Decontamination of the hospital environment : new technologies for infection control

Environmental contamination is being increasingly recognized as a significant source of healthcare-associated infection (HAI). Cross-contamination of the patient from the environment can result from the direct transfer of organisms from the air and surfaces, or indirectly from the hospital environment via contact with healthcare workers or equipment. Traditional methods of environmental decontamination, including cleaning with disinfectants, and the standard infection control procedures implemented by modern Health Services, are critical to controlling the spread of potentially pathogenic microbial contaminants from environmental sources to the patient; however there is constant pressure to maintain, and indeed, improve on the standards that are in place to ensure optimal patient care. To address this issue, much research has been directed towards the development and testing of novel ‘whole-room’ environmental decontamination methods which could be used to enhance hospital hygiene, and consequently reduce the risk of HAI-acquisition from environmental sources. Gaseous methods such as the use of hydrogen peroxide, chlorine dioxide, ozone and steam, as well as ultraviolet and violet-blue visible light methods have all been laboratory tested, and to varying extents, clinically evaluated to assess their efficacy for environmental decontamination. This review article considers these different decontamination technologies, discussing their mechanism of action, antimicrobial efficacy, and advantages and limitations, with a view to providing the reader with a comprehensive overview of the technological advances being developed to reduce the levels of environmental contamination around patient areas, thus aiding in the fight against healthcare-associated infection