Tara N. Palmore, MD; David K. Henderson, MD
This article was published online first at www.annals.org on 11 August 2015.
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-1798.
Requests for Single Reprints: David K. Henderson, MD, National Institutes of Health Clinical Center, Building 10, Room 6-1480, MSC-1504, Bethesda, MD 20892; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Palmore and Henderson: National Institutes of Health Clinical Center, Building 10, Room 6-1480, MSC-1504, Bethesda, MD 20892.
Palmore T., Henderson D.; Intensifying the Focus on the Contribution of the Inanimate Environment to Health Care–Associated Infections. Ann Intern Med. 2015;163:642-643. doi: 10.7326/M15-1798
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Published: Ann Intern Med. 2015;163(8):642-643.
Published at www.annals.org on 11 August 2015
Reducing transmission of multidrug-resistant organisms and Clostridium difficile in hospitals is a critical priority. Infections caused by these pathogens are increasingly common and are frequently associated with adverse outcomes (1, 2). Historically, cleanliness and disinfection of the hospital environment have been logical foci for health care epidemiology. As antimicrobial options for treating multidrug-resistant bacterial infections decrease, the importance of accurately identifying routes of spread of health care–associated infections (HAIs) and implementing effective preventive interventions becomes even more critical.
The relative role that the environment plays in the transmission of HAIs has been a topic of decades-long debate, with persons in the health care epidemiology community vacillating between skepticism and conviction. Unlike near-universal acceptance of the importance of hand hygiene, the prevailing view of the contribution of the inanimate health care environment to the spread of HAIs has swung back and forth like a pendulum. Both cultural shifts and new studies have elicited opposing opinions about the role of the environment in HAI transmission and the corollary role of disinfection in reducing these infections (3). Convincing health care personnel to clean their hands at every opportunity is challenging, but maintaining a hospital environment that is free from contamination is perhaps even more difficult.
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Hospital Medicine, Infectious Disease.
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