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Is there so much attention to disinfection of environmental surfaces?

Author:Site Editor     Publish Time: 2021-03-24      Origin:Site

From the professional point of view of the evidence-based basis of hospitals, the accumulated evidence of hospital sensation in the past ten years shows that the surface of contaminated environmental objects has outbreaks of VRE, MRSA, Acinetobacter baumannii, Pseudomonas aeruginosa, and norovirus. It is of great significance in communication with the hospital.


There are literatures showing that nosocomial infection refers to the infection acquired by inpatients in the hospital. In the United States, about 5% of all emergency hospitalization patients will develop nosocomial infections. Statistics in 2002 show that there are approximately 1.7 million cases of nosocomial infections each year. Nosocomial infection is the fifth leading cause of death, second only to heart disease (28.5%), cancer (22.8%), stroke (6.7%) and accidental death. Approximately 99,000 people in the United States died of hospital infections in 2002. The increase in medical costs due to hospital infections in the United States is about 6.7 billion U.S. dollars.


It can be seen that nosocomial infection not only has a high mortality rate, but also brings great economic losses. It has become an important factor restricting the development of medicine and affecting the safety of patients and medical staff. Therefore, prevention and control of nosocomial infection is a very important link. Studies have also shown that 10% to 70% of hospital infections are preventable.


One of the important measures to prevent nosocomial infection is to do a good job of disinfecting the surface of environmental objects.


At present, hospitals mainly use six categories of products for disinfection of environmental surfaces, namely: quaternary ammonium salts, phenols, chlorine-containing products, high-concentration alcohols, quaternary ammonium salts and low-concentration alcohol mixtures, and hydrogen peroxide. .


  • Quaternary ammonium salt

Such surface disinfectants are low-efficiency disinfectants and are widely used for cleaning and disinfecting the surfaces of hospital objects and medical instruments. The bactericidal mechanism of quaternary ammonium salt is that it contains positive ion groups. Quaternary ammonium salt can denature protein, affect the metabolism of bacteria and fungi, and play a bactericidal effect. The quaternary ammonium salt has no irritating smell, but it is not effective against tuberculosis bacilli, and the sterilization time is longer (usually 10 minutes).


  • Highly concentrated alcohol

The main mechanism of alcohol sterilization is that it can denature proteins, thereby destroying cell walls and cell membranes. When using alcohol for disinfection, the concentration must be between 70% and 95% to achieve the best sterilization effect. Alcohol used for surface disinfectant mainly includes ethanol and isopropanol. Alcohol is easy to damage the surface of cleaning objects, is flammable, and has poor cleaning effect. Alcohol evaporates quickly and usually evaporates before the required sterilization time is reached, thus reducing the disinfection effect.


  • Chlorine-containing disinfectants

Generally, this kind of surface disinfectant has the advantages of broad spectrum, high efficiency, low toxicity and low price, and it is one of the common hospital disinfectants at present. However, this type of disinfectant also has many shortcomings. For example, chlorine-containing disinfection has a strong peculiar smell, can react with ammonia, phosphoric acid, acetic acid and other chemical reagents to produce harmful gases, has a bleaching effect, and the diluted chlorine disinfectant is unstable (hence It is necessary to prepare fresh diluent every day), it is easy to inactivate when encountering organic matter, and will corrode metal products.


  • Quaternary ammonium salts and low-concentration alcohols are used together

This type of surface disinfectant combines the effects of quaternary ammonium salts and alcohol, has a fast sterilization speed, can kill Mycobacterium tuberculosis, and is an intermediate disinfectant. Due to the use of low-concentration alcohol (less than 20%), the cleaning effect is very good, at the same time it has good compatibility with the surface of the object, and it is not easy to ignite.


  • Phenols

Phenolic disinfectants have a long history. They were widely used in hospital disinfection before the 1970s. They were once one of the main disinfectants in hospitals. However, due to the widespread use of new disinfectants plus the inherent shortcomings of phenolic surface disinfectants and environmental pollution, they are currently Has gradually withdrawn from the medical disinfection market.


  • Hydrogen peroxide


The main mechanism of sterilization is that it can form free radicals, which destroy important cell components such as phospholipids and deoxyribonucleic acid on the cell membrane, thereby killing microorganisms. This type of surface disinfectant has a fast sterilization speed, and the main component after decomposition is water, so it is very environmentally friendly. But the compatibility is not good, and it is easy to damage the surface of the object being cleaned and the medical instrument.


1. Disinfect in accordance with the principles of norms and standards


1) The GB15982-2012 "Sanitation Standard for Hospital Disinfection" promulgated in 2012 in my country specifically has management requirements for the disinfection of environmental objects:


2) WS/T368-2012 "Technical Specification for Disinfection in Medical Institutions" promulgated in 2012 has requirements:

3) The WS/T 512-2016 "Management Regulations for Environmental Surface Cleaning and Disinfection of Medical Institutions" promulgated in 2016 put forward many new concepts, such as:


①High-frequency contact surface: increase the frequency of cleaning and disinfection;


②Clean-disinfect one-step method: promote the use of disinfectant wipes;


③Drag/floor towel revolution: cleaning unit, material change (microfiber material), repeated soaking is prohibited, and mechanical cleaning and disinfection methods are recommended.


④Cleaning tools: use color coding: (yellow, blue, red, green) management.


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2. Do daily cleaning and disinfection


3. Targeted intensive cleaning and disinfection

① All departments and clinical departments are divided into low-risk areas, medium-risk areas, and high-risk areas according to their risk levels. Different risk areas should implement different levels of environmental cleaning and disinfection management.


②Environmental surfaces contaminated by the patient's body fluids, blood, excreta, secretions, etc., should be removed with adsorbable materials, and then suitable disinfectants should be selected for disinfection according to the characteristics of the contaminated pathogen.



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