Among the appliable strategies for the improvement of cleaning and disinfection practices are the use of new materials and/or disinfectants, the training and audit of operators, and the use of new automated technologies, which are becoming increasingly important. In particular, no-touch disinfection technologies have the great advantage of not being dependent on the operator, ensuring process repeatability. Furthermore, their effectiveness has been demonstrated even on sites that are difficult to reach with manual intervention. Their use complements but does not replace ordinary cleaning and disinfection protocols. In the past few years, ultraviolet disinfection systems have been widely investigated and used as a way to improve standard cleaning protocols. Currently, ultraviolet devices are automated in order to guarantee process repeatability and reduce human errors. The application of UV devices as an addition to traditional environmental cleaning has become increasingly common due to their effectiveness in reducing the environmental microbial burden in a shorter time compared to other technologies using chemical products [
These organisms belong to a group of carbapenem-resistant, gram-negative bacteria of national and international concern because of their implication as an emerging cause of severe healthcare-associated infections. In , the World Health Organization published the first global guidelines for the prevention and control of CRE-CRAB-CRPsA in healthcare facilities, which include environmental cleaning and disinfection as a key recommendation.
The cleaning procedure is not only dependent on the chemicals used but also on the personnel performing it. As reported by Toffollutti et al., there are differences between housekeeping and outsourcing cleaning staff in ensuring adequate levels of hygiene; outsourcing cleaning services was associated with a greater incidence of meticillin-resistant Staphylococcus aureus (MRSA) and worse patient perceptions of cleanliness [
In our study, we evaluated the efficacy of the UV-C treatment only on the reduction in mesophilic growth that mainly represents human contamination, but not on specific pathogens of interest; however, the reduction was very significant, suggesting that this system can easily eliminate pathogens as well. We have previously demonstrated that the adoption of an automated UV-C-disinfection robot in the enhancement of SOP in high-risk settings was successful in reducing pathogens on high-touch surfaces, improving the patients safety [
In settings where hospital cleaning services are assigned to private sector contractors, the use of new no-touch technologies could be considered in outsourcing contracts as an improvement action in the event of non-compliance in the cleaning service. The dedicated personnel should be adequately trained not only on the cleaning protocols to be adopted but also on infection control issues, underlining the key role of cleaning procedures.