Comparative Analysis of Chemical and Bioorganic Disinfectants in Hospital Settings: Focus on Citriferine and Filiferine, Application in Neonatal Units

Introduction: Healthcare-associated infections (HAIs) are one of the main challenges for health systems, especially in low- and middle-income countries, where the incidence can reach up to 15% of hospitalized patients. Hospital cleaning and disinfection are essential measures to improve the quality of care and environmental protection, being especially crucial in hospitals with limited resources. However, traditional products present notable disadvantages, motivating the analysis of bioorganic alternatives such as Citriferine and Filiferin. Moreover, recent studies have highlighted the importance of evaluating the compatibility of these products with commonly used medical materials to avoid damage that could affect their functionality. In this context, an integrated approach considering both short- and long-term efficacy and safety is a priority. Objective: To evaluate the efficacy, safety, and environmental relevance of Citriferine and Filiferine in comparison to conventional disinfectants, with an emphasis on their application in neonatal units. Methods: A systematic review was conducted using PubMed (98 entries), EMBASE (54), LILACS (45), and gray literature, totaling 197 records. After applying inclusion criteria (controlled trials, observational studies with clear clinical or microbiological outcomes, peer review) and exclusion criteria (absence of control group, insufficient data, low quality), 27 studies (18 clinical, 4 in vitro, 5 environmental), and 4 hospital reports were selected for final analysis. The risk of bias was assessed using validated tools, and pilot and in vitro studies were contextualized regarding their limitations. Detailed analyses of Filiferina’s microbiological efficacy and toxicological profile previously published were included to ensure methodological integrity of the selection [1]. Results: Both bioorganic alternatives showed antimicrobial efficacy equivalent to chemical disinfectants (MIC 1:1000 - 1:2000) and 100% compliance with asepsis protocols with negative cultures in neonatology, monitored through formal audits. The cost per gallon of active Citriferine/Filiferine solution at 5% is $4.39 USD, eight times lower than 2% glutaraldehyde, which is highly relevant for hospitals with limited resources. Hospital pilot reports and recent reviews ruled out toxic outcomes and highlighted advantages in tolerability, biodegradability, and material compatibility. The product also demonstrates prolonged chemical and biological stability. Its