and the lack of epidemiological data are frequently mentioned as an argument against routine disinfection. While the exact extent of the impact of contaminated surfaces on the rate of infections is difficult to establish, there is sufficient evidence for the possibility of cross-contamination from surfaces to patients and staff, and vice-versa, to make surface disinfection indispensable. Effective disinfection is dependent on risk assessment, on the use of products with tested efficacy, on suitable application methods and on the evaluation and monitoring of disinfection. The German Hospital Hygiene and Infection Prevention Commission (KRINKO) addresses these aspects in its very detailed recommendation ‘Hygiene Requirements on the Cleaning and Disinfection of Surfaces’. The German Association for Applied Hygiene (VAH) develops test methods and compiles a list of tested and certified disinfectant products to ensure product effectiveness. Public health authorities in Germany support the use of certified disinfectants. On a European level, much effort is put into the development of internationally acceptable practice-relevant test protocols for efficacy testing of disinfectants.ConclusionSurface disinfection should be viewed as part of a bundle of strategies in hospital hygiene. In order to ensure effective disinfection, the use of properly tested disinfectant products is essential. VAHaims to create a platform for tested disinfectants that is recognised European-wide. In addition, detailed recommendations on the prerequisites for effective surface disinfection processes, such as issued by KRIKNO, should be provided.