Environmental contamination and hospital-acquired infection: factors that are easily overlooked

Indoor Air. 2015 Oct;25(5):462-74. doi: 10.1111/ina.12170. Epub 2014 Nov 20.


There is an ongoing debate about the reasons for and factors contributing to healthcare-associated infection (HAI). Different solutions have been proposed over time to control the spread of HAI, with more focus on hand hygiene than on other aspects such as preventing the aerial dissemination of bacteria. Yet, it emerges that there is a need for a more pluralistic approach to infection control; one that reflects the complexity of the systems associated with HAI and involves multidisciplinary teams including hospital doctors, infection control nurses, microbiologists, architects, and engineers with expertise in building design and facilities management. This study reviews the knowledge base on the role that environmental contamination plays in the transmission of HAI, with the aim of raising awareness regarding infection control issues that are frequently overlooked. From the discussion presented in the study, it is clear that many unknowns persist regarding aerial dissemination of bacteria, and its control via cleaning and disinfection of the clinical environment. There is a paucity of good-quality epidemiological data, making it difficult for healthcare authorities to develop evidence-based policies. Consequently, there is a strong need for carefully designed studies to determine the impact of environmental contamination on the spread of HAI.

Keywords: Aerial dissemination; Duct cleaning; Environmental contamination; Healthcare-associated infection; Hospital microbiome.

Publication types

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

MeSH terms

  • Air Microbiology*
  • Bacterial Infections / transmission
  • Cross Infection / transmission*
  • Humans
  • Infection Control
  • Mycoses / transmission
  • Ventilation / instrumentation