Related Experiment Video
Updated: Mar 28, 2026
Culturing and Maintaining Clostridium difficile in an Anaerobic Environment
Published on: September 14, 2013
Bacterial contamination of inanimate surfaces and equipment in the intensive care unit
Vincenzo Russotto1, Andrea Cortegiani1, Santi Maurizio Raineri1
1Department of Biopathology and Medical Biotechnologies (DIBIMED), Section of Anaesthesia, Analgesia, Intensive Care and Emergency, University Hospital Paolo Giaccone, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy.
Abstract:
Intensive care unit (ICU)-acquired infections are a challenging health problem worldwide, especially when caused by multidrug-resistant (MDR) pathogens. In ICUs, inanimate surfaces and equipment (e.g., bedrails, stethoscopes, medical charts, ultrasound machine) may be contaminated by bacteria, including MDR isolates. Cross-transmission of microorganisms from inanimate surfaces may have a significant role for ICU-acquired colonization and infections. Contamination may result from healthcare workers' hands or by direct patient shedding of bacteria which are able to survive up to several months on dry surfaces. A higher environmental contamination has been reported around infected patients than around patients who are only colonized and, in this last group, a correlation has been observed between frequency of environmental contamination and culture-positive body sites. Healthcare workers not only contaminate their hands after direct patient contact but also after touching inanimate surfaces and equipment in the patient zone (the patient and his/her immediate surroundings). Inadequate hand hygiene before and after entering a patient zone may result in cross-transmission of pathogens and patient colonization or infection. A number of equipment items and commonly used objects in ICU carry bacteria which, in most cases, show the same antibiotic susceptibility profiles of those isolated from patients. The aim of this review is to provide an updated evidence about contamination of inanimate surfaces and equipment in ICU in light of the concept of patient zone and the possible implications for bacterial pathogen cross-transmission to critically ill patients.
Insights
Intensive care unit (ICU) surfaces can harbor multidrug-resistant (MDR) pathogens, leading to healthcare-associated infections. Environmental contamination and inadequate hand hygiene facilitate pathogen cross-transmission to critically ill patients.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Environmental Microbiology
Background:
- Intensive care unit (ICU)-acquired infections pose a significant global health challenge, particularly those caused by multidrug-resistant (MDR) pathogens.
- Inanimate surfaces and medical equipment within ICUs frequently become contaminated with bacteria, including MDR strains, contributing to patient colonization and infection.
- The 'patient zone' concept highlights how healthcare workers' hands and direct patient shedding can lead to environmental contamination, facilitating pathogen cross-transmission.
Purpose of the Study:
- To review current evidence on the contamination of inanimate surfaces and equipment in ICUs.
- To explore the role of the 'patient zone' in bacterial pathogen cross-transmission.
- To discuss the implications for preventing infections in critically ill patients.
Main Methods:
- Literature review of studies investigating environmental contamination in ICUs.
- Analysis of bacterial contamination on surfaces like bedrails, stethoscopes, and medical charts.
- Examination of the relationship between environmental contamination, patient colonization, and healthcare worker hand hygiene.
Main Results:
- Inanimate surfaces and equipment in ICUs are frequently contaminated with bacteria, including MDR pathogens.
- Contamination levels are higher around infected patients compared to colonized patients.
- Bacteria isolated from surfaces often share antibiotic susceptibility profiles with patient isolates, indicating cross-transmission.
Conclusions:
- Environmental contamination in ICUs is a critical reservoir for MDR pathogens.
- Effective hand hygiene and understanding the 'patient zone' are crucial to interrupt pathogen cross-transmission.
- Minimizing environmental contamination is essential for preventing ICU-acquired infections and improving patient outcomes.
Related Concept Videos
01:30Cleaning, Sterilization, and Disinfection
Cleaning
The cleaning process usually involves using water with detergents or enzymatic cleaner and removing foreign material from objects and surfaces, including organic material such as body fluids or inorganic material like soil. Cleaning is performed before high-level disinfection and sterilization because foreign materials on the cover of the devices interfere with process...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Standard Precaution
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
01:17Transmission-based Precautions I: Contact, Enteric, and Droplets
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...