Lessons Learned for Surface Hygiene

As a result of the COVID-19 pandemic, the WHO has called for surface hygiene to be carried out more frequently. Experts are again warning of a new risk of pandemic proportions: the global spread of multidrug-resistant pathogens. Intensifying surface disinfection would also be necessary here in light of poor compliance.

The most important facts:

  • With the COVID-19 pandemic, surfaces potentially being a source of transmission also became a focus of preventative measures.
  • Contaminated surfaces play a particularly important role in the transmission of multi-resistant bacteria.
  • Only one third of the necessary surfaces in inpatient and outpatient health institutions are disinfected properly.
  • After surface disinfection has been carried out, re-contamination with pathogens can reach the initial level again after just 1.5 to 2.5 hours.

In May 2020, the WHO called for surface hygiene to be carried out more frequently in health institutions to combat the COVID-19 pandemic. The role of inanimate surfaces in the transmission of SARS-CoV-2 has not yet been conclusively investigated. The WHO recommendations for intensifying surface hygiene are based on studies addressing other coronaviruses such as SARS-CoV and MERS-CoV. Contact surfaces have been identified as important sources of transmission for both coronavirus species.

Resistant germs on surfaces

With its recommendation, the WHO draws attention to surface hygiene as an important measure to prevent pathogen transmission. Inanimate surfaces have long been known as a source of transmission of pathogenic germs. In outbreak situations, contamination of the patient’s immediate surroundings is often detected. The main focus is on (resistant) pathogens such as C. difficile, MRSA, VRE, A. baumannii and noroviruses. Contaminated surfaces are significantly involved in the spread of gram-negative bacteria. For example, the risk of becoming infected with carbapenem-resistant A. baumannii increases 2.77-fold if the surrounding surfaces are contaminated.

Compliance with surface disinfection is lacking

Disinfecting the surfaces close to the patient can significantly reduce the risk of transmission of pathogens. Ideally, ready-to-use disinfectants or appropriately pre-soaked disposable wipes are suitable for this purpose. However, despite useful application solutions, compliance with surface hygiene is lacking according to studies: An investigation into the disinfection rate on surfaces with frequent hand and skin contact showed a rate of only 35 percent. At the same time, further studies show that the contamination of surfaces in intensive care units, e.g. with MRSA, quickly returns to the initial level after disinfection.


Surface disinfection demands increased attention, and not just within the context of the COVID-19 pandemic. Surfaces in patient rooms with frequent hand and skin contact are, as of now, not disinfected to a sufficient level. To protect patients from dangerous germs such as gram-negative bacteria, surface disinfection in patient rooms must be intensified.

TIP: When it comes to surface disinfection, frequently touched surfaces in hospitals are often overlooked. Graphical representations of the individual rooms and the correct sequence for disinfection help to increase compliance.


World Health Organization (2020). Cleaning and disinfection of environmental surfaces in the context of COVID-19. Interim guidance
Interim guidance 15 May 2020Klöcker U. (2015) Reinigung und Desinfektion im Krankenhaus. HYSIST, Düsseldorf
Kampf G. (2013). Flächendesinfektion. Krankenhaushygiene up2date
Hubert HA et al. (2012). Intrinsic bacterial burden associated with intensive care unit hospital beds: Effects of disinfection on population recovery and mitigation of potential infection risk. American Journal of Infection Control

Also interesting:
„Hygiene in context with Corona“
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