Hospital Floors May Be Underappreciated Source Of Hospital Infections Interview with:

Curtis J. Donskey, MD Geriatric Research, Education, and Clinical Center Cleveland Veterans Affairs Medical Center Cleveland, OH 44106

Dr. Curtis J. Donskey

Curtis J. Donskey, MD
Geriatric Research, Education, and Clinical Center
Cleveland Veterans Affairs Medical Center
Cleveland, OH 44106 What is the background for this study? 

Response: Many hospitals are making efforts to improve cleaning to reduce the risk for transmission of infection from contaminated environmental surfaces. Most of these efforts focus on surfaces like bed rails that are frequently touched by staff and patients. Despite the fact that floors have consistently been the most heavily contaminated surfaces in hospitals, they have not been a focus of cleaning interventions because they are rarely touched. However, it is plausible that bacteria on floors could picked up by shoes and socks and then transferred onto hands. In a recent study, we found that when a nonpathogenic virus was inoculated onto floors in hospital rooms, it did spread to the hands of patients and to surfaces inside and outside the room. Based on those results, we assessed the frequency of floor contamination in 5 hospitals and examined the potential for transfer of bacteria from the floor to hands.  What are the main findings?

Response:In 5 hospitals, we found that floors in patient rooms were frequently contaminated with important pathogens, including Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). C. difficile spores were found most often and were present on the floor in about half of all rooms, including in rooms of patients who did not have C. difficile infection. We also observed that 41% of hospital rooms had objects on the floor that are frequently touched. These objects included medical devices, personal items, and bed linens. Touching these objects frequently resulted in transfer of pathogens to hands. What should readers take away from your report?

Response: Our results suggest that floors in hospital rooms could be an underappreciated source for spread of pathogens. Healthcare personnel and patients should be aware that they should avoid placing high-touch objects on the floor and that they should clean their hands if they pick up an object from the floor. What recommendations do you have for future research as a result of this study?

Response: Studies are needed to examine how effective current floor cleaning methods are for removal of pathogenic bacteria from floors. The finding that C. difficile spores were frequently recovered from floors is a particular concern since sporicidal disinfectants are not typically used on floors. Studies are needed to identify effective ways to reduce levels of C. difficile on floors. A lot of hospitals now use UV light to disinfect rooms, so it would be good to study how effective these devices are in reducing C. difficile spores on the floor. Finally, studies are needed to determine the potential for shoes, wheelchairs, and other wheeled equipment to pick up and spread pathogens on floors.

Curtis Donskey has received research funding from Clorox, EcoLab, Altapure, and GOJO. Thank you for your contribution to the community.


Are hospital floors an underappreciated reservoir for transmission of health care-associated pathogens?
Deshpande, Abhishek et al.
American Journal of Infection Control , Volume 45 , Issue 3 , 336 – 338

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on March 2, 2017 by Marie Benz MD FAAD