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Two methods for cleaning waxed polyvinylchloride and porcelain grès hospital room floors were compared in order to determine their decontamination capacity: dry wiping followed by damp washing, and damp washing followed by dry wiping. Dry wiping followed by damp washing did not produce any significant reduction in the average bacterial load. However, damp washing followed by dry wiping reduced the bacterial load for both types of flooring. The difference was statistically significant.

Decontaminating mats made of several layers of adhesive sheets (water-based acrylic 6 g/m2) supplemented with a bactericidal agent (3-1 benzoisothiazolin) at a concentration of 25% were placed in the passages providing access to the operating rooms of an orthopaedic service. Contact plates containing tryptone soy agar were used to assess bacterial concentration at specific points in front of and beyond the mats. For trolley passageways two areas were defined: central and lateral paths, corresponding to the areas walked upon by the personnel pushing the trolleys and to the paths covered by the trolley wheels, respectively. In order to exclude a simple mechanical effect, a comparison of bacterial loads at defined sites beyond the mats was carried out in the presence and in the absence of decontaminating mats. Bacterial colony counts in the presence of decontaminating mats were substantially and statistically significantly reduced compared with the absence of mats. The lower mean number of colony-forming units detected at points located beyond the mats parallels this finding; this difference is also statistically significant. We thus conclude that decontaminating mats are potentially useful in decreasing micro-organism carry-over due to personnel or the passage of trolleys into areas at high risk of infection such as operating rooms.

Surgical hand disinfection (with an alcohol-based hand rub) and surgical handwash (with an antiseptic-based liquid soap) are accepted measures to reduce the risk for surgical site infections. The new European Standards allow a comparison of their antimicrobial efficacy. The bactericidal activity of surgical hand rubs [Sterillium and Softaman, (active ingredient=alcohols)] and handwashes [Derman plus (triclosan), Hibiscrub (chlorhexidine) and Betadine (PVP-iodine)] was tested according to the prEN 12054 suspension test using Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus hirae, and to prEN 12791 for the effect on resident skin flora in comparison with 1-propanol, 60% (v/v). All five products achieved a reduction of test bacteria within 3 min of >10(5)-fold so fulfilling prEN 12054. However, only Hibiscrub, Sterillium and Softa Man met the requirements of prEN 12791, giving a mean reduction of resident micro-organisms (immediate and sustained effect) which was not significantly lower than the reference alcohol (P>0.1; Wilcoxon matched-pairs signed-rank test). Sterillium was significantly more effective than the reference alcohol (immediate and sustained affect). Products for surgical hand disinfection may have equal antimicrobial activity in suspension tests but show large differences under practical conditions. Healthcare workers should not rely on results from suspension tests when deciding on a product for surgical hand disinfection.

A study was undertaken to determine the resources available in Italian hospitals for the control of nosocomial infections and the factors favouring a successful approach. During January-May 2000 a questionnaire about infection control was sent to the hospital health director of all Italian National Health System hospitals treating acute patients and with more than 3500 admissions in 1999. An active programme was defined as a hospital infection control committee (HICC) meeting at least four times in 1999, the presence of a doctor with infection control responsibilities, a nurse employed in infection control and at least one surveillance activity and one infection control guideline issued or updated in the past two years. There was a response rate of 87.5% (463/529). Almost fifteen percent (69/463) of hospitals had an active programme for Infection Control and 76.2% (353/463) had a HICC. Seventy-one percent (330/463) of the hospitals had a hospital infection control physician and 53% (250/463) had infection control nurses. Fifty-two percent (242/463) reported at least one surveillance activity and 70.8% (328/463) had issued or updated at least one guidance document in the last two years. The presence of regional policies [odds ratio (OR) 8.7], operative groups (OR 4.2), at least one full-time nurse (OR 4.6) and a hospital annual plan which specified infection control (OR 2.1) were statistically associated with an active programme in the multivariate analysis.

A protocol for the disinfection of gastroduodenoscopes, retrograde cholangiopancreatography endoscopes and colonoscopes using endoscope washers is described. The process recommends initial manual washing with a disinfectant containing didecyldimethylammonium chloride, surfactants and enzymes, a second washing in the endoscope washer using a detergent associated with a bacteriostatic, fungistatic substance (benzoisothiazolone) and finally the use of a 2% glutaraldehyde product buffered at pH6. After treatment with 2% Steranios added to the washer, less than 1 micro-organism/ml liquid was found in the following units: 83% of the colonoscopes, 83% of the oesophagogastroduodenoscopes, 83% of the main channels of the retrograde cholangiopancreatography endoscopes and 75% of the auxiliary channels of the latter instruments. In 14% of the colonoscopes, 42% of the gastroduodenoscopes, 42% of the main and 50% of auxiliary channels in the retrograde cholangiopancreatography endoscopes there were no signs of microbial growth in the wash liquid. The results obtained indicated that this protocol allowed adequate disinfection of the endoscope channels, structurally the most difficult part of the instrument to disinfect. Emphasis is given to the degree by which instrument contamination can increase during overnight storage, suggesting that endoscopes need to be submitted to further disinfection after overnight storage. Moreover, the water flowing into the washers can also cause instrument recontamination, particularly during the final rinses. Therefore, to better safeguard the health of patients undergoing endoscopy, special care must be taken to maintain the filters and disinfect the washers themselves, no matter how effective the disinfection protocol used may be., (Copyright 2000 The Hospital Infection Society.)