Intensifying the Focus on the Contribution of the Inanimate Environment to Health Care–Associated Infections
Authors: Tara N. Palmore, David K. Henderson
Journal: Annals of Internal Medicine (2015)

Editorials20 October 2015Intensifying the Focus on the Contribution of the Inanimate Environment to Health Care–Associated InfectionsTara N. Palmore, MD and David K. Henderson, MDTara N. Palmore, MDFrom National Institutes of Health Clinical Center, Bethesda, Maryland.Search for more papers by this author and David K. Henderson, MDFrom National Institutes of Health Clinical Center, Bethesda, Maryland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-1798 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail 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 ...References1. Lessa FC, Mu Y, Bamberg WM, Beldavs ZG, Dumyati GK, Dunn JR, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015;372:825-34. [PMID: 25714160] doi:10.1056/NEJMoa1408913 CrossrefMedlineGoogle Scholar2. Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States, 2013. Atlanta, GA: Centers for Disease Control and Prevention; 2013:5. Accessed at www.cdc.gov/drugresistance/threat-report-2013/pdf/ar-threats-2013-508.pdf on 21 July 2015. Google Scholar3. Maki DG, Alvarado CJ, Hassemer CA, Zilz MA. Relation of the inanimate hospital environment to endemic nosocomial infection. N Engl J Med. 1982;307:1562-6. [PMID: 6815529] CrossrefMedlineGoogle Scholar4. McDonald LC, Arduino M. Editorial commentary: climbing the evidentiary hierarchy for environmental infection control [Editorial]. Clin Infect Dis. 2013;56:36-9. [PMID: 23042965] doi:10.1093/cid/cis845 CrossrefMedlineGoogle Scholar5. Carling PC, Parry MM, Rupp ME, Po JL, Dick B, Von Beheren S; Healthcare Environmental Hygiene Study Group. Improving cleaning of the environment surrounding patients in 36 acute care hospitals. Infect Control Hosp Epidemiol. 2008;29:1035-41. [PMID: 18851687] doi:10.1086/591940 CrossrefMedlineGoogle Scholar6. Han JH, Sullivan N, Leas BF, Pegues DA, Kaczmarek JL, Umscheid CA. Cleaning hospital room surfaces to prevent health care–associated infections. A technical brief. Ann Intern Med. 2015;163:598-607. doi:10.7326/M15-1192 LinkGoogle Scholar7. Snitkin ES, Zelazny AM, Thomas PJ, Stock F, Henderson DK, Palmore TN, et al; NISC Comparative Sequencing Program Group. Tracking a hospital outbreak of carbapenem-resistant Klebsiella pneumoniae with whole-genome sequencing. Sci Transl Med. 2012;4:148ra116. [PMID: 22914622] doi:10.1126/scitranslmed.3004129 CrossrefMedlineGoogle Scholar8. Hota S, Hirji Z, Stockton K, Lemieux C, Dedier H, Wolfaardt G, et al. Outbreak of multidrug-resistant Pseudomonas aeruginosa colonization and infection secondary to imperfect intensive care unit room design. Infect Control Hosp Epidemiol. 2009;30:25-33. [PMID: 19046054] doi:10.1086/592700 CrossrefMedlineGoogle Scholar9. Henderson DK, Palmore TN. Critical gaps in knowledge of the epidemiology and pathophysiology of healthcare-associated infections. Infect Control Hosp Epidemiol. 2010;31 Suppl 1:S4-6. [PMID: 20929367] doi:10.1086/655984 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Tara N. Palmore, MD; David K. Henderson, MDAffiliations: From National Institutes of Health Clinical Center, Bethesda, Maryland.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-1798.Corresponding Author: David K. Henderson, MD, National Institutes of Health Clinical Center, Building 10, Room 6-1480, MSC-1504, Bethesda, MD 20892; e-mail, [email protected]gov.Current Author Addresses: Drs. Palmore and Henderson: National Institutes of Health Clinical Center, Building 10, Room 6-1480, MSC-1504, Bethesda, MD 20892.This article was published online first at www.annals.org on 11 August 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCleaning Hospital Room Surfaces to Prevent Health Care–Associated Infections Jennifer H. Han , Nancy Sullivan , Brian F. Leas , David A. Pegues , Janice L. Kaczmarek , and Craig A. Umscheid Cleaning Hospital Room Surfaces to Prevent Health Care–Associated Infections Jennifer H. Han , Nancy Sullivan , Brian F. Leas , David A. Pegues , Janice L. Kaczmarek , and Craig A. Umscheid Metrics Cited byBacteria on the Soles of Patient-Issued Nonskid Slipper SocksWastewater drains: epidemiology and interventions in 23 carbapenem-resistant organism outbreaks 20 October 2015Volume 163, Issue 8Page: 642-643KeywordsDisinfectionEnvironmental healthEpidemiologyHealth careMultidrug resistancePathogenesisPathogensPatientsPrevention, policy, and public healthSafety ePublished: 20 October 2015 Issue Published: 20 October 2015 PDF downloadLoading ...