Regional Hospital Wiener Neustadt, Wiener Neustadt, Austria; Institute for Skin Integrity and Infection Prevention, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK.
Infection Control Programme and Division of Infectious Diseases, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
J Hosp Infect. 2021 Jul;113:104-114. doi: 10.1016/j.jhin.2021.03.010. Epub 2021 Mar 17.
Healthcare-associated infections (HAIs) are the most common adverse outcomes due to delivery of medical care. HAIs increase morbidity and mortality, prolong hospital stay, and are associated with additional healthcare costs. Contaminated surfaces, particularly those that are touched frequently, act as reservoirs for pathogens and contribute towards pathogen transmission. Therefore, healthcare hygiene requires a comprehensive approach whereby different strategies may be implemented together, next to targeted, risk-based approaches, in order to reduce the risk of HAIs for patients. This approach includes hand hygiene in conjunction with environmental cleaning and disinfection of surfaces and clinical equipment. This review focuses on routine environmental cleaning and disinfection including areas with a moderate risk of contamination, such as general wards. As scientific evidence has not yet resulted in universally accepted guidelines nor led to universally accepted practical recommendations pertaining to surface cleaning and disinfection, this review provides expert guidance for healthcare workers in their daily practice. It also covers outbreak situations and suggests practical guidance for clinically relevant pathogens. Key elements of environmental cleaning and disinfection, including a fundamental clinical risk assessment, choice of appropriate disinfectants and cleaning equipment, definitions for standardized cleaning processes and the relevance of structured training, are reviewed in detail with a focus on practical topics and implementation.
医疗保健相关感染（HAI）是由于医疗保健导致的最常见不良后果。HAI 会增加发病率和死亡率，延长住院时间，并与额外的医疗保健费用相关。受污染的表面，特别是经常接触的表面，充当病原体的储存库，并导致病原体传播。因此，医疗保健卫生需要采取综合方法，除了有针对性的基于风险的方法外，还可以同时实施不同的策略，以降低患者发生 HAI 的风险。这种方法包括手卫生以及表面和临床设备的环境卫生清洁和消毒。本综述重点介绍常规环境卫生清洁和消毒，包括污染中度风险区域，如普通病房。由于科学证据尚未导致普遍接受的指南，也没有导致普遍接受的关于表面清洁和消毒的实际建议，因此本综述为医疗保健工作者在日常实践中提供了专家指导。它还涵盖了暴发情况，并为临床相关病原体提供了实用指导。环境清洁和消毒的关键要素，包括基本的临床风险评估、选择适当的消毒剂和清洁设备、标准化清洁过程的定义以及结构化培训的相关性，都进行了详细审查，重点关注实际问题和实施。
