hospitals, health care, pandemic

Shoes, Stretchers and Floors May Transmit Pathogens in Hospital Settings Interview with: 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
Professor of Medicine
Case Western Reserve University
Staff Physician, Infectious Diseases Section,
Louis Stokes Cleveland VA Medical Center What is the background for this study?

Response: The goal of the study was to obtain a better understanding of how healthcare-associated pathogens are transmitted.  Infection control efforts tend to emphasize hand hygiene and cleaning of high-touch surfaces in patient rooms.  However, there is evidence that portable equipment and floors could be underappreciated sources of transmission.

We previously found that a nonpathogenic virus inoculated onto floors in patient rooms spread rapidly to the hands of patients and to surfaces in the room and throughout the ward.  This raised concern that pathogens could spread by the same route. What are the main findings? 

Response: In the current study, we did not find evidence that interactions with personnel or equipment resulted in contamination of patients or high-touch surfaces in rooms of hospitalized patients.  All cultures collected immediately after these types of observed interactions were negative.  Rather, healthcare-associated pathogens were initially recovered from the floor in rooms of newly admitted patients followed by detection on sock bottoms, bedding, and high-touch surfaces. What should readers take away from your report?

hospital-stretcher-floorsResponse: Our findings suggest that pathogens often enter patient rooms on shoes of personnel or on wheeled equipment and may be transferred from the floor to high-touch surfaces.  One way to address this route of transmission would be to clean and disinfect floors better.  In our study, cleaning and disinfection of floors with a relatively mild disinfectant followed by operation of a UV-C room decontamination device resulted in consistent negative cultures of floors before patients were admitted.  One could consider more aggressive approaches such as having personnel decontaminate their shoes or wear shoe covers before entering rooms.  However, more research would be needed to determine if those types of measures are beneficial. What recommendations do you have for future research as a result of this work?

Response: Future studies are needed to test whether interventions such as improved cleaning and disinfection of floors result in reduced acquisition of colonization and infection with pathogens.  We only studied 3 common bacterial pathogens.  Future studies are needed to assess the potential for contaminated floors to contribute to transmission of other pathogens, including Candida species and viruses.

Any disclosures?

I have received research funding unrelated to this project from Clorox, PDI, and Pfizer.


Abstract in Proceedings from Decennial 2020: The Sixth International Conference on Healthcare-Associated Infections.
Published as a supplement issue in the journal Infection Control & Hospital Epidemiology. 


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Last Updated on October 31, 2020 by Marie Benz MD FAAD