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Abstract

More evidence is emerging on the importance of the clinical environment in encouraging hospital infection. This review considers the role of cleaning as an effective means to control infection. It describes the location of pathogen reservoirs and methods for evaluating hospitals’ cleanliness. Novel biocides, antimicrobial coatings and equipment are available, many of which have not been assessed against patient outcome. Cleaning practices should be tailored to clinical risk, given the wide-ranging surfaces, equipment and building design. There is confusion between nursing and domestic personnel over the allocation of cleaning responsibilities and neither may receive sufficient training and/or time to complete their duties. Since less labourious practices for dirt removal are always attractive, there is a danger that traditional cleaning methods are forgotten or ignored. Few studies have examined detergent-based regimens or modelled these against infection risk for different patient categories. Fear of infection encourages the use of powerful disinfectants for the elimination of real or imagined pathogens in hospitals. Not only do these agents offer false assurance against contamination, their disinfection potential cannot be achieved without the prior removal of organic soil. Detergent-based cleaning is cheaper than using disinfectants and much less toxic. Hospital cleaning in the 21st century deserves further investigation for routine and outbreak practices.

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References

  1. Dancer SJ (1999) Mopping up hospital infection. J Hosp Infect 43:85–100

    Article  PubMed  CAS  Google Scholar 

  2. Malik RE, Cooper RA, Griffith CJ (2003) Use of audit tools to evaluate the efficacy of cleaning systems in hospitals. Am J Infect Control 31:181–187

    Article  PubMed  Google Scholar 

  3. Dettenkofer M, Wenzler S, Amthor S, Antes G, Motschall E, Daschner FD (2004) Does disinfection of environmental surfaces influence nosocomial infection rates? A systematic review. Am J Infect Control 32:84–89

    Article  PubMed  Google Scholar 

  4. Dancer SJ (2004) How do we assess hospital cleaning? A proposal for microbiological standards for surface hygiene in hospitals. J Hosp Infect 56:10–15

    Article  PubMed  CAS  Google Scholar 

  5. Carling PC, Bartley JM (2010) Evaluating hygienic cleaning in health care settings: what you do not know can harm your patients. Am J Infect Control 38:S41–S50

    Article  PubMed  Google Scholar 

  6. Kramer A, Schwebke I, Kampf G (2006) How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infect Dis 6:130

    Article  PubMed  Google Scholar 

  7. Wagenvoort JHT, De Brauwer EIGB, Penders RJR, Willems RJ, Top J, Bonten MJ (2011) Environmental survival of vancomycin-resistant Enterococcus faecium. J Hosp Infect 77:282–283

    Article  PubMed  CAS  Google Scholar 

  8. Getchell-White SI, Donowitz LG, Gröschel DH (1989) The inanimate environment of an intensive care unit as a potential source of nosocomial bacteria: evidence for long survival of Acinetobacter calcoaceticus. Infect Control Hosp Epidemiol 10:402–407

    Article  PubMed  CAS  Google Scholar 

  9. Casewell M, Phillips I (1977) Hands as route of transmission for Klebsiella species. Br Med J 2:1315–1317

    Article  PubMed  CAS  Google Scholar 

  10. Sanderson PJ, Weissler S (1992) Recovery of coliforms from the hands of nurses and patients: activities leading to contamination. J Hosp Infect 21:85–93

    Article  PubMed  CAS  Google Scholar 

  11. Barker J, Vipond IB, Bloomfield SF (2004) Effects of cleaning and disinfection in reducing the spread of norovirus contamination via environmental surfaces. J Hosp Infect 58:42–49

    Article  PubMed  CAS  Google Scholar 

  12. Roberts K, Smith CF, Snelling AM, Kerr KG, Banfield KR, Sleigh PA, Beggs CB (2008) Aerial dissemination of Clostridium difficile spores. BMC Infect Dis 8:7

    Article  PubMed  Google Scholar 

  13. Bhalla A, Pultz NJ, Gries DM, Ray AJ, Eckstein EC, Aron DC, Donskey CJ (2004) Acquisition of nosocomial pathogens on hands after contact with environmental surfaces near hospitalized patients. Infect Control Hosp Epidemiol 25:164–167

    Article  PubMed  Google Scholar 

  14. Lemmen SW, Häfner H, Zolldann D, Stanzel S, Lütticken R (2004) Distribution of multi-resistant Gram-negative versus Gram-positive bacteria in the hospital inanimate environment. J Hosp Infect 56:191–197

    Article  PubMed  CAS  Google Scholar 

  15. Dancer SJ, White LF, Robertson C (2008) Monitoring environmental cleanliness on two surgical wards. Int J Environ Health Res 18:357–364

    Article  PubMed  Google Scholar 

  16. Kaatz GW, Gitlin SD, Schaberg DR, Wilson KH, Kauffman CA, Seo SM, Fekety R (1998) Acquisition of Clostridium difficile from the hospital environment. Am J Epidemiol 127:1289–1294

    Google Scholar 

  17. Wu HM, Fornek M, Schwab KJ, Chapin AR, Gibson K, Schwab E, Spencer C, Henning K (2005) A norovirus outbreak at a long-term-care facility: the role of environmental surface contamination. Infect Control Hosp Epidemiol 26:802–810

    Article  PubMed  Google Scholar 

  18. Kerr KG, Snelling AM (2009) Pseudomonas aeruginosa: a formidable and ever-present adversary. J Hosp Infect 73:338–344

    Article  PubMed  CAS  Google Scholar 

  19. Alfa MJ, Dueck C, Olson N, Degagne P, Papetti S, Wald A, Lo E, Harding G (2008) UV-visible marker confirms that environmental persistence of Clostridium difficile spores in toilets of patients with C. difficile-associated diarrhea is associated with lack of compliance with cleaning protocol. BMC Infect Dis 8:64–70

    Article  PubMed  Google Scholar 

  20. Noble MA, Isaac-Renton JL, Bryce EA, Roscoe DL, Roberts FJ, Walker M, Scharf S, Walsh A, Altamirano-Dimas M, Gribble M (1998) The toilet as a transmission vector of vancomycin-resistant enterococci. J Hosp Infect 40:237–241

    Article  PubMed  CAS  Google Scholar 

  21. Morter S, Bennet G, Fish J, Richards J, Allen DJ, Nawaz S, Iturriza-Gómara M, Brolly S, Gray J (2011) Norovirus in the hospital setting: virus introduction and spread within the hospital environment. J Hosp Infect 77:106–112

    Article  PubMed  CAS  Google Scholar 

  22. Malnick S, Bardenstein R, Huszar M, Gabbay J, Borkow G (2008) Pyjamas and sheets as a potential source of nosocomial pathogens. J Hosp Infect 70:89–92

    Article  PubMed  CAS  Google Scholar 

  23. Dancer SJ, White LF, Lamb J, Girvan EK, Robertson C (2009) Measuring the effect of enhanced cleaning in a UK hospital: a prospective cross-over study. BMC Med 7:28

    Article  PubMed  Google Scholar 

  24. Wilcox MH, Fawley WN, Wigglesworth N, Parnell P, Verity P, Freeman J (2003) Comparison of the effect of detergent versus hypochlorite cleaning on environmental contamination and incidence of Clostridium difficile infection. J Hosp Infect 54:109–114

    Article  PubMed  CAS  Google Scholar 

  25. Huang SS, Datta R, Platt R (2006) Risk of acquiring antibiotic-resistant bacteria from prior room occupants. Arch Intern Med 166:1945–1951

    Article  PubMed  Google Scholar 

  26. Shaughnessy M, Micielli R, Depestel D et al (2008) Evaluation of hospital room assignment and acquisition of Clostridium difficile associated diarrhoea (CDAD). Poster K-4194; presented at the 48th Annual ICAAC/IDSA 46th Annual Meeting, Washington DC, October 2008

  27. Wilks M, Wilson A, Warwick S, Price E, Kennedy D, Ely A, Millar MR (2006) Control of an outbreak of multidrug-resistant Acinetobacter baumannii-calcoaceticus colonization and infection in an intensive care unit (ICU) without closing the ICU or placing patients in isolation. Infect Control Hosp Epidemiol 27:654–658

    Article  PubMed  Google Scholar 

  28. Oelberg DG, Joyner SE, Jiang X, Laborde D, Islam MP, Pickering LK (2000) Detection of pathogen transmission in neonatal nurseries using DNA markers as surrogate indicators. Pediatrics 105:311–315

    Article  PubMed  CAS  Google Scholar 

  29. Rheinbaben F, Schünemann S, Gross T, Wolff MH (2000) Transmission of viruses via contact in a household setting: experiments using bacteriophage straight phiX174 as a model virus. J Hosp Infect 46:61–66

    Article  PubMed  CAS  Google Scholar 

  30. Hayden MK, Blom DW, Lyle EA, Moore CG, Weinstein RA (2008) Risk of hand or glove contamination after contact with patients colonized with vancomycin-resistant enterococcus or the colonized patients’ environment. Infect Control Hosp Epidemiol 29:149–154

    Article  PubMed  Google Scholar 

  31. Creamer E, Dorrian S, Dolan A, Sherlock O, Fitzgerald-Hughes D, Thomas T, Walsh J, Shore A, Sullivan D, Kinnevey P, Rossney AS, Cunney R, Coleman D, Humphreys H (2010) When are the hands of healthcare workers positive for methicillin-resistant Staphylococcus aureus? J Hosp Infect 75:107–111

    Article  PubMed  CAS  Google Scholar 

  32. Rampling A, Wiseman S, Davis L, Hyett AP, Walbridge AN, Payne GC, Cornaby AJ (2001) Evidence that hospital hygiene is important in the control of methicillin-resistant Staphylococcus aureus. J Hosp Infect 49:109–116

    Article  PubMed  CAS  Google Scholar 

  33. Hayden MK, Bonten MJ, Blom DW, Lyle EA, van de Vijver DA, Weinstein RA (2006) Reduction in acquisition of vancomycin-resistant enterococcus after enforcement of routine environmental cleaning measures. Clin Infect Dis 42:1552–1560

    Article  PubMed  Google Scholar 

  34. McMullen KM, Zack J, Coopersmith CM, Kollef M, Dubberke E, Warren DK (2007) Use of hypochlorite solution to decrease rates of Clostridium difficile-associated diarrhea. Infect Control Hosp Epidemiol 28:205–207

    Article  PubMed  Google Scholar 

  35. Tankovic J, Legrand P, de Gatines G, Chemineau V, Brun-Buisson C, Duval J (1994) Characterization of a hospital outbreak of imipenem-resistant Acinetobacter baumannii by phenotypic and genotypic typing methods. J Clin Microbiol 32:2677–2681

    PubMed  CAS  Google Scholar 

  36. Denton M, Wilcox MH, Parnell P, Green D, Keer V, Hawkey PM, Evans I, Murphy P (2004) Role of environmental cleaning in controlling an outbreak of Acinetobacter baumannii on a neurosurgical intensive care unit. J Hosp Infect 56:106–110

    Article  PubMed  CAS  Google Scholar 

  37. Weber DJ, Rutala WA, Blanchet CN, Jordan M, Gergen MF (1999) Faucet aerators: a source of patient colonization with Stenotrophomonas maltophilia. Am J Infect Control 27:59–63

    Article  PubMed  CAS  Google Scholar 

  38. Mehtar S (1993) How to cost and fund an infection control programme. J Hosp Infect 25:57–69

    Article  PubMed  CAS  Google Scholar 

  39. Wilson APR, Smyth D, Moore G, Singleton J, Jackson R, Gant V, Jeanes A, Shaw S, James E, Cooper B, Kafatos G, Cookson B, Singer M, Bellingan G (2011) The impact of enhanced cleaning within the intensive care unit on contamination of the near-patient environment with hospital pathogens: a randomized crossover study in critical care units in two hospitals. Crit Care Med (in press)

  40. Aldeyab MA, McElnay JC, Elshibly SM, Hughes CM, McDowell DA, McMahon MA, Scott MG, Kearney MP (2009) Evaluation of the efficacy of a conventional cleaning regimen in removing methicillin-resistant Staphylococcus aureus from contaminated surfaces in an intensive care unit. Infect Control Hosp Epidemiol 30:304–306

    Article  PubMed  Google Scholar 

  41. Hardy KJ, Gossain S, Henderson N, Drugan C, Oppenheim BA, Gao F, Hawkey PM (2007) Rapid recontamination with MRSA of the environment of an intensive care unit after decontamination with hydrogen peroxide vapour. J Hosp Infect 66:360–368

    Article  PubMed  CAS  Google Scholar 

  42. Nerandzic MM, Cadnum JL, Pultz MJ, Donskey CJ (2010) Evaluation of an automated ultraviolet radiation device for decontamination of Clostridium difficile and other healthcare-associated pathogens in hospital rooms. BMC Infect Dis 10:197

    Article  PubMed  Google Scholar 

  43. Anderson RE, Young V, Stewart M, Robertson C, Dancer SJ (2011) Cleanliness audit of clinical surfaces and equipment: who cleans what? J Hosp Infect (in press)

  44. Carling PC, Briggs JL, Perkins J, Highlander D (2006) Improved cleaning of patient rooms using a new targeting method. Clin Infect Dis 42:385–388

    Article  PubMed  Google Scholar 

  45. Goodman ER, Platt R, Bass R, Onderdonk AB, Yokoe DS, Huang SS (2008) Impact of an environmental cleaning intervention on the presence of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci on surfaces in intensive care unit rooms. Infect Control Hosp Epidemiol 29:593–599

    Article  PubMed  Google Scholar 

  46. Eckstein BC, Adams DA, Eckstein EC, Rao A, Sethi AK, Yadavalli GK, Donskey CJ (2007) Reduction of Clostridium difficile and vancomycin-resistant Enterococcus contamination of environmental surfaces after an intervention to improve cleaning methods. BMC Infect Dis 7:61

    Article  PubMed  Google Scholar 

  47. Boyce JM, Havill NL, Dumigan DG, Golebiewski M, Balogun O, Rizvani R (2009) Monitoring the effectiveness of hospital cleaning practices by use of an adenosine triphosphate bioluminescence assay. Infect Control Hosp Epidemiol 30:678–684

    Article  PubMed  Google Scholar 

  48. Ptak J, Tostenson L, Kirkland K, Taylor E (2009) Who is responsible for cleaning that? Presentation number: 13-168. Am J Infect Control 37:E133–E134

    Google Scholar 

  49. Dumigan DG, Boyce JM, Havill NL, Golebiewski M, Balogun O, Rizvani R (2010) Who is really caring for your environment of care? Developing standardized cleaning procedures and effective monitoring techniques. Am J Infect Control 38:387–392

    Article  PubMed  Google Scholar 

  50. White LF, Dancer SJ, Robertson C, McDonald J (2008) Are hygiene standards useful in assessing infection risk? Am J Infect Control 36:381–384

    Article  PubMed  Google Scholar 

  51. Lewis T, Griffith C, Gallo M, Weinbren M (2008) A modified ATP benchmark for evaluating the cleaning of some hospital environmental surfaces. J Hosp Infect 69:156–163

    Article  PubMed  CAS  Google Scholar 

  52. Mulvey D, Redding P, Robertson C, Woodall C, Kingsmore P, Bedwell D, Dancer SJ (2011) Finding a benchmark for monitoring hospital cleanliness. J Hosp Infect 77:25–30

    Article  PubMed  CAS  Google Scholar 

  53. Kay D, Bartram J, Prüss A, Ashbolt N, Wyer MD, Fleisher JM, Fewtrell L, Rogers A, Rees G (2004) Derivation of numerical values for the World Health Organization guidelines for recreational waters. Water Res 38:1296–1304

    Article  PubMed  CAS  Google Scholar 

  54. Pasquarella C, Pitzurra O, Savino A (2000) The index of microbial air contamination. J Hosp Infect 46:241–256

    Article  PubMed  CAS  Google Scholar 

  55. Sherlock O, O’Connell N, Creamer E, Humphreys H (2009) Is it really clean? An evaluation of the efficacy of four methods for determining hospital cleanliness. J Hosp Infect 72:140–146

    Article  PubMed  CAS  Google Scholar 

  56. Silliker Inc. (2010) Performance evaluation of various ATP detecting units. Food Science Center, South Holland, Illinois

    Google Scholar 

  57. Brown E, Eder AR, Thompson KM (2010) Do surface and cleaning chemistries interfere with ATP measurement systems for monitoring patient room hygiene? J Hosp Infect 74:193–195

    Article  PubMed  CAS  Google Scholar 

  58. Hota B, Blom DW, Lyle EA, Weinstein RA, Hayden MK (2009) Interventional evaluation of environmental contamination by vancomycin-resistant enterococci: failure of personnel, product, or procedure? J Hosp Infect 71:123–131

    Article  PubMed  CAS  Google Scholar 

  59. Guerrero D, Carling P, Jury L, Ponnada S, Nerandzic M, Eckstein EC (2010) Beyond the “Hawthorne effect”: reduction of Clostridium difficile environmental contamination through active intervention to improve cleaning practices. Abstract 60; Fifth Decennial International Conference on Healthcare-Associated Infections, Atlanta, Georgia, March 2010

  60. Davies S (2005) Hospital contract cleaning and infection control. UNISON, London

    Google Scholar 

  61. National Patient Safety Agency (NPSA) (2007) The national specifications for cleanliness in the NHS: a framework for setting and measuring performance outcomes. NPSA, London, April 2007

    Google Scholar 

  62. Hugonnet S, Chevrolet J-C, Pittet D (2007) The effect of workload on infection risk in critically ill patients. Crit Care Med 35:76–81

    Article  PubMed  Google Scholar 

  63. Davies S (2009) Making the connections: contract cleaning and infection control. UNISON, London

    Google Scholar 

  64. Scott E, Bloomfield SF (1990) The survival and transfer of microbial contamination via cloths, hands and utensils. J Appl Bacteriol 68:271–278

    Article  PubMed  CAS  Google Scholar 

  65. Dharan S, Mourouga P, Copin P, Bessmer G, Tschanz B, Pittet D (1999) Routine disinfection of patients’ environmental surfaces. Myth or reality? J Hosp Infect 42:113–117

    Article  PubMed  CAS  Google Scholar 

  66. Moore G, Griffith C (2006) A laboratory evaluation of the decontamination properties of microfibre cloths. J Hosp Infect 64:379–385

    Article  PubMed  CAS  Google Scholar 

  67. Bergen LK, Meyer M, Høg M, Rubenhagen B, Andersen LP (2009) Spread of bacteria on surfaces when cleaning with microfibre cloths. J Hosp Infect 71:132–137

    Article  PubMed  CAS  Google Scholar 

  68. Kümmerer K (2003) Significance of antibiotics in the environment. J Antimicrob Chemother 52:5–7

    Article  PubMed  Google Scholar 

  69. Rutala WA, Weber DJ (1999) Infection control: the role of disinfection and sterilization. J Hosp Infect 43:S43–S55

    Article  PubMed  Google Scholar 

  70. Mandal J, Kate A, Parija SC (2010) Microbicidal effect of electrolysed detergent water. J Hosp Infect 76:94–95

    Article  PubMed  CAS  Google Scholar 

  71. Berrington AW, Pedler SJ (1998) Investigation of gaseous ozone for MRSA decontamination of hospital side-rooms. J Hosp Infect 40:61–65

    Article  PubMed  CAS  Google Scholar 

  72. Department of Health (DoH) (2007) An integrated approach to hospital cleaning: microfibre cloth and steam cleaning technology. DoH, London, May 2007

    Google Scholar 

  73. Cleaning Matters (December, 2010). Home page at: http://www.cleaning-matters.co.uk

  74. Falagas ME, Thomaidis PC, Kotsantis IK, Sgouros K, Samonis G, Karageorgopoulos DE (2011) Airborne hydrogen peroxide for disinfection of the hospital environment and infection control: a systematic review. J Hosp Infect (in press)

  75. Sharma M, Hudson JB (2008) Ozone gas is an effective and practical antibacterial agent. Am J Infect Control 36:559–563

    Article  PubMed  Google Scholar 

  76. Jury LA, Cadnum JL, Jennings-Sanders A, Eckstein EC, Chang S, Donskey CJ (2010) Evaluation of an alcohol-based power sanitizing system for decontamination of hospital rooms of patients with methicillin-resistant Staphylococcus aureus carriage. Am J Infect Control 38:234–236

    Article  PubMed  CAS  Google Scholar 

  77. Maclean M, MacGregor SJ, Anderson JG, Woolsey GA, Coia JE, Hamilton K, Taggart I, Watson SB, Thakker B, Gettinby G (2010) Environmental decontamination of a hospital isolation room using high-intensity narrow-spectrum light. J Hosp Infect 76:247–251

    Article  PubMed  CAS  Google Scholar 

  78. Shepherd SJ, Beggs CB, Smith CF, Kerr KG, Noakes CJ, Sleigh PA (2010) Effect of negative air ions on the potential for bacterial contamination of plastic medical equipment. BMC Infect Dis 10:92

    Article  PubMed  Google Scholar 

  79. Moore G, Ali S, FitzGerald G, Muzslay M, Atkinson S, Smith S, Cryer P, Gush C; SmartIdeas Research Student Group, Wilson APR (2010) Ward assessment of SmartIdeas Project: bringing source isolation to the patient. J Hosp Infect 76:103–107

    Article  PubMed  CAS  Google Scholar 

  80. Page K, Wilson M, Parkin IP (2009) Antimicrobial surfaces and their potential in reducing the role of the inanimate environment in the incidence of hospital-acquired infections. J Mater Chem 19:3819–3831

    Article  CAS  Google Scholar 

  81. De Muynck W, De Belie N, Verstraete W (2010) Antimicrobial mortar surfaces for the improvement of hygienic conditions. J Appl Microbiol 108:62–72

    Article  PubMed  Google Scholar 

  82. Nanda A, Saravanan M (2009) Biosynthesis of silver nanoparticles from Staphylococcus aureus and its antimicrobial activity against MRSA and MRSE. Nanomedicine 5:452–456

    Article  PubMed  CAS  Google Scholar 

  83. Weaver L, Michels HT, Keevil CW (2008) Survival of Clostridium difficile on copper and steel: futuristic options for hospital hygiene. J Hosp Infect 68:145–151

    Article  PubMed  CAS  Google Scholar 

  84. Taylor L, Phillips P, Hastings R (2009) Reduction of bacterial contamination in a healthcare environment by silver antimicrobial technology. J Infect Prevent 10:6–12

    Article  Google Scholar 

  85. O’Hanlon SJ, Enright MC (2009) A novel bactericidal fabric coating with potent in vitro activity against meticillin-resistant Staphylococcus aureus (MRSA). Int J Antimicrob Agents 33:427–431

    Article  PubMed  Google Scholar 

  86. Casey AL, Adams D, Karpanen TJ, Lambert PA, Cookson BD, Nightingale P, Miruszenko L, Shillam R, Christian P, Elliott TSJ (2010) Role of copper in reducing hospital environment contamination. J Hosp Infect 74:72–77

    Article  PubMed  CAS  Google Scholar 

  87. D’Arcy N (2001) Antimicrobials in plastics: a global review. Plast Addit Compound 3:12–15

    Article  Google Scholar 

  88. Parkin IP, Palgrave RG (2005) Self-cleaning coatings. J Mater Chem 15:1689–1695

    Article  CAS  Google Scholar 

  89. Su W, Wei SS, Hu SQ, Tang JX (2009) Preparation of TiO(2)/Ag colloids with ultraviolet resistance and antibacterial property using short chain polyethylene glycol. J Hazard Mater 172:716–720

    Article  PubMed  CAS  Google Scholar 

  90. Tierno PM Jr (1999) Efficacy of triclosan. Am J Infect Control 27:71–72

    Article  PubMed  Google Scholar 

  91. Sainsbury’s Supermarkets Ltd. Microban antibacterial protection. Sainsbury’s Supermarkets Ltd., UK

  92. Braid JJ, Wale MCJ (2001) The antibacterial activity of triclosan-impregnated storage boxes against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Bacillus cereus and Shewanella putrefaciens in conditions simulating domestic use. J Antimicrob Chemother 49:87–94

    Article  Google Scholar 

  93. Brady MJ, Lisay CM, Yurkovetskiy AV, Sawan SP (2003) Persistent silver disinfectant for the environmental control of pathogenic bacteria. Am J Infect Control 31:208–214

    Article  PubMed  Google Scholar 

  94. Dancer SJ (2010) Control of transmission of infection in hospitals requires more than clean hands. Infect Control Hosp Epidemiol 31:958–960

    Article  PubMed  Google Scholar 

  95. Davies A, Pottage T, Bennett A, Walker J (2011) Gaseous and air decontamination technologies for Clostridium difficile in the healthcare environment. J Hosp Infect 77:199–203

    Article  PubMed  CAS  Google Scholar 

  96. Griffith CJ, Dancer SJ (2009) Hospital cleaning: problems with steam cleaning and microfibre. J Hosp Infect 72:360–361

    Article  PubMed  CAS  Google Scholar 

  97. Diab-Elschahawi M, Assadian O, Blacky A, Stadler M, Pernicka E, Berger J, Resch H, Koller W (2010) Evaluation of the decontamination efficacy of new and reprocessed microfiber cleaning cloth compared with other commonly used cleaning cloths in the hospital. Am J Infect Control 38:289–292

    Article  PubMed  Google Scholar 

  98. Memarzadeh F, Olmsted RN, Bartley JM (2010) Applications of ultraviolet germicidal irradiation disinfection in health care facilities: effective adjunct, but not stand-alone technology. Am J Infect Control 38:S13–S24

    Article  PubMed  Google Scholar 

  99. Sweeney CP, Dancer SJ (2009) Can hospital computers be disinfected using a hand-held UV light source? J Hosp Infect 72:92–94

    Article  PubMed  CAS  Google Scholar 

  100. Sattar SA (2010) Promises and pitfalls of recent advances in chemical means of preventing the spread of nosocomial infections by environmental surfaces. Am J Infect Control 38:S34–S40

    Article  PubMed  Google Scholar 

  101. Russell AD (2004) Bacterial adaptation and resistance to antiseptics, disinfectants and preservatives is not a new phenomenon. J Hosp Infect 57:97–104

    Article  PubMed  CAS  Google Scholar 

  102. Levy SB, McMurray LM (1999) Author reply: efficacy of triclosan. Am J Infect Control 27:72–74

    Article  Google Scholar 

  103. Schweitzer HP (2001) Triclosan: a widely used biocide and its link to antibiotics. FEMS Microbiol Lett 202:1–7

    Article  Google Scholar 

  104. Dancer SJ (2009) The role of environmental cleaning in the control of hospital-acquired infection. J Hosp Infect 73:378–385

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

Thanks are due to Chris Griffith, Phil Carling, Steve Davies (Cardiff University) and Karen Jennings (UNISON) for their support on the importance of hospital cleaning.

Conflict of interests

The author has received funding from UNISON, the UK Healthcare Workers Union, for the hospital cleaning studies.

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Correspondence to S. J. Dancer.

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Dancer, S.J. Hospital cleaning in the 21st century. Eur J Clin Microbiol Infect Dis 30, 1473–1481 (2011). https://doi.org/10.1007/s10096-011-1250-x

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