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Christenson EC, Cronk R, Atkinson H, Bhatt A, Berdiel E, Cawley M, Cho G, Coleman CK, Harrington C, Heilferty K, Fejfar D, Grant EJ, Grigg K, Joshi T, Mohan S, Pelak G, Shu Y, Bartram J. Evidence Map and Systematic Review of Disinfection Efficacy on Environmental Surfaces in Healthcare Facilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11100. [PMID: 34769620 PMCID: PMC8582915 DOI: 10.3390/ijerph182111100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 01/23/2023]
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.
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Affiliation(s)
- Elizabeth C. Christenson
- The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
| | - Ryan Cronk
- The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
- 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; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
| | - Aayush Bhatt
- The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
| | - Emilio Berdiel
- The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
| | - Michelle Cawley
- Health Sciences Library, University of North Carolina, Chapel Hill, NC 27599, USA; (M.C.); (K.G.); (G.P.)
| | - Grace Cho
- The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
| | - Collin Knox Coleman
- The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
| | - Cailee Harrington
- The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
| | - Kylie Heilferty
- The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
| | - Don Fejfar
- The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
| | - Emily J. Grant
- The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
| | - Karen Grigg
- Health Sciences Library, University of North Carolina, Chapel Hill, NC 27599, USA; (M.C.); (K.G.); (G.P.)
| | - Tanmay Joshi
- The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
| | - Suniti Mohan
- The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
| | - Grace Pelak
- Health Sciences Library, University of North Carolina, Chapel Hill, NC 27599, USA; (M.C.); (K.G.); (G.P.)
| | - Yuhong Shu
- The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
| | - Jamie Bartram
- The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (E.C.C.); (R.C.); (H.A.); (A.B.); (E.B.); (G.C.); (C.K.C.); (C.H.); (K.H.); (D.F.); (E.J.G.); (T.J.); (S.M.); (Y.S.)
- School of Civil Engineering, University of Leeds, Leeds LS2 9DY, UK
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Cloutier M, Mantovani D, Rosei F. Antibacterial Coatings: Challenges, Perspectives, and Opportunities. Trends Biotechnol 2015; 33:637-652. [PMID: 26463723 DOI: 10.1016/j.tibtech.2015.09.002] [Citation(s) in RCA: 392] [Impact Index Per Article: 43.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 08/24/2015] [Accepted: 09/08/2015] [Indexed: 01/03/2023]
Abstract
Antibacterial coatings are rapidly emerging as a primary component of the global mitigation strategy of bacterial pathogens. Thanks to recent concurrent advances in materials science and biotechnology methodologies, and a growing understanding of environmental microbiology, an extensive variety of options are now available to design surfaces with antibacterial properties. However, progress towards a more widespread use in clinical settings crucially depends on addressing the key outstanding issues. We review release-based antibacterial coatings and focus on the challenges and opportunities presented by the latest generation of these materials. In particular, we highlight recent approaches aimed at controlling the release of antibacterial agents, imparting multi-functionality, and enhancing long-term stability.
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Affiliation(s)
- M Cloutier
- Laboratory for Biomaterials and Bioengineering, Department of Min-Met-Materials Engineering, and Centre Hospitalier Universitaire de Québec Research Center, Laval University, Pavillon Pouliot, Local 1745-E, Québec, QC, G1V 0A6, Canada
| | - D Mantovani
- Laboratory for Biomaterials and Bioengineering, Department of Min-Met-Materials Engineering, and Centre Hospitalier Universitaire de Québec Research Center, Laval University, Pavillon Pouliot, Local 1745-E, Québec, QC, G1V 0A6, Canada.
| | - F Rosei
- Institut National de la Recherche Scientifique (INRS), 1650 Boulevard Lionel Boulet, Varennes, QC, J3X 1S2 Canada; Institute for Fundamental and Frontier Science, University of Electronic Science and Technology of China, Chengdu 610054, PR China.
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