Chemical disinfectants: Controversies regarding their use in low risk healthcare environments (part 1)

In recent years, the number of disinfectants designed to decontaminate healthcare environments and reusable, non-invasive care equipment (NICE) has increased markedly, making the selection of the most appropriate disinfectant a somewhat daunting prospect. In addition to the microbial challenge, there are numerous factors to consider including: efficacy; range and speed of activity; stability of the ingredients; compatibility of the disinfectant with surfaces; inactivation of the disinfectant by organic matter; method of application; convenience; health and safety concerns; and cost. While the microbial challenge continues to evolve, and novel disinfectants continue to emerge, guidance updates have been notably absent. Most healthcare surfaces belong to a UK-defined category of 'low risk' for which guidance dictates 'cleaning and drying is usually sufficient'. This paper assesses the evidence and arguments regarding the use of disinfectants for low-risk healthcare surfaces. A novel subcategorisation of 'low risk' is presented to provide a more specific up-to-date disinfectant needs assessment.