Hygiene yesterday, today, tomorrow

I began my career in 1945 by tracing the footsteps of the legendary Max von Pettenkofer and Robert Koch. At that time their influence was still discernible, and continues to be. The first major innovation was the introduction of antibiotics, which some people believed would now dispense with the need for disinfection and sterilization. The next major development was the introduction of hospital hygiene as a discipline in its own right, aimed at highlighting the growing risk of nosocomial infections, albeit also against the background of the, admittedly, brilliant but unceasingly innovative armamentarium of medical paraphernalia and fittings. As regards the pathogens, viruses were seen to play an increasingly more prominent role as nosocomial pathogens, giving rise to completely novel challenges and problems in the field of disinfection and sterilization. In 1956 at Prof. Pette’s institute in Hamburg it generally took weeks to produce the results to diagnose poliomyelitis. Their value was immensely important for science – but their value to the doctor and patients was questionable. The introduction of inexpensive sterile disposable syringes and other disposable equipment represented, in my opinion, the next milestone. In the meantime, there was a dramatic increase in the overall constellation of problems caused by the continuing upsurge in antibiotic bacterial resistance. And with growing awareness of environmental issues, the late 60s set in motion a new avalanche where one had to strive not only to keep abreast of matters, but also to ensure that science continued to prevail as the highest instance. Today we are facing completely different, but in principle still similar problems in consolidating the status of disinfection and sterilization, e.g. when it comes to the ultra delicate devices that in some cases are heavily contaminated after routine clinical use. Hence we elderly infection control experts still have a task to accomplish: to issue warnings again and again against accepting as “fate” the unresolved problems, but instead to highlight the very core of the problem. Disinfection and sterilization is a topical issue and will always continue to be just that: to protect the population and patients, and to protect ourselves as well as personnel in hospitals, medical practice and research.