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Bloomfield S, Exner M, Flemming HC, Goroncy-Bermes P, Hartemann P, Heeg P, Ilschner C, Krämer I, Merkens W, Oltmanns P, Rotter M, Rutala WA, Sonntag HG, Trautmann M. Lesser-known or hidden reservoirs of infection and implications for adequate prevention strategies: Where to look and what to look for. GMS HYGIENE AND INFECTION CONTROL 2015; 10:Doc04. [PMID: 25699227 PMCID: PMC4332272 DOI: 10.3205/dgkh000247] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In developing hygiene strategies, in recent years, the major focus has been on the hands as the key route of infection transmission. However, there is a multitude of lesser-known and underestimated reservoirs for microorganisms which are the triggering sources and vehicles for outbreaks or sporadic cases of infection. Among those are water reservoirs such as sink drains, fixtures, decorative water fountains and waste-water treatment plants, frequently touched textile surfaces such as private curtains in hospitals and laundry, but also transvaginal ultrasound probes, parenteral drug products, and disinfectant wipe dispensers. The review of outbreak reports also reveals Gram-negative and multiple-drug resistant microorganisms to have become an increasingly frequent and severe threat in medical settings. In some instances, the causative organisms are particularly difficult to identify because they are concealed in biofilms or in a state referred to as viable but nonculturable, which eludes conventional culture media-based detection methods. There is an enormous preventative potential in these insights, which has not been fully tapped. New and emerging pathogens, novel pathogen detection methods, and hidden reservoirs of infection should hence be given special consideration when designing the layout of buildings and medical devices, but also when defining the core competencies for medical staff, establishing programmes for patient empowerment and education of the general public, and when implementing protocols for the prevention and control of infections in medical, community and domestic settings.
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Affiliation(s)
- Sally Bloomfield
- London School of Hygiene and Tropical Medicine, International Scientific Forum on Home Hygiene, London, UK
| | - Martin Exner
- Institute of Hygiene and Public Health, Bonn University, Bonn, Germany
| | | | | | - Philippe Hartemann
- Departement Environment et Santé Publique S.E.R.E.S., Faculté de Médicine, Nancy, France
| | - Peter Heeg
- Institute of Medical Microbiology and Hygiene, Tübingen, Germany
| | - Carola Ilschner
- Institute of Hygiene and Public Health, Bonn University, Bonn, Germany
| | - Irene Krämer
- Pharmacy Department of Mainz University, Mainz, Germany
| | | | | | | | | | | | - Matthias Trautmann
- Department of Hospital Hygiene at Stuttgart Hospital, Stuttgart, Germany
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