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Antibiotic resistance, the hygiene hypothesis - and the need for targeted hygiene. Sally Bloomfield Chairman and Scientific Advisory Board Member, IFH Hon. Professor, London School of Hygiene and Tropical Medicine. In the last 10-15 years hygiene has moved up the health agenda.
Antibiotic resistance, the hygiene hypothesis - and the need for targeted hygiene
Chairman and Scientific Advisory Board Member, IFH
Hon. Professor, London School of Hygiene and Tropical Medicine
What has brought about the change ?
Good hygiene practice is key to reducing these risks - in many cases the first line of defence
Biocides and antibiotic
The hygiene hypothesis
The “targeted approach to
Could hygiene undermine immunity to infectious disease or promote atopic disease
colonisation or clinical infection?
“hygiene” or “cleanliness”?
We’ve become too clean for our own good?
This seems unlikely because:
Evidence of link with domestic hygiene is weak.
Overall data suggest that we are regularly exposed to pathogens, commensals and environmental microbes.
Also need to bear in mind:
people, food, pets, water, insects
- probability of contamination c. harmful microbes
- infective dose
- probability of transfer/cross contamination- such that human exposure could result
Good hygiene is not about “creating a germ free home” but about identifying high risk sites and situations and targeting hygiene measures appropriately (i.e as and where necessary) to reduce exposure to microbes which could be harmful
- reducing the risks
“a level of germs which is not harmful to health”
Detergent-based hygienic cleaning
- chemical disinfectant products
- heat (e.g boiling or >60°C)
or: Combined removal and kill
- laundry - removal, heat and bleach kill
- dishwashing - removal, heat kill
In deciding whether “soap and water” is the appropriate hygiene procedure or whether a disinfectant is needed - need to consider:
chicken contaminated with Salmonella or Campylobacter
Cogan, Bloomfield and Humphries, Letters in Appl.Microbiology 1999, 29,354-358
General hygiene - effectiveness of hygiene procedures in eliminating norovirus from surfaces (N = 14)
Barker, Vipond and Bloomfield, J. Hospital Infection 2004, 58, 42-49
Surfaces soiled with faeces/norovirus
Contaminated cloth used to
wipe a clean surface
on home hygiene
Biocides and resistance
Targeted approach to home hygiene
IFH guidelines and teaching materials