The hospital environment and its microbial burden: challenges and solutions

Pathogenic microorganisms persist in the hospital environment from hours to months, depending on factors such as location, number, biofilm formation, intrinsic resistance of organisms to various cleaning products as well as local conditions. While the Centers for Disease Control and Prevention (CDC) does not recommend routine microbiological sampling, in addition to visual inspection and checklist, various novel techniques have been employed, with excellent results; for example: fluorescent marker method, adenosine triphosphate bioluminescence assay and ultraviolet powder (13,14). A recent meta-analysis has found that ultraviolet light no-touch disinfection technology may be effective in reducing CDI rates and VRE infection rates but has found no effect on rates of MRSA or gram-negative MDRO infections (16). The UV light technology has some limitations related to variable antimicrobial effect depending on the location and orientation of objects and surfaces relative to the UV light unit, with decreased activity in remote and shadowed areas (18), but multivector ultraviolet systems with shadowless delivery and pulse xenon ultraviolet technologies are being developed.