Cleaning and disinfection in outbreak control – experiences with different pathogens

BackgroundEnvironmental cleaning and disinfection is well known as an essential part of preventing hospital-acquired infections. We describe the observation of two outbreaks of nosocomial infections with different pathogens in a tertiary care teaching hospital in Germany. Cleaning and disinfection procedures were essential measures to stop the outbreaks.MethodsWe used a standardised procedure for dealing with the outbreaks. One of the most important measures was a change in the cleaning and disinfection process which was conducted by staff with special training in disinfection. After disposal of all single-use materials, a scrub-wipe disinfection processwith high concentrations (3%) of an oxygen radical-producing substance was performed in the affected rooms, followed by nebulisation with the same product (3%). Finally, the room was cleaned again with another scrub-wipe process at routine concentration (0.5%).ResultsAfter changing the routine cleaning and disinfection procedure (twice daily with a 0.5% concentration of a radical-producing substance performed by housekeeping) to a 3-step cleaning process using a higher concentration (3%) of the substance performed by workers specially trained in disinfection, the outbreaks stopped.ConclusionIn combination with a multidisciplinary coordination team and training, the cleaning and disinfection process was one of the most important steps in stopping outbreaks of nosocomial infections.