Turning Our Attention to the Floor
Written by: Sarah Wornow ‘23
Edited by: Geat Ramush ‘23
According to the CDC, there are over 1.7 million hospital-acquired infections (HAIs) in American hospitals annually . HAIs are infections that arise while receiving any form of health care, such as going to the hospital for surgery or visiting your primary care doctor’s office for a checkup. These infections are extremely problematic, as most of the bacteria, fungi, and viruses that cause these infections are multidrug-resistant and very difficult to cure the body of. Unfortunately, this antimicrobial resistance results in HAIs being one of the leading causes of death in the US . Transmission of these infections can either occur through contact with an infected healthcare worker or through touching a contaminated surface, which is why disinfecting high-touch surfaces and washing hands in a hospital (and in general) is essential. However, even with proper cleaning, hospitals still have very high rates of HAIs. There must be another explanation as to why HAIs are so common.
Part of the answer comes from an unexpected place: the floor. We don’t normally touch the floor with our hands, and therefore it is not thought of as a place that can catalyze the transmission of HAIs. However, objects that fall on the ground or that are picked up from the ground will carry whatever bacteria colonize that area of the floor. That bacteria can be harmless, or, in the worst case, it can be one of the microorganisms that causes an HAI. Examples of objects that frequently come into contact with the floor and then picked up include call buttons, blood pressure cuffs, bedding, and bags . These objects can all transmit pathogens to an unsuspecting patient and lead to infection.
The bacteria Clostridium difficile and Staphylococcus aureus (MRSA) are two of the most common sources of HAIs. Alarmingly, Redmond et al. recently discovered that these two pathogens rapidly spread to the floors of disinfected patient rooms following interactions between medical staff, portable medical devices, and patients. This small observational study focused on rooms that had been disinfected following standard hospital procedure and then occupied by a patient. By the end of the study, both C. difficile and MRSA were found not only on the floors of the patients’ rooms but also on the bedding and socks of the patients. Subsequently, these bacteria were then found on objects which the patients frequently touched around the rooms . These results are startling because both patients and doctors can be blind-sided by the fact that these deadly pathogens rapidly circulate throughout a hospital despite proper surface disinfection and hand washing.
Improving floor disinfection methods can potentially decrease the rate of transmission of HAIs by slowing the spread of HAI-inducing bacteria on the floor. In addition, if patients are more aware of the risks of placing high-touch objects on the floor of their hospital room, they will actively try to avoid doing so, in turn reducing their risk of potentially exposing themself to harmful bacteria. Raising awareness of this issue will be key to reducing the number of unnecessary and preventable infections in hospitals and hopefully result in HAIs becoming a worry of the past.
 Haque M, Sartelli M, McKimm J, Abu Bakar M. Health care-associated infections -- an overview. Infection and Drug Resistance. 2018; 11, 2321-2333. [Cited 2020 Nov 23]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6245375/
 Paddock C. Contaminated hospital floors may help to spread infection. MedicalNewsToday [Internet] [Cited 2020 Nov 25]. Available from: https://www.medicalnewstoday.com/articles/316139#High-touch-objects-often-in-contact-with-contaminated-floors
 Redmond S, Cadnum J, Pearlmutter B, Herrera N, Donskey C. Timing and Route of Contamination of Patient Rooms with Healthcare-Associated Pathogens. Infection Control & Hospital Epidemiology. 2020; 41. [Cited 2020 Nov 25]. Available from: https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/timing-and-route-of-contamination-of-patient-rooms-with-healthcareassociated-pathogens/EB175F2A79659F07D0FD2AA56D0D6C79
 Image Citation: https://invisiverse.wonderhowto.com/news/hospital-floors-may-look-clean-but-theyre-teeming-with-deadly-superbugs-including-mrsa-vre-c-diff-0176402/
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