Hygiene Prize and award of the Hygieia Medal of the Rudolf Schülke Foundation

The festive award ceremony took place on March 15, 2024 at the Anglo-German Club in Hamburg. After the ceremonial opening speech by the chairman Prof. Dr. med. Martin Exner from the University Hospital Bonn and a speech by Jan-Dirk Auris, CEO of Schülke & Mayr GmbH, in which he emphasized the importance of research in the field of infection prevention, the renowned hygiene prize was awarded this year for two works (see below for detailed information):

Study by the PD Dr. rer. nat. Tilman E. Klassert¹ research group: Dynamics of bacterial colonization and spread of antibiotic resistance genes in the hospital environment after initial patient occupancy: a longitudinal metagenetic study.

Study of the working group PD Dr. med. Rasmus Leistner²: Environmental cleaning to prevent hospital-acquired infections in non-intensive care units: a single-center randomized controlled crossover study comparing soap-based, disinfectant-based and probiotic-based cleaning.

The Hygiene Prize of the Rudolf Schülke Foundation honors individuals whose work has made a decisive contribution to developments in infection prevention and public health. The Board of Directors and Advisory Board of the Rudolf Schülke Foundation recognize the achievements of the medical professionals with the prize, which is endowed with 15,000 euros.

During this year's ceremony, Dr. Bärbel Christiansen from Kiel also received the Hygieia Medal. This medal is awarded every two years to people who have dedicated their life's work to hygiene and microbiology. In his laudatory speech, Prof. Dr. med. Martin Exner, Chairman of the Rudolf Schülke Foundation, made special mention of her role as Chairwoman of the Commission for Hospital Hygiene and Infection Prevention (KRINKO). Dr. Bärbel Christiansen had been particularly successful in motivating the members in the preparation of highly complex recommendations. Her leadership of the KRINKO was "a true masterstroke".

Details of the studies

The study by PD Dr. rer. nat. Tilman E. Klassert is the first international study to look at both the development of the hospital microbiome and the associated spread of antibiotic resistance determinants in the environment of a normal ward in a newly built hospital.

Following the completion of the new Charité ward block, Dr. Klassert's team took surface samples (door handles, floors and washbasins) from nine different hospital rooms over a period of more than six months, before and after they were occupied by patients for the first time. A total of 1,547 samples from surfaces and patients were analyzed for the composition of the microbiome and the spread of antibiotic resistance genes in hospital rooms using high-throughput sequencing methods.

This work aims to gain a deeper understanding of the structure of the bacterial community in the hospital environment (hospital microbiome). This understanding is crucial to prevent nosocomial infections and contain the spread of antibiotic resistance genes. Particularly noteworthy was the observation of a highly significant increase in antibiotic resistance determinants on the hospital room surfaces studied. The working group's study thus formed the basis for further studies as part of the KARMIN project (German Federal Ministry of Education and Research), which investigated various cleaning strategies for the prevention of nosocomial infections and the containment of antibiotic resistance genes. One of the studies from this series (Klassert et al., 2022) was included in a recommendation of the KRINKO (Commission for Hospital Hygiene and Infection Prevention at the RKI) immediately after its publication.

The Rudolf Schülke Foundation also recognizes the study as it served as a starting point for further research projects and has shaped the understanding of the microbiome as a stable component of the hospital environment and a potential reservoir for antibiotic resistance genes.

The study by the PD Dr. med. Rasmus Leistner working group is the first randomized clinical trial (RCT) internationally to focus on the prevention of hospital infections through daily environmental cleaning on normal wards. Two established cleaning agents (soap-based and disinfectant) were compared with a new group of substances, the probiotic cleaning agents. The results of the study show that all three cleaning agents are equally effective in preventing nosocomial infections on normal wards.

The working group considered the conditions of the study and prerequisites to be a comparably low initial level of nosocomial infections as in Germany, a high standard of environmental cleaning (avoidance of cross-contamination, cleaning with microfiber cloths, high-quality staff training) and very good hand hygiene compliance.

Probiotic cleaning agents are already used worldwide in infection prevention in hospitals and, in addition to infection protection, have other properties that make them interesting for the healthcare sector. The special environmental compatibility and the long-lasting cleaning effect due to bacterial cleaning mechanisms, especially on biofilm, should be emphasized.

The Rudolf Schülke Foundation honored the study as it represents a milestone for infection prevention in hospitals.