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Background: The Rudolf Schuelke Foundation addresses topics related to hygiene, infection prevention and public health. In this context a panel of scientists from various European countries discussed “The Role of Surface Disinfection in Infection Prevention”. The most important findings and conclusions of this meeting are summarised in the present consensus paper. Aim: Although the relevance of surface disinfection is increasingly being accepted, there are still a number of issues which remain controversial. In particular, the following topics were addressed: Transferral of microbes from surface to patients as a cause of infection, requirements for surface disinfectants, biocidal resistance and toxicity, future challenges. Methods and findings: After discussion and review of current scientific literature the authors agreed that contaminated surfaces contribute to the transmission of pathogens and may thus pose an infection hazard. Targeted surface disinfection based on a risk profile is seen as an indispensable constituent in a multibarrier approach of universal infection control precautions. Resistance and cross-resistance depend on the disinfectant agent as well as on the microbial species. Prudent implementation of surface disinfection regimens tested to be effective can prevent or minimize adverse effects. Conclusions: Disinfection must be viewed as a holistic process. There is a need for defining standard principles for cleaning and disinfection, for ensuring compliance with these principles by measures such as written standard operating procedures, adequate training and suitable audit systems. Also, test procedures must be set up in order to demonstrate the efficacy of disinfectants including new application methods such as pre-soaked wipes for surface disinfection., GMS Hygiene and Infection Control; 8(1):Doc10; ISSN 2196-5226

Hand hygiene is the most important measure to protect against the spread of nosocomial infections. With the development of in vitro und in vivo test methods for evaluation of the effect of hand hygiene, there has been a sharp increase over the past 50 years in the body of knowledge relating to effective methods for removal from the hands or killing and inactivation of pathogens. In 1958 the German Society of Hygiene and Microbiology (DGHM) published a first "Guidelines for Testing Chemical Disinfectants" and included only those hand disinfection products on its "List of Tested Chemical Disinfectants Found To Be Effective" that had been tested as per the methods cited in the guidelines. The American Society of Testing and Materials (today: ASTM International) was next, with the first test protocols for hand disinfection products, which in 1974 were adopted by the US Food and Drug Agency as "Guidelines" in a "Tentative Final Monograph" (TFM) and in 1994, having revised it to incorporate new insights, it was published once again. Where the user is concerned, guidelines for hand disinfection containing information on indication and implementation are of course more important than methods dealing with efficacy testing of products. Such guidelines are compiled within the hospitals by the infection control teams set up during the 1970s. Written guidelines were also published by several healthcare institutions, scientific societies and associations. The guidelines formulated by the World Health Organisation (WHO), in an expert committee under the direction of Didier Pittet, proved to be the most successful of the attempts undertaken at global level to enhance hand hygiene. The most remarkable changes appear to be the efforts aimed at improving compliance among medical personnel and the increasing international acceptance of hand disinfection by using alcohols in the form of rubs; whether this will be with lotions or gels remains to be seen. Die Händehygiene ist die wichtigste Maßnahme zur Verhütung der Ausbreitung von Krankenhausinfektionen. Mit der Entwicklung von Testmethoden in vitro und in vivo zur Evaluierung des Effektes hat sich seit der Mitte des letzten Jahrhunderts das Wissen über wirksame Methoden der Entfernung von Krankheitserregern von den Händen, deren Abtötung und Inaktivierung in den letzten 50 Jahren sprunghaft erweitert. 1958 veröffentlicht die Deutsche Gesellschaft für Hygiene und Mikrobiologie (DGHM) die ersten "Richtlinien für die Prüfung chemischer Desinfektionsmittel" und nahm Produkte zur Händedesinfektion in ihre "Liste der geprüften und für wirksam befundenen chemischen Desinfektionsmittel" nur auf, wenn diese nach den darin enthaltenen Methoden geprüft worden waren. Es folgte die American Society of Testing and Materials (heute: ASTM International), mit den ersten Testprotokollen für Produkte zur Händedesinfektion, die 1974 von der US Food and Drug Agency als "Guidelines" in einem "Tentative Final Monograph" (TFM) übernommen und 1994 überarbeitet erneut herausgegeben wurden. Für den Anwender sind Richtlinien zur Händehygiene, die über Indikation und Durchführung informieren wichtiger als Methoden zur Wirksamkeitsprüfung der Produkte. Derartige Richtlinien werden innerhalb von Krankenhäusern von den in den 1970er-Jahren formierten Hygiene-Teams erstellt. Schriftliche Richtlinien wurden auch von zahlreichen im Gesundheitswesen tätigen Institutionen, wissenschaftlichen Gesellschaften und Vereinen publiziert. Als bedeutender Erfolg sind die globalen Richtlinien zur Händehygiene durch die Weltgesundheitsorganisation (WHO) durch ein Expertenkomitee unter Leitung von Didier Pittet zu werten. Am wichtigsten aber scheinen alle Bemühungen um die Verbesserung der Compliance des medizinischen Personals und die international zunehmende Akzeptanz der Händedesinfektion durch Verwendung von Alkoholen in Form von Einreibverfahren - ob mit Lotionen oder Gelen wird die Zukunft zeigen.