Infection Control through Environmental Hygiene: Challenges and Solutions

Abstract

The healthcare environment plays a critical role in the transmission of significant healthcare-associated pathogens, including vancomycin-resistant enterococci (VRE), Clostridium difficile, Acinetobacter spp., methicillin-resistant Staphylococcus aureus (MRSA), and norovirus. These pathogens can persist on surfaces for extended periods, increasing the risk of acquisition by patients and healthcare workers. Historically, hospital cleanliness was primarily an aesthetic priority, but growing evidence has demonstrated the benefits of enhanced cleaning and decontamination in controlling outbreaks and reducing sporadic transmission. Effective cleaning has been shown to decrease environmental contamination and patient acquisition rates for various pathogens, including MRSA, VRE, C. difficile, and Acinetobacter spp. However, the optimal cleaning methods, frequency, equipment, and standards for surface cleanliness remain subject to ongoing debate. Manual cleaning using detergents or disinfectants is the most common approach, with a focus on high-touch surfaces and frequently used equipment. Automated decontamination devices, such as those utilizing steam, UV light, ozone, or hydrogen peroxide vapor, have emerged as promising adjuncts to manual cleaning, particularly for terminal disinfection. However, their cost-effectiveness and impact on healthcare-associated infection rates require further evaluation. Antimicrobial surfaces and innovative technologies offer additional strategies for enhancing environmental hygiene. Nonetheless, cleaning remains a fundamental infection control measure in modern hospitals, and further research is needed to optimize its implementation in a practical and economically feasible manner.