Please take a look at the picture of my home bathroom. (Yes, I cleaned it prior to taking the picture) Can you tell me exactly what germs are lurking on the surface? No? Why not? Oh, right...bacteria, viruses, fungi, etc. are microscopic organisms invisible to the naked eye. So if neither of us can assertively identify which microorganisms are present, how can we be expected to select just the right disinfectant with the appropriate germicidal claims to kill precisely what’s on the surface? The quick and easy answer: We can’t. Therefore, our best option is to use disinfectants that are broadly effective against all of the different classes of pathogens typically present in the environment if we wish to confidently eradicate all of them from the surface.
The CDC recognized this as a critically important aspect of disinfectant selection in their 2008 Disinfection and Sterilization Guideline. They listed that an ideal disinfectant should “have a wide antimicrobial spectrum”. This broad antimicrobial spectrum serves to support a pro-active or preventative approach to cleaning and disinfection. Rather than waiting for patients to be afflicted with infections from more difficult to kill pathogens and scrambling to implement a disinfectant that will control or intervene in the transmission of the organism, an ideal procedure will utilize a broadly effective disinfectant that will prevent the transmission of both easy-to-kill microorganisms such as Influenza A but also more difficult to kill pathogens such as Norovirus. In an era of drug resistant microorganisms that are immensely difficult to treat once contracted, the onus must switch to preventing the transmission of these pathogens in the first place.
The one caveat to this way of thinking is the daily use of sporicidal agents. These products are typically much more highly concentrated chemical solutions prepared to inactivate spores, the most difficult to kill microorganisms. While their use will also effectively annihilate all other microbial life forms, their safety profile inhibits their safe and effective ongoing or daily use. Therefore, these types of products are best suited for task oriented applications alongside a broad spectrum disinfectant that will address all other pathogens.
In next week’s blog we’ll further address this other critically important aspect of disinfectant selection – the safety profile of the product. But in the meantime, how does your healthcare institution approach the selection of disinfectants?
Hasta la vista
Lee – The Germinator
