We have started a new year, and over the last three weeks, there have been many great yet concerning articles on healthcare-associated infections (HAIs):

• Hospital Surfaces Can Harbor Harmful Microbes Even After Routine Disinfection (APIC, 1/11/24)
• Despite Disinfection, Bugs Thrive on High-Touch Hospital Surfaces: Unusual pathogens may pose threat to immunocompromised patients researchers say (MedPage Today, 1/11/24)
• A Review of the Evidence on the Role of Floors and Shoes in the Dissemination of Pathogens in a Healthcare Setting (NIH, 1/5/24)
• Bacterial contamination on clinical surfaces and oxygen device accessories in the emergency unit of tertiary health facility in Ghana (NIH, 1/2/24)
• The role of the hospital bed in hospital-onset Clostridioides difficile: A retrospective study with mediation analysis (Cambridge University Press, 12/13/23)

This is not a complete list of the recent research and articles that discuss and provide scientific evidence of the problem. It is great research, and I highly recommend people read these articles—and then take in the fact that a crisis of epidemic proportions is happening in our healthcare facilities, STILL. This is not something new, and as the years go by, microbes have mutated and developed resistance to standard treatments of care, prompting antimicrobial stewardship programs in every healthcare facility worldwide.

Every year, new innovative products that support effective cleaning and disinfection come to the market, new protocols and processes are recommended and implemented, and a year later, new research shows the same issues. We all agree this is a crisis that leaves patients at risk.

When are we going to stop ignoring the root causes of HAIs?

Before teams tasked with cleaning, disinfecting, or reprocessing take action, it’s crucial to recognize what hinders effective solutions to this longstanding problem.

While the current focus is on improving cleaning and disinfection, a better understanding of basic microbiology and how microbes live, breathe, and lurk in and on surfaces would make a meaningful difference in how we address root causes that inhibit effective cleaning and disinfection. Additional issues include:

• The design of healthcare spaces and devices
• Surface material selection
• Testing for material compatibility with disinfectants
• Evaluating regulatory requirements for testing surfaces for compatibility
• Manufacturer IFUs that do not align with infection prevention guidelines and strategies within healthcare facilities

While the list above is not exhaustive, it sheds light on some of the root causes inhibiting sustainable progress in cleaning, disinfecting, and reprocessing. Unfortunately, these issues are often not fully understood, overlooked, or dismissed because they are complex and it is tempting to demand more robust cleaning and disinfection. However, this approach may inadvertently cause damage, fostering microbial reservoirs, biofilm formation, and supporting resilient microbes on surfaces.

There is no single solution to this problem. It is essential to start where the problems begin and then implement a range of solutions.

The Healthcare Surfaces Institute has been dedicated to understanding surface science for many years, acknowledging and addressing these foundational issues.

The HSI Board of Directors invites you to be part of the solution and work with us to address root causes. It can begin by watching our January 24^th presentation, where these issues are addressed by a group of healthcare professionals dedicated to finding sustainable solutions.

Beyond Disinfection: Unraveling the Complexity of HAIs and Surface Contamination

Watch our expert presenters discuss the challenges healthcare professionals face working to mitigate the spread of infections within our healthcare facilities and how we can address the root causes of these issues to create multi-modal solutions.

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