PRACTICE When standard precaution measures are not enough Pathogens that require enhanced hygiene measures Resistant pathogens: routine disinfection ineffective in about 10% of healthcare-associated infections Based on data from European point prevalence surveys conducted at regular intervals by the European Centre for Disease Prevention and Control (ECDC), the majority of healthcare-associated infections (approximately 90%) are caused by vegetative bacteria, such as S. aureus (including MRSA), E. coli and K. pneumoniae [2, 3]. These pathogens can easily be inactivated using lowalcohol surface disinfectants as part of standard precaution procedures. However, an estimated 10% of healthcare-associated In surface hygiene, there is a distinction between routine disinfection, which forms part of standard precaution measures, and targeted disinfection. Routine disinfection involves wiping down near-patient surfaces daily with a bactericidal and yeasticidal disinfectant which is also active against enveloped viruses (standard precaution measures), while targeted disinfection measures include terminal disinfection, disinfection in the event of contamination, and situations in which a special spectrum of activity is required (e.g. in isolation rooms) [1]. References 1. Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut (RKI) (2022). Bundesgesundheitsbl 65:1074-1115. https://doi. org/10.1007/s00103-022-03576-1 2. European Centre for Disease Prevention and Control (ECDC) (2023). Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals, 2016-2017. Stockholm. 3. European Centre for Disease Prevention and Control (ECDC) (2024) Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals, 2022-2023. Stockholm.* 4. Liu C et al. (2023) Antibiotics (Basel) 12: 1141. https://doi.org/10.3390/antibiotics12071141 10% of healthcare-associated infections require a spectrum of activity that goes beyond standard precautions. 90% of healthcare-associated infections can be prevented by using products with bactericidal, yeasticidal and efficacy against enveloped viruses. infections are caused by more difficult-to-combat pathogens [2,3]. Clostridioides difficile is of particular relevance to healthcare facilities as it forms spores that are difficult to inactivate and can cause severe diarrhoeal diseases that are highly contagious to vulnerable individuals. Due to the emergence of hypervirulent strains, C. difficile can quickly put entire hospitals in a state of emergency [4]. Consistent hand hygiene is particularly important for both staff and patients. In addition, surfaces and wet rooms in close proximity to patients should be cleaned daily using a sporicidal disinfectant, such as one based on hydrogen peroxide. Vegetative bacteria: 85% Yeasts (e.g. Candida sp.) 5% Enveloped viruses: > 1% Basic hygiene 90% Bacterial spores 8% Fungi: 1% Non-enveloped viruses: < 1% Enhanced 10% spectrum of efficacy These estimates are based on data from the last two European point prevalence surveys [2, 3]. The relative frequencies of C. difficile may have been overestimated as a positive microbiological result is required by definition. This analysis does not take into account healthcare-associated infections with SARS-CoV-2. 19
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