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

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. Grant, Karen Grigg, Tanmay Joshi, Suniti Mohan, Grace Pelak, Yuhong Shu and Jamie Bartram
Additional contact information
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
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

IJERPH, 2021, vol. 18, issue 21, 1-22

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.

Keywords: disinfection; healthcare facilities; healthcare-associated infections; environmental surfaces; infection prevention and control (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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