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From infestation to infection: a systematic review of arthropod-mediated microbial transmission in hospitals

Stephanie Stroever1, Rishi Patel2, Barrett Meeks2

  • 1Department of Medical Education, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.

Antimicrobial Stewardship & Healthcare Epidemiology : ASHE
|January 21, 2026
PubMed
Abstract

Insights

Arthropods like cockroaches and flies in hospitals can carry dangerous bacteria and viruses. Evidence suggests they may transmit infections to patients, highlighting the need for better pest control and hygiene.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Environmental Health

Background:

  • Healthcare-associated infections (HAIs) pose a significant threat to patient safety.
  • The role of arthropods as vectors for pathogen transmission within healthcare settings is not fully understood.

Purpose of the Study:

  • To systematically review and evaluate evidence on arthropod-associated pathogen transmission in healthcare facilities.
  • To inform infection prevention strategies and policies.

Main Methods:

  • A systematic review adhering to PRISMA guidelines was conducted.
  • Searches included major databases (PubMed, MEDLINE, Embase, CENTRAL) and grey literature.
  • 73 studies investigating microbial carriage or transmission by arthropods in healthcare environments were included.

Main Results:

  • Studies from diverse global regions identified cockroaches, flies, and ants as common arthropods.
  • Arthropods harbored clinically significant bacteria (e.g., MRSA, VRE, MDR-E. cloacae), fungi, and viruses.
  • Limited but compelling evidence indicated arthropod-associated patient transmission of pathogens like K. pneumoniae and dengue virus.

Conclusions:

  • Arthropods frequently carry clinically relevant and antimicrobial-resistant microbes in healthcare settings.
  • Evidence supports a potential role for arthropods in patient-to-patient pathogen transmission.
  • Enhanced pest management and environmental hygiene are critical for infection prevention.

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