Just how efficacious are the cleaning and disinfection interventions performed in healthcare institutions? And what standard are hospitals using to evaluate cleaning efforts?  While it has been suggested that the food industry cleanliness standard (surface bioburden level of <2.5 cfu/cm²) be adopted in healthcare as an indication of relative cleanliness, there is still a lack of conclusive evidence that these levels of contamination relate to the prevention of healthcare-associated infections (HAIs).A historical review to place this topic in perspective is in order here. As Dancer (2004) observed, “There may be a link between dirty hospitals and the rising numbers of hospital-acquired infections but there is little evidence to be able to substantiate this at present ... Unfortunately, the mechanisms for evaluating the quality of hospital cleaning regimens are limited.”