Blazejewski Caroline, Guerry Mary-Jane, Preau Sébastien, Durocher Alain, Nseir Saad
Intensive Care Unit, Calmette Hospital, University Hospital of Lille, boulevard du Pr Leclercq, 59037 Lille cedex, France.
Infect Disord Drug Targets. 2011 Aug;11(4):365-75. doi: 10.2174/187152611796504818.
Hospital-acquired infections (HAI) represent the most common adverse event in the intensive care unit (ICU). Their prevalence is high and they are associated with increased morbidity and mortality. The environment plays a central role in the transmission of hospital-acquired pathogens (HAP) and in the pathogenesis of HAI. Many bacteria, especially multidrug resistant ones, can survive for several months in the hospital environment in particular in areas close to the patients. It has been proven that pathogens are transmitted from the environment to the patients. Many studies have concluded that current cleaning methods are microbiologically ineffective. This failure concerns daily cleaning as well as terminal cleaning after patient discharge. It has been demonstrated that improvements in environmental cleaning are associated with a decrease in the rate of HAP and of HAI. New cleaning methods could enhance hospital cleaning efficiency. Three new technologies seem promising because they are microbiologically effective, easy and safe to use: (1) hydrogen peroxide vapor and (2) UV light decontamination are used for terminal cleaning. These techniques are effective even in difficultly accessible areas. (3) ultramicrofibers which can be associated with a copper-based biocide can be used for daily cleaning. Other methods such as ozone, steam or high-efficiency particulate air filtration are not efficient enough to be considered serious contenders for the improvement of the quality of the hospital environment. These new technologies have not been yet linked to a decrease in the prevalence and the incidence in HAP and HAI. It remains difficult to justify the extra-cost associated with these new methods until more studies can confirm their effectiveness in the management of HAI.
医院获得性感染（HAI）是重症监护病房（ICU）中最常见的不良事件。其发生率很高，且与发病率和死亡率的增加相关。环境在医院获得性病原体（HAP）的传播以及HAI的发病机制中起着核心作用。许多细菌，尤其是多重耐药菌，能在医院环境中存活数月，特别是在靠近患者的区域。已证实病原体可从环境传播至患者。许多研究得出结论，当前的清洁方法在微生物学上效果不佳。这种不足涉及日常清洁以及患者出院后的终末清洁。已证明环境清洁的改善与HAP和HAI发生率的降低相关。新的清洁方法可提高医院清洁效率。三种新技术似乎很有前景，因为它们在微生物学上有效、使用方便且安全：（1）过氧化氢蒸汽和（2）紫外线消毒用于终末清洁。这些技术即使在难以到达的区域也有效。（3）可与铜基杀菌剂结合使用的超细纤维可用于日常清洁。其他方法，如臭氧、蒸汽或高效空气微粒过滤，效率不够高，不足以被视为改善医院环境质量的有力竞争者。这些新技术尚未与HAP和HAI的患病率和发病率降低相关联。在更多研究能够证实其在HAI管理中的有效性之前，仍难以证明与这些新方法相关的额外成本是合理的。
