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Evidence Map and Systematic Review of Disinfection Efficacy on Environmental Surfaces in Healthcare Facilities

Author

Listed:
  • Elizabeth C. Christenson

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Ryan Cronk

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
    ICF, Durham, NC 27713, USA)

  • Helen Atkinson

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Aayush Bhatt

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Emilio Berdiel

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Michelle Cawley

    (Health Sciences Library, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Grace Cho

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Collin Knox Coleman

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Cailee Harrington

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Kylie Heilferty

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Don Fejfar

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Emily J. Grant

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Karen Grigg

    (Health Sciences Library, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Tanmay Joshi

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Suniti Mohan

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Grace Pelak

    (Health Sciences Library, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Yuhong Shu

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA)

  • Jamie Bartram

    (The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
    School of Civil Engineering, University of Leeds, Leeds LS2 9DY, UK)

Abstract

Healthcare-associated infections (HAIs) contribute to patient morbidity and mortality with an estimated 1.7 million infections and 99,000 deaths costing USD $28–34 billion annually in the United States alone. There is little understanding as to if current environmental surface disinfection practices reduce pathogen load, and subsequently HAIs, in critical care settings. This evidence map includes a systematic review on the efficacy of disinfecting environmental surfaces in healthcare facilities. We screened 17,064 abstracts, 635 full texts, and included 181 articles for data extraction and study quality assessment. We reviewed ten disinfectant types and compared disinfectants with respect to study design, outcome organism, and fourteen indictors of study quality. We found important areas for improvement and gaps in the research related to study design, implementation, and analysis. Implementation of disinfection, a determinant of disinfection outcomes, was not measured in most studies and few studies assessed fungi or viruses. Assessing and comparing disinfection efficacy was impeded by study heterogeneity; however, we catalogued the outcomes and results for each disinfection type. We concluded that guidelines for disinfectant use are primarily based on laboratory data rather than a systematic review of in situ disinfection efficacy. It is critically important for practitioners and researchers to consider system-level efficacy and not just the efficacy of the disinfectant.

Suggested Citation

  • Elizabeth C. Christenson & Ryan Cronk & Helen Atkinson & Aayush Bhatt & Emilio Berdiel & Michelle Cawley & Grace Cho & Collin Knox Coleman & Cailee Harrington & Kylie Heilferty & Don Fejfar & Emily J., 2021. "Evidence Map and Systematic Review of Disinfection Efficacy on Environmental Surfaces in Healthcare Facilities," IJERPH, MDPI, vol. 18(21), pages 1-22, October.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:21:p:11100-:d:662206
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    References listed on IDEAS

    as
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    3. Arun Varghese & Michelle Cawley & Tao Hong, 2018. "Supervised clustering for automated document classification and prioritization: a case study using toxicological abstracts," Environment Systems and Decisions, Springer, vol. 38(3), pages 398-414, September.
    4. Beatrice Casini & Benedetta Tuvo & Maria Luisa Cristina & Anna Maria Spagnolo & Michele Totaro & Angelo Baggiani & Gaetano Pierpaolo Privitera, 2019. "Evaluation of an Ultraviolet C (UVC) Light-Emitting Device for Disinfection of High Touch Surfaces in Hospital Critical Areas," IJERPH, MDPI, vol. 16(19), pages 1-10, September.
    5. Yu-Huai Ho & Lih-Shinn Wang & Hui-Li Jiang & Chih-Hui Chang & Chia-Jung Hsieh & Dan-Chi Chang & Hsin-Yu Tu & Tan-Yun Chiu & Huei-Jen Chao & Chun-Chieh Tseng, 2016. "Use of a Sampling Area-Adjusted Adenosine Triphosphate Bioluminescence Assay Based on Digital Image Quantification to Assess the Cleanliness of Hospital Surfaces," IJERPH, MDPI, vol. 13(6), pages 1-12, June.
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