Centre for Research on Environmental Microbiology (CREM), Faculty of Medicine, University of Ottawa, Ontario, Canada.
Am J Infect Control. 2010 Jun;38(5 Suppl 1):S34-40. doi: 10.1016/j.ajic.2010.04.207.
Hard, nonporous environmental surfaces in health care settings are now receiving due recognition for their role in the spread of several types of nosocomial pathogens. The corresponding increase in the means to decontaminate such surfaces to interrupt the spread of infections is leading to the marketing of a plethora of products and procedures, including the "green" variety, with varying claims of microbicidal activity, human and environmental safety, and materials compatibility. Limitations of the existing methods to assess environmental surface disinfectants and the regulations that govern their premarket registration make objective evaluations difficult. Label claims of many such products also do not reflect the realities of field use along with a strong tendency to focus on the "bug de jour." Furthermore, whereas wiping is often an integral part of environmental surface decontamination, products meant for the purpose are rarely assessed with the physical effect of wiping incorporated. Many "green" products possess neither the spectrum of microbicidal activity nor the speed of action essential for use in health care settings. In general, "self-sanitizing" surfaces being marketed actively these days require greater scrutiny for field-relevant microbicidal activity as well as the potential to enhance microbicide resistance. The widening use of environmental surface disinfectants is also raising concerns on their human and environmental safety at many levels along with the realization that routine surface disinfection procedures in health care settings are frequently inadequate and possibly counterproductive. All this points to an urgent review of the basic procedures for assessing existing and new environmental surface disinfectants for their microbicidal activity, label claims, registration requirements, overall safety, and routine practices of environmental surface decontamination.
在医疗机构中，硬质、无孔的环境表面现在因其在传播多种医院病原体方面的作用而受到重视。为了阻断感染传播，相应地增加了对这些表面进行消毒的方法，这导致了大量产品和程序的上市，包括“绿色”产品，它们具有不同的杀菌活性、人体和环境安全性以及材料相容性的声称。现有的评估环境表面消毒剂的方法存在局限性，以及监管其上市前注册的规定，使得客观评估变得困难。许多此类产品的标签声称也没有反映现场使用的实际情况，并且存在强烈的倾向关注“当下的病菌”。此外，擦拭通常是环境表面消毒的一个组成部分，但用于该目的的产品很少与擦拭的物理效果一起进行评估。许多“绿色”产品既没有必要的杀菌活性范围，也没有在医疗机构中使用所需的作用速度。总的来说，目前市场上积极推广的“自消毒”表面需要更严格地审查其现场相关的杀菌活性以及增强抗微生物剂耐药性的潜力。环境表面消毒剂的广泛使用也引起了人们对其在许多层面上的人体和环境安全性的关注，同时也意识到医疗机构中的常规表面消毒程序常常是不够的，甚至可能适得其反。所有这些都表明，迫切需要对现有的和新的环境表面消毒剂的杀菌活性、标签声称、注册要求、总体安全性以及环境表面消毒的常规实践进行基本程序的审查。
