Prof Stephanie Dancer

NHS Lanarkshire and Professor of Microbiology at Edinburgh Napier University in Scotland

Smart cleaning: a weapon in the war against antibiotic resistant superbugs

Now that cleaning and decontamination are recognised as an integral element of infection control in healthcare, it is time to examine the process in more detail. This is because cleaning practices vary widely between hospitals and both time and energy may well be wasted with poorly-defined duties. Furthermore, inefficient, inappropriate and inadequate cleaning will not reduce the risk of infection but could even enhance it. Given the increasing risk from multiply-resistant hospital pathogens, cleaning near-patient surfaces has become the subject of much debate.

Not surprisingly, the risks from multiply-resistant pathogens have generated interest in automated devices delivering hydrogen peroxide or ultraviolet light for healthcare decontamination. Routine use of these devices requires robust justification from standardized and controlled studies since clinical benefits are not guaranteed and costs vastly exceed those required for manual cleaning. It is likely that a systematic cleaning process, underpinned by relevant training, would be helpful for domestic staff, managers and ward staff. This presentation will highlight a manual evidence-based cleaning framework for the occupied bed space in general hospital wards.

Despite toxicity and lack of cost benefit, concern over acquisition of resistant pathogens encourages the use of powerful disinfectants for eliminating pathogens, especially when there is an outbreak. Unfortunately, these agents inflict damage on people and the environment, making them a controversial choice for routine cleaning practices. Smart cleaning can circumvent expensive decontamination methods in order to protect patients and save money.


Stephanie is a medical microbiologist in NHS Lanarkshire and Professor of Microbiology at Edinburgh Napier University in Scotland. She edited the Journal of Hospital Infection for over 20 years, five of them as editor-in-chief, and now edits for Infection, Disease & Health and International Journal of Antimicrobial Agents. She trained at St. Bartholomew’s Hospital in London followed by postgraduate studies at Guy’s Hospital, where she gained a thesis on the epidemiology and biochemistry of toxin-producing staphylococci. She has worked and travelled all over the world, including the Canadian High Arctic, where she resuscitated 30,000-year-old organisms from glacial ice. She spent six years as Infection Control Officer for Argyll before moving to Health Protection Scotland as their inaugural microbiologist (2002-5). There, she set up MRSA surveillance for Scotland, evaluated real-time PCR for MRSA screening and helped establish the Scottish Microbiology Forum. She has been a member of national working groups on antibiotic prescribing, MRSA and hospital cleaning, and is a current or recent member of NHS Scotland Decontamination; UK NICE (infection control & antimicrobial prescribing); UK HTA (screening and diagnostics); ESCMID groups on infection control, MRSA & multi-resistant Gram-negative bacilli; and 2013 ECCMID conference committee. She is currently advising DEFRA on surface cleaning and hygiene during the Covid-19 crisis and collaborating with an international group of virologists, physicists, ventilation engineers and aerosol scientists on airborne spread of SARS-CoV-2. She has published books, book chapters and around 180 papers in peer-reviewed journals on hospital cleaning, antimicrobial management, infection control and MRSA. At present, she balances editorial duties with research and teaching, specifically antimicrobial stewardship and environmental control of hospital pathogens.

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