Exner Martin
Institute of Hygiene and Public Health, University of Bonn, Bonn, Germany.
GMS Krankenhhyg Interdiszip. 2007 Sep 13;2(1):Doc19.
Virtually no prevention strategy in hospital hygiene has been the focus of such frequent controversial discussions as the role of surface disinfection. Set against that background, the Commission for Hospital Hygiene and Infection Prevention at the Robert Koch Institute founded a working group comprising members with divergent views of risk evaluation as regards the role of disinfection. This working group produced a most carefully drafted guideline on how to deal with various risk areas and also incorporated a new provision into the guideline, stating that: "Cleaning and disinfection procedures must be organized and implemented such that there is no increase in the microbial load or spread of facultatively pathogenic or pathogenic microorganisms on surfaces."Numerous studies have come to the conclusion that surface disinfection constitutes a basic infection control measure with which the spread of pathogens can be controlled. Conversely, when using only detergents such a form of control is not possible, something that must be taken into account in future when engaging in risk evaluation and formulating infection control measures. In view of the burgeoning trend in, for example, norovirus outbreaks, also in hospitals and nursing homes, such insights are of paramount importance and attest to the need for disinfection of surfaces and of areas with frequent hand and skin contacts. This discussion about the need for surface disinfection has, in addition to causing confusion among users, led to a decline in the willingness to accept hygienic practices, thus increasing the risk of occurrence of nosocomial infections as well as of antibiotic-resistant microorganisms.
在医院卫生领域，几乎没有哪种预防策略像表面消毒的作用那样，成为如此频繁的争议性讨论焦点。在此背景下，罗伯特·科赫研究所的医院卫生与感染预防委员会成立了一个工作组，其成员对消毒作用的风险评估观点各异。该工作组制定了一份精心起草的指南，内容涉及如何应对各类风险领域，并且在指南中纳入了一项新规定，即：“清洁和消毒程序的组织与实施必须确保表面上兼性致病或致病微生物的微生物负荷不会增加，也不会扩散。”众多研究得出结论，表面消毒是一项基本的感染控制措施，通过它可以控制病原体的传播。相反，仅使用洗涤剂则无法实现这种控制形式，这在未来进行风险评估和制定感染控制措施时必须予以考虑。鉴于例如诺如病毒在医院和养老院等场所爆发的趋势不断增加，这些见解至关重要，证明了对表面以及频繁接触手和皮肤的区域进行消毒的必要性。关于表面消毒必要性的这场讨论，除了在使用者中造成困惑之外，还导致接受卫生做法的意愿下降，从而增加了医院感染以及对抗生素耐药微生物出现的风险。
