Disinfection vs. Cleaning: Why the Distinction Matters in Hospitals

In healthcare environments, the distinction between cleaning and disinfection is often misunderstood — yet it’s crucial for preventing healthcare-associated infections (HAIs). Though these processes are complementary, they serve very different purposes and must follow a strict sequence to be effective.

Cleaning: Removing Visible Soils

Cleaning refers to the removal of visible dirt, dust, organic matter, and debris from surfaces. It is a necessary first step, as the presence of residues can impede the effectiveness of disinfectants. In hospital settings, cleaning is typically done using detergents or neutral cleaners, targeting high-touch surfaces such as bed rails, tray tables, and medical equipment.

Disinfection: Destroying Microorganisms

Disinfection, on the other hand, involves applying chemical agents to eliminate pathogenic microorganisms such as bacteria and viruses on inert surfaces. For disinfection to be effective, surfaces must be pre-cleaned. Disinfectants must also be used according to their spectrum of activity, required contact time, and concentration levels.

A Logical Sequence: Clean First, Then Disinfect

Best practices in hospitals call for a two-step process: cleaning first, followed by disinfection. For example, during patient discharge or transfer, a terminal disinfection is performed only after all surfaces in the room have been meticulously cleaned. This sequence is critical for breaking the chain of transmission of pathogens such as C. difficile or MRSA.

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A virus transmitted from computers to humans

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Virus on my keyboard, really?

Did you know that your keyboard and mouse are covered with bacteria and viruses? This may sound obvious when we think about it. Using computers is very common and the risk to be infected seems banal. However, in certain environments such as hospitals this contamination could reveal critical.

In fact, many bacteria and virus breaks have been associated with computers. It’s the case for a hospital in Great Britain, where a study revealed that 42% of tested keyboards were contaminated with the MRSA bacteria, which was directly related to higher MRSA infections as compared to other hospitals where keyboard contamination was lower (1). Another study carried out in Great Britain found that keyboards had been a breeding-ground for the norovirus, which then lead to a break of gastro-enteritis. A virus transmitted from computers to humans… who would’ve thought about that!

Don’t panic, solutions exist!

First and unforgettable is hand washing. In order to limit bacteria and virus spreads, hand washing is essential. Then, to avoid washing our hands every time we use a computer, an alcohol-based antiseptic liquid would do the trick. If our hands are dirty, washing hands before touching the keyboard is also recommended. Finally, it is wise to disinfect your keyboard and mouse from time to time. A renowned researcher named William Rutala, or Bill for his friends, has demonstrated that computer keyboards do not seem to deteriorate after being cleaned 300 times with different disinfectant solutions.

Long story short, we often forget daily objects as being a breeding-ground for viruses and bacteria. For example, mobile phones are often neglected as well despite the fact that we touch them and constantly put them on our face.

But no need to become hypochondriac, it’s enough to follow basic preventive measures. In other words, make little changes and set frequent disinfections based on the risk associated with your environment.

 

(1). Devine J., Is methicilin-resistant Staphylococcus aureus (MRSA) contamination of ward-based computer terminals a surrogate marker for nosocomial MRSA transmission and handwashing compliance? J Hosp Infect. 2001;48:72-5

(2). Morter S., et coll. Norovirus in the hospital setting: virus introduction and spread within the hospital environment. J. Hosp Infect. 2011 Feb;77(2):106-12