When standard precaution measures are not enough Surface disinfection – the 90:10 concept Standard precaution measures sufficient for 90% of pathogens According to current data from the European Centre for Disease Prevention and Control (ECDC), the majority of healthcare-associated infections (HAI) in medical facilities are caused by vegetative bacteria. Around 90% of healthcare-associated infections are caused by pathogens such as Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae [1, 3]. These can be effectively combatted using broad-spectrum surface disinfectants. In most cases, taking the standard precaution and using disinfectants that are bactericidal, yeasticidal, and virucidal against enveloped viruses is sufficient. 10% of pathogens require an advanced spectrum of efficacy Around 10% of HAI are caused by highly persistent pathogens. These include the spore-forming bacterium Clostridioides difficile (approximately 8%), as well as fungi and non-enveloped viruses to a much lesser extent [1, 3]. These pathogens are not inactivated by disinfectants that cover the basic spectrum of efficacy [4]. Effective prevention of transmission therefore requires the targeted use of sporicidal, fungicidal and/or virucidal disinfectants. Particularly relevant: prevention and control of C. difficile Clostridioides difficile infections (CDI) have been increasing worldwide since 2003 and are highly relevant in everyday clinical practice. CDI, often follow previous antibiotic therapy and manifest as severe diarrhoea, abdominal pain and fever. They can lead to intestinal perforation or sepsis. Transmission can occur through direct contact, e.g. via the hands, or indirect contact, e.g. via contaminated surfaces [6]. As Clostridioides difficile spores can survive on surfaces for months, the patient environment plays a greater role in transmission than with other pathogens. In addition to practicing good hand hygiene and wearing personal protective equipment (PPE), the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute recommends wiping down surfaces that patients come into contact daily using a disinfectant proven to be effective against C. difficile. An oxidising agent is preferable [7]. Each year, around 4.3 million patients acquire at least one healthcare-associated infection (HAI) during an inpatient hospital stay in the EU [1]. Preventing HAI is therefore a high priority. Surface disinfection plays an important role in this [2]. There are two types of disinfection: daily routine and targeted [2]. The 90:10 surface concept offers a practical solution by reconciling safety and resource conservation. Clostridioides difficile Staphylococcus aureus Escherichia coli Klebsiella pneumoniae PRACTICE 20
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