Hospital hotel services as risk factors for infection among immunocompromised patients

Much is known about the association of urinary catheters, respiratory-assist devices, intravenous catheters and infusions, and other clinically related equipment with a risk of infection. The compromised host tends to develop infection with organisms that are frequently encountered in the normal flora. However, the results of surveillance cultures suggest that these organisms have indeed been acquired during hospitalization. This report suggests that many of these pathogens are acquired not as a result of clinically related activities but, rather, in conjunction with the "hotel services" of the hospital, such as the supply of food, water, and air. Tentative recommendations to hospitals for reducing the risk of infection from these services include proper design and maintenance of air-ventilating systems, regular monitoring of the water system, and preparation of foods low in microbial content for granulocytopenic patients.