Highlights
- •Disinfection in healthcare facilities typically focuses on high-touch surfaces.
- •Portable equipment has been linked to pathogen transmission.
- •Emerging evidence suggests that floors could also contribute to transmission.
- •Practical approaches are needed to address portable equipment and floors.
Efforts to improve environmental cleaning and disinfection typically focus primarily
on high-touch surfaces in patient rooms. This review highlights evidence that portable
equipment and other shared devices and floors may be underappreciated as sources of
dissemination of health care–associated pathogens. Practical approaches to address
these sites of contamination are emphasized.
Key Words
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References
- Does improving surface cleaning and disinfection reduce health care-associated infections?.Am J Infect Control. 2013; 41: S12-S19
- The role of patient care items as a fomite in healthcare-associated outbreaks and infection prevention.Clin Infect Dis. 2017; 65: 1412-1419
- Quantitative assessment of interactions between hospitalized patients and portable medical equipment and other fomites.Am J Infect Control. 2017; 45: 1276-1278
- Spores on wheels: wheelchairs are a potential vector for dissemination of pathogens in healthcare facilities.Am J Infect Control. 2019; 47: 459-461
- What is on that keyboard? Detecting hidden environmental reservoirs of Clostridium difficile during an outbreak associated with North American pulsed-field gel electrophoresis type 1 strains.Am J Infect Control. 2009; 37: 15-19
- Effectiveness of an ultraviolet radiation device for disinfection of personal use items in rooms of long-term care facility residents.in: Paper presented at the Society for Healthcare Epidemiology of America Annual Meeting, Atlanta, GA2016 May 18-21
- Environmental surfaces in healthcare facilities are a potential source for transmission of Candida auris and other Candida species.Infect Control Hosp Epidemiol. 2017; 38: 1107-1109
- Evaluation of a novel alcohol-based surface disinfectant for disinfection of hard and soft surfaces in healthcare facilities.Open Forum Infect Dis. 2017; 4: ofx054
- Wheelchair cleaning and disinfection in Canadian health care facilities: “That's wheelie gross!.Am J Infect Control. 2014; 42: 1173-1177
- Shedding of methicillin-resistant Staphylococcus aureus by colonized patients during procedures and patient care activities.Infect Control Hosp Epidemiol. 2019; 40: 328-332
- Candida auris in an intensive care setting.N Engl J Med. 2019; 380: 890-891
- Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers.Ann Intern Med. 1992; 117: 112-116
- Epidemiological study of hospital-acquired infection with vancomycin-resistant Enterococcus faecium: possible transmission by an electronic ear-probe thermometer.Infect Control Hosp Epidemiol. 1997; 18: 771-773
- Reduction in the incidence of Clostridium difficile-associated diarrhea in an acute care hospital and a skilled nursing facility following replacement of electronic thermometers with single-use disposables.Infect Control Hosp Epidemiol. 1992; 13: 98-103
- Enterobacter cloacae outbreak in the NICU related to disinfected thermometers.J Hosp Infect. 2000; 45: 29-34
- A randomized crossover study of disposable thermometers for prevention of Clostridium difficile and other nosocomial infections.Infect Control Hosp Epidemiol. 1998; 19: 494-499
- Reduction in vancomycin-resistant Enterococcus and Clostridium difficile infections following change to tympanic thermometers.Infect Control Hosp Epidemiol. 1998; 19: 333-336
- Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA).Clin Infect Dis. 2018; 66: 987-994
- A Candida auris outbreak and its control in an intensive care setting.N Engl J Med. 2018; 379: 1322-1331
- Effectiveness of disinfectants against Candida auris and other Candida species.Infect Control Hosp Epidemiol. 2017; 38: 1240-1243
- Evaluation of viral surrogate markers for study of pathogen dissemination during simulations of patient care.Open Forum Infect Dis. 2017; 4: ofx128
- Contaminated portable equipment is a potential vector for dissemination of pathogens in the intensive care unit.Infect Control Hosp Epidemiol. 2017; 38: 1247-1249
- Evaluation of an automated ultraviolet-C light disinfection device and patient hand hygiene for reduction of pathogen transfer from interactive touchscreen computer kiosks.Am J Infect Control. 2018; 46: 464-467
- Evaluation of the potential for electronic thermometers to contribute to spread of healthcare-associated pathogens.Am J Infect Control. 2018; 46: 708-710
- Transmission of Clostridium difficile from asymptomatically colonized or infected long-term care facility residents.Infect Control Hosp Epidemiol. 2018; 39: 909-916
- Sharing is not always a good thing: use of a DNA marker to investigate the potential for ward-to-ward dissemination of healthcare-associated pathogens.Infect Control Hosp Epidemiol. 2019; 40: 214-216
Rutala WA, Weber DJ, The Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. Available from: https://www.cdc.gov/infectioncontrol/pdf/guidelines/disinfection-guidelines.pdf. Accessed March 27, 2019.
- Cleanliness of portable medical equipment disinfected by nursing staff.Am J Infect Control. 2011; 39: 602-604
- Practical approaches for assessment of daily and post-discharge room disinfection in healthcare facilities.Curr Infect Dis Rep. 2017; 19: 32
- Evaluation of an enclosed ultraviolet-C radiation device for decontamination of mobile handheld devices.Am J Infect Control. 2016; 44: 724-726
- Evaluation of a low-intensity ultraviolet-C radiation device for decontamination of computer keyboards.Am J Infect Control. 2016; 44: 705-707
- Evaluation of hospital floors as a potential source of pathogen dissemination using a nonpathogenic virus as a surrogate marker.Infect Control Hosp Epidemiol. 2016; 37: 1374-1377
- Are hospital floors an underappreciated reservoir for transmission of health care-associated pathogens?.Am J Infect Control. 2017; 45: 336-338
- Efficacy of manual cleaning and an ultraviolet C room decontamination device in reducing health care-associated pathogens on hospital floors.Am J Infect Control. 2018; 46: 584-586
- Mechanisms for floor surfaces or environmental ground contamination to cause human infection: a systematic review.Epidemiol Infect. 2017; 145: 347-357
- Patient shoe covers: transferring bacteria from the floor onto surgical bedsheets.Am J Infect Control. 2016; 44: 1430-1432
- Non-slip socks: a potential reservoir for transmitting multidrug resistant organisms in hospitals?.J Hosp Infect. 2016; 94: 273-275
- Evaluation of a shoe sole UVC device to reduce pathogen colonization on floors, surfaces and patients.J Hosp Infect. 2018; 98: 96-101
- Routine disinfection of patients’ environmental surfaces. Myth or reality?.J Hosp Infect. 1999; 42: 113-117
- Postdischarge decontamination of MRSA, VRE, and Clostridium difficile isolation rooms using 2 commercially available automated ultraviolet-C-emitting devices.Am J Infect Control. 2016; 44: 416-420
Article info
Footnotes
Funding/support: This work was supported by a Merit Review grant from the Department of Veterans Affairs to C.J.D.
Conflicts of interest: None to report.
Identification
Copyright
Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.
