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Chemical disinfection in hospitals. 2nd Edn
Journal of Hospital Infection (1995) 30, 83-84
Book Review Chemical Disinfection in Hospitals. 2nd Edn. Ayliffe man PN. London: Public Health Laboratory paperback. 72 pp. ISBN 0901144347.
GAJ, Coates D, HoffService, 1993. E6.50
The inappropriate use of chemical disinfectants in hospitals is not uncommon. Apart from the unnecessary costs incurred, the abuse of disinfectants may result in cross-infection or point-source outbreaks that carry significant morbidity and mortality. The choice of the numerous agents is bewildering; the front cover of this book subtly indicates the measure of this problem as, with close scrutiny, one can see the long list of disinfectants that are available. There are few texts which give clear practical guidelines and the second edition of this small booklet (72 pages) produced by the Public Health Laboratory Service will be welcomed by many users of disinfectants, especially those with responsibilities for drawing up disinfectant policies. There seems to be a conspiracy to conceal from the potential purchasers the expertise of the three authors. Indeed, there is no indication of their qualifications or allegiances anywhere in this publication. One wonders whether there was a preface that was omitted or an intention to ‘sanitize’ their authority. The cognoscenti will, however, appreciate that they are in the hands of the masters. This text is clear and appropriate for clinical microbiologists, infectious diseases physicians, nurses, and especially infection control nurses and medical and dental students (now, we are told preoccupied with learning rather than being taught). They will all find a refreshing balance between heavy texts of detail published elsewhere and a welcome simplicity and commonsense. For so few pages, the subject is covered comprehensively with excellent sections on the principles of disinfection, the properties of disinfectants, safety issues, disinfection of the environment and the use of disinfectants in the laboratory. Agents and immersion times for endoscopes are clearly discussed and there is a useful summary policy for the decontamination of other equipment and the environment, There are a few criticisms. Some might have hoped for further references to scientific studies, including those from the authors (especially Professor Ayliffe), who between them have over the last 30 years published many papers on the scientific evaluation of disinfectants. A more detailed exploration of the importance and indications for handwashing would also have been welcome. There is, for example, no mention of the useful residual action of certain skin disinfectants. 0195-6701/95/050083
0 1995 The Hospital
+02 $08.00/O
83
Infectmn
Society
84
Book review
Those concerned with infection control, either in hospital or in the nonhospital community, should purchase this book tomorrow. If they all followed its advice there would be immediate improvement in the use and knowledge of disinfectants, and more effective policies; and one could guarantee the saving of millions of dollars following the cessation of chemical disinfection of theatre floors and walls (Germany), the fogging of operating theatres (Japan), cross-infection via hands (all countries) and most importantly, a decrease in cross-infection from the inadequate disinfection of endoscopes. At E6.50 this has to be a bargain. Be sure there are enough copies in your department to ensure that yours has not been ‘borrowed’ when you really need it!
M. W. Casewell
Dulwich Public Health Laboratory and Department of Medical Microbiology, King’s College School of Medicine and Dentistry, Bessamer Road, London SE5 SPY, UK
Book Review Chemical Disinfection in Hospitals. 2nd Edn. Ayliffe man PN. London: Public Health Laboratory paperback. 72 pp. ISBN 0901144347.
GAJ, Coates D, HoffService, 1993. E6.50
The inappropriate use of chemical disinfectants in hospitals is not uncommon. Apart from the unnecessary costs incurred, the abuse of disinfectants may result in cross-infection or point-source outbreaks that carry significant morbidity and mortality. The choice of the numerous agents is bewildering; the front cover of this book subtly indicates the measure of this problem as, with close scrutiny, one can see the long list of disinfectants that are available. There are few texts which give clear practical guidelines and the second edition of this small booklet (72 pages) produced by the Public Health Laboratory Service will be welcomed by many users of disinfectants, especially those with responsibilities for drawing up disinfectant policies. There seems to be a conspiracy to conceal from the potential purchasers the expertise of the three authors. Indeed, there is no indication of their qualifications or allegiances anywhere in this publication. One wonders whether there was a preface that was omitted or an intention to ‘sanitize’ their authority. The cognoscenti will, however, appreciate that they are in the hands of the masters. This text is clear and appropriate for clinical microbiologists, infectious diseases physicians, nurses, and especially infection control nurses and medical and dental students (now, we are told preoccupied with learning rather than being taught). They will all find a refreshing balance between heavy texts of detail published elsewhere and a welcome simplicity and commonsense. For so few pages, the subject is covered comprehensively with excellent sections on the principles of disinfection, the properties of disinfectants, safety issues, disinfection of the environment and the use of disinfectants in the laboratory. Agents and immersion times for endoscopes are clearly discussed and there is a useful summary policy for the decontamination of other equipment and the environment, There are a few criticisms. Some might have hoped for further references to scientific studies, including those from the authors (especially Professor Ayliffe), who between them have over the last 30 years published many papers on the scientific evaluation of disinfectants. A more detailed exploration of the importance and indications for handwashing would also have been welcome. There is, for example, no mention of the useful residual action of certain skin disinfectants. 0195-6701/95/050083
0 1995 The Hospital
+02 $08.00/O
83
Infectmn
Society
84
Book review
Those concerned with infection control, either in hospital or in the nonhospital community, should purchase this book tomorrow. If they all followed its advice there would be immediate improvement in the use and knowledge of disinfectants, and more effective policies; and one could guarantee the saving of millions of dollars following the cessation of chemical disinfection of theatre floors and walls (Germany), the fogging of operating theatres (Japan), cross-infection via hands (all countries) and most importantly, a decrease in cross-infection from the inadequate disinfection of endoscopes. At E6.50 this has to be a bargain. Be sure there are enough copies in your department to ensure that yours has not been ‘borrowed’ when you really need it!
M. W. Casewell
Dulwich Public Health Laboratory and Department of Medical Microbiology, King’s College School of Medicine and Dentistry, Bessamer Road, London SE5 SPY, UK