Intensifying the Focus on the Contribution of the Inanimate Environment to Health Care–Associated Infections

Reducing transmission of multidrug-resistant organ-isms and Clostridium difficile in hospitals is a critical priority. Infections caused by these pathogens are in-creasingly common and frequently associated with ad-verse outcomes (1, 2). Historically, cleanliness and dis-infection of the hospital environment have been logical foci for health care epidemiology. As antimicrobial op-tions for treating multidrug-resistant bacterial infections decrease, the importance of accurately identifying routes of spread of health care–associated infections (HAIs) and implementing effective preventive interven-tions becomes even more critical. The relative role that the environment plays in the transmission of HAIs has been a topic of decades-long debate with persons in the health care epidemiology community, vacillating between skepticism and convic