BIOCIDES
Innovation & progress
To achieve the goal of HAI prevention and reduction , new disinfection and cleaning products have been developed for use in healthcare facilities . Dilutable concentrates , sprays and wipes are common product forms used by nursing and environmental services staff according to infection prevention protocols .
The different forms allow for multiple ways of disinfecting and cleaning , although wipes are one of the most common and preferred formats used on surfaces other than floors , as they provide ease of use , combined cleaning and disinfection , and offer a ' lower risk of application error since they are fully ready to use .
The products themselves are highly regulated , such as by the US Environmental Protection Agency ( EPA ) or via the Biocidal Product Registration process in Europe . This means they are rigorously tested for efficacy against established protocols to deliver the disinfection needed to clean the surface . They are tested according to specified methods to ensure that the product will deliver the claimed effectiveness .
In such testing critical attributes are defined for their effectiveness , including the time required for disinfection , defining the breadth and spectrum of disinfection , and even the types of surfaces on which the disinfection is viable . Further , the testing is performed against standard pathogenic organisms of concern , which are highlighted on product labels that provide guidance on what product to use and how to use it .
A critical emerging issue , as alluded to above , is the increase and spread of drug-resistant organisms . Resistance to antibiotics such as methicillin , vancomycin , carbapenem , or cephalosporins make it more difficult for healthcare providers to solve the problem of infection after it is contracted .
This rise in antibiotic resistance highlights a key role that disinfectants , which are not antibiotics but broadspectrum antimicrobials , can play in helping to break this emerging chain of infection . In fact , recent studies indicate that disinfectant use is a critical and sustainable way to reduce the spread of HAIs and minimise antibiotic resistance . 16 Hence , disinfectants are critical components for HAI mitigation .
Another area of advance has been in understanding the role biofilms play in HAI transmission and the development of antibiotic resistance . 17 Biofilms are communities of microorganisms that live within an extracellular polymeric matrix produced by the microorganisms that attach to surfaces , allowing the organisms to adapt and survive in new environments .
Biofilm-related infections pose a particular risk due to the difficulty to disinfect and treat . The recognition of such challenges led the EPA to develop protocols in collaboration with the Center of Biofilm Engineering at Montana State University to test products and provide means to develop products for use against wet biofilms . 18 - 19
Further , there is growing recognition of the role of dry biofilms as an additional and likely representative of prolific type of contamination on surfaces in healthcare facilities that contribute to HAI transmission . 20 Therefore advances in disinfection technologies that target these metrics and emerging needs will help to meet both current and future needs of the healthcare industry to reduce infection risk .
Future of disinfection
The combination of recognising the need for cleaning protocols to reduce HAIs and concern over drug-resistant organisms has led to the development of many types of products to combat these challenges , many that are available to use by a healthcare facility or network . Some of this variation is the result of where disinfection and cleaning are needed , in intensive care units , device disinfection or general area cleaning .
In general , there are three different levels of disinfection , each with multiple product types and features . They are designated according
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