In identifying the source of outbreaks and developing hygiene strategies, does our current focus on hand hygiene prevent us from taking an objective view. This review by the Rudolf Schulke Foundation, Hamburg takes a wide ranging look at the multitude of lesser-known and underestimated reservoirs of microorganisms which are known to act as sources of infection.
These range from water reservoirs such as sink drains, fixtures, decorative water fountains and waste-water treatment plants, frequently touched textile surfaces such as private curtains in hospitals and laundry. It also includes parenteral drug products, and disinfectant wipe dispensers. We tend to overlook the fact that, in some instances, the causative organisms are not identified because they are concealed in biofilms or in a state referred to as viable but nonculturable, which eludes conventional culture media-based detection methods. The authors conclude that new and emerging pathogens, novel pathogen detection methods, and hidden reservoirs of infection should hence be given special consideration when designing the layout of buildings and medical devices, but also when defining the core competencies for medical staff, establishing programmes for patient empowerment and education of the general public, and when implementing protocols for the prevention and control of infections in medical, community and domestic settings.
The paper is published in GMS Hygiene and Infection Control 2015 and can be downloaded from: http://www.egms.de/en/journals/dgkh/2015-10/dgkh000247.shtml