Study of the persistence of selected Gram-negative bacteria pathogens of healthcare-associated infections on hospital fabrics

Published:December 06, 2021DOI:


      • Gram-negative bacteria persist on fabrics for more than a month.
      • Moisture enhanced bacterial cells persistence on fabrics.
      • Contaminated fabrics are potential fomites in healthcare settings.



      The ability of healthcare associate infection (HAI) pathogens to persist on fomites is crucial to their transmission within the healthcare setting, this study evaluated the persistence of 3 common HAI pathogens on fabrics materials commonly used in healthcare settings.


      Persistence of bacteria species on fabric was investigate by inoculating standardized inoculum prepared from the clinical isolates of Pseudomonas aeruginosa, Escherichia coli and Acinetobacter baumannii on sterile swatches of 100% cotton, microfiber and polyester. Viable bacteria persisting on the inoculated fabrics were evaluated immediate after inoculation and subsequently at 96-hour interval for 32 days using the drop plate technique. The effect of moisture on the persistence of the studied bacteria isolates was also evaluated.


      Between 3 and 6 log reduction in the viability of the inoculated bacteria cells were observed after 32 days of inoculation on fabrics. Generally, lower viable cells were recovered from the microfiber fabrics compared to others, while higher viable cells were recovered from wet fabrics compared to the dry fabrics in this study.

      Discussion and conclusions

      This study demonstrated that HAI bacteria pathogens can persist for more than a month on hospital fabrics, and that their persistence can be enhanced by moisture.

      Key Words

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        • Dalton KR
        • Rock C
        • Carroll KC
        • Davis MF
        One Health in hospitals: how understanding the dynamics of people, animals, and the hospital built-environment can be used to better inform interventions for antimicrobial-resistant gram-positive infections.
        Antimicrob Resist Infect Control. 2020; 9: 1-17
        • Haque M
        • Sartelli M
        • McKimm J
        • Bakar MA
        Health care-associated infections–an overview.
        Infect Drug Resist. 2018; 11: 2321
        • Emerson CB
        • Eyzaguirre LM
        • Albrecht JS
        • Comer AC
        • Harris AD
        • Furuno JP
        Healthcare-associated infection and hospital readmission.
        Infect Control Hosp Epidemiol. 2012; 33: 539-544
        • Souza ES
        • Belei RA
        • Carrilho CMDDM
        • et al.
        Mortality and risks related to healthcare-associated infection.
        Texto Contexto-Enfermagem. 2015; 24: 220-228
      1. World Health Organization, 2011. Report on the burden of endemic health care-associated infection worldwide.

        • Chaoui L
        • Mhand R
        • Mellouki F
        • Rhallabi N
        Contamination of the surfaces of a health care environment by multidrug-resistant (MDR) bacteria.
        Int J Microbiol. 2019; 2019: 1-7
        • Chia PY
        • Sengupta S
        • Kukreja A
        • Ponnampalavanar SS
        • Ng OT
        • Marimuthu K
        The role of hospital environment in transmissions of multidrug-resistant gram-negative organisms.
        Antimicrob Resist Infect Control. 2020; 9: 1-11
        • Kanamori H
        • Rutala WA
        • Weber DJ
        The role of patient care items as a fomite in healthcare-associated outbreaks and infection prevention.
        Clin Infect Dis. 2017; 65: 1412-1419
        • Getu A
        • Sahu O
        Technical fabric as health care material.
        Biomed Sci Eng. 2014; 2: 35-39
        • Das I
        • Lambert P
        • Hill D
        • Noy M
        • Bion J
        • Elliott T
        Carbapenem-resistant Acinetobacter and role of curtains in an outbreak in intensive care units.
        J Hosp Infect. 2002; 50: 110-114
        • Hosein IK
        • Hoffman PN
        • Ellam S
        • et al.
        Summertime Bacillus cereus colonization of hospital newborns traced to contaminated, laundered linen.
        J Hosp Infect. 2013; 85: 149-154
        • Osawa K
        • Baba C
        • Ishimoto T
        Significance of methicillin-resistant Staphylococcus aureus (MRSA) survey in a university teaching hospital.
        J Infect Chemother. 2003; 9: 172-177
        • Schmithausen RM
        • Sib E
        • Exner M
        • et al.
        The washing machine as a reservoir for transmission of extended-spectrum-beta-lactamase (CTX-M-15)-producing Klebsiella oxytoca ST201 to newborns.
        Appl Environ Microbiol. 2019; 85 (e01435–19)
        • Herigstad B
        • Hamilton M
        • Heersink J
        How to optimize the drop plate method for enumerating bacteria.
        J Microbiol Methods. 2001; 44: 121-129
        • Peleg AY
        • Hooper DC
        Hospital-acquired infections due to gram-negative bacteria.
        N Engl J Med. 2010; 362: 1804-1813
        • Piedrahita CT
        • Cadnum JL
        • Jencson AL
        • Shaikh AA
        • Ghannoum MA
        • Donskey CJ
        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
        • Koca O
        • Altoparlak U
        • Ayyildiz A
        • Kaynar H
        Persistence of nosocomial pathogens on various fabrics.
        Eurasian J Med. 2012; 44: p.28
        • Neely AN
        A survey of gram-negative bacteria survival on hospital fabrics and plastics.
        J Burn Care Rehabil. 2000; 21: 523-527
        • Colclasure VJ
        • Soderquist TJ
        • Lynch T
        • et al.
        Coliform bacteria, fabrics, and the environment.
        Am J Infect Control. 2015; 43: 154-158
        • Esteves DC
        • Pereira VC
        • Souza JM
        • et al.
        Influence of biological fluids in bacterial viability on different hospital surfaces and fomites.
        Am J Infect Control. 2016; 44: 311-314
        • Islam MS
        • Hossain MA
        • Khan SI
        • et al.
        Survival of Shigella dysenteriae type 1 on fomites.
        J Health Popul Nutr. 2001; : 177-182
        • Williams AP
        • Avery LM
        • Killham K
        • Jones DL
        Persistence of Escherichia coli O157 on farm surfaces under different environmental conditions.
        J Appl Microbiol. 2005; 98: 1075-1083
        • Munk S
        • Johansen C
        • Stahnke LH
        • Adler-Nissen J
        Microbial survival and odor in laundry.
        J Surfactants Deterg. 2001; 4: 385-394