Healthcare-associated infections: tackling environmental spread

Surface transmission has been identified as an important route of pathogen spread, especially within the healthcare environment. Here, Jade Pallett discusses viral and bacterial transmission and looks at the key issues and evidence.

Environmental transmission of pathogens has been a long-recognised mechanism for the spread of infectious diseases.1,2 While this transmission can occur on any surface, the high traffic nature of healthcare facilities can increase risks of surface transmission.3 The healthcare environment is known to include a wide range of microorganisms, some of which are considered significant pathogens to humans.2 Generally, microorganisms tend to prefer to grow and replicate in organic, moist environments. However, they can persist under dry conditions. Despite being able to culture and detect microorganisms on surfaces and in the air, assessing their contribution in causing infection/disease can be difficult.

            The potential for contaminated surfaces to contribute to the transmission of pathogens within the healthcare environment depends on a number of factors.4 These factors include the ability for survival on a variety of dry surfaces, the frequency of surface contamination on areas commonly touched by patients and healthcare workers, and whether or not the resulting concentration of pathogens is sufficiently high to cause transmission to humans.

            Some pathogens, such as Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) are able to remain viable on a range of surfaces for days or weeks, sometimes even months.5,6 Despite multiple factors being required to create the conditions necessary in order for pathogens to be transmitted via environmental surfaces, environmental transmission is still a proven route of infection within the healthcare environment.

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