important means to prevent the chain of infection .
Much of this early understanding was driven by insufficient understanding of the fundamental microbiology of bacterial communities and impact of surface transmission to patients . 8 However , innovation in epidemiology and molecular biology changed this view , with the implementation of protocols and reviews of procedures improving dramatically over the last two decades . 9 - 11
Surfaces are now understood to be critical sources for pathogens and contribute to transmission , with proper hygiene requiring a more comprehensive approach to reduce or eliminate risk . 12 This change has led to the development of specific roadmaps and health targets across many countries .
The US Department of Health & Human Services established targets for national acute care hospital metrics in 2016 with the National
Action Plan to Prevent Health Care-Associated Infections : Road Map to Elimination . 13 The roadmap set targets for HAI reduction across seven key parameters from 2015 to 2020 : 1 . Central line-associated bloodstream infections 2 . Catheter-associated urinary tracts infections 3 . Invasive healthcareassociated methicillin-resistant Staphylococcus aureus ( MRSA ) 4 . Hospital-onset MRSA 5 . Hospital-onset Clostridium difficile infections 6 . Surgical site infections ( SSI ) 7 . C . difficile-related hospitalisations ( HCUP )
The intent is to track the occurrence from HAIs at the national level every five years , establish if protocols are being used effectively to break the chain of infection from HAIs and hence reduce the corresponding human and monetary costs associated with them .
Disinfection is not simply the removal of visual soil and dirt . It involves testing against a wide range of organisms that can cause infections , such as bacteria , viruses , mycobacteria , moulds and yeasts . These broad classes of organisms typically have critical pathogenic targets , including a class described as ESKAPE organisms . They include six pathogens that exhibit multidrug resistance :
• Enterococcus faecium
• Staphylococcus aureus
• Klebsiella pneumoniae
• Acinetobacter baumannii
• Pseudomonas aeruginosa
• Enterobacter spp14
Candida auris is an additional emerging pathogenic mould of concern , as is the continued challenge of C . difficile infections , evidenced by the CDC using two tracking parameters for HAIs associated with Clostridium infections . 15
28 SPECIALITY CHEMICALS MAGAZINE ESTABLISHED 1981