title: The role of the healthcare environment in the spread of multidrug-resistant organisms: update on current best practices for containment.
abstract: The role of the environment in harboring and transmitting multidrug-resistant organisms has become clearer due to a series of publications linking environmental contamination with increased risk of hospital-associated infections. The incidence of antimicrobial resistance is also increasing, leading to higher morbidity and mortality associated with hospital-associated infections. The purpose of this review is to evaluate the evidence supporting the existing methods of environmental control of organisms: environmental disinfection, contact precautions, and hand hygiene. These methods have been routinely employed, but transmission of multidrug-resistant organisms continues to occur in healthcare facilities throughout the country and worldwide. Several new technologies have entered the healthcare market that have the potential to close this gap and enhance the containment of multidrug-resistant organisms: improved chemical disinfection, environmental monitoring, molecular epidemiology, self-cleaning surfaces, and automated disinfection systems. A review of the existing literature regarding these interventions is provided. Overall, the role of the environment is still underestimated and new techniques may be required to mitigate the role that environmental transmission plays in acquisition of multidrug-resistant organisms.
authors.affiliation: Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Roy F
authors.initials: RF
authors.lastname: Chemaly
authors.affiliation: Xenex Healthcare Services, San Antonio, TX, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Simmons
authors.affiliation: Xenex Healthcare Services, San Antonio, TX, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Dale
authors.affiliation: Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Shashank S
authors.initials: SS
authors.lastname: Ghantoji
authors.affiliation: Xenex Healthcare Services, San Antonio, TX, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Rodriguez
authors.affiliation: Xenex Healthcare Services, San Antonio, TX, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Gubb
authors.affiliation: Xenex Healthcare Services, San Antonio, TX, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Stachowiak
authors.affiliation: Xenex Healthcare Services, San Antonio, TX, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Stibich
keywords: Best Practices; Disinfection; Environmental Cleaning; MDROs; No-Touch Disinfection