The role of the intestinal tract as a reservoir and source for transmission of nosocomial pathogens

Clin Infect Dis. 2004 Jul 15;39(2):219-26. doi: 10.1086/422002. Epub 2004 Jun 25.


The intestinal tract provides an important reservoir for many nosocomial pathogens, including Enterococcus species, Enterobacteriaciae, Clostridium difficile, and Candida species. These organisms share several common risk factors and often coexist in the intestinal tract. Disruption of normal barriers, such as gastric acidity and the indigenous microflora of the colon, facilitates overgrowth of pathogens. Factors such as fecal incontinence and diarrhea contribute to the subsequent dissemination of pathogens into the health care environment. Selective pressure exerted by antibiotics plays a particularly important role in pathogen colonization, and adverse effects associated with these agents often persist beyond the period of treatment. Infection-control measures that are implemented to control individual pathogens may have a positive or negative impact on efforts to control other pathogens that colonize the intestinal tract.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Animals
  • Antibiosis
  • Colon / microbiology
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Cross Infection / transmission*
  • Disease Reservoirs
  • Humans
  • Infection Control / methods
  • Intestines / microbiology*
  • Precipitating Factors