Evidence Spotty for Hospital Cleaning Practices Randomized trials must fill gaps in evidence for cleaning, disinfection, and monitoring

Han's group performed a systematic overview of all scientific literature on cleaning, disinfecting, and monitoring of frequently touched surfaces in inpatient facilities, focusing on studies examining surface contamination, colonization and infections with Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci. They evaluated three broad categories of evidence, specifically which agents and methods were being used for cleaning surfaces, how the "effectiveness and appropriateness" of cleaning was monitored, and what systems-level factors were needed to best facilitate cleaning practices. Studies on chemical disinfectants like bleach, chlorine, and peroxide solutions reported mixed findings. Six studies on disinfecting wipes and 17 studies on no-touch methods (UV light, hydrogen peroxide vapor) had positive outcomes, some of which included decreased infection rates. Seven out of eight studies on antimicrobial coatings, such as copper, also reported positive findings. "The newer technologies such as UV light and hydrogen peroxide vapor seem to have promising results, but we can't know how well they work compared with or in addition to other cleaning methods until we have randomized control trials," Han explained. http://www.medpagetoday.com/HospitalBasedMedicine/InfectionControl/53023?xid=nl_mpt_DHE_2015-08-12&eun=g721819d0r