review · Environmental Health Insights
Inanimate hospital surfaces and equipment, known as fomites, serve as significant reservoirs for hospital-acquired pathogens in intensive care units. An analysis of literature published between 1990 and 2023 shows that approximately 40 percent of fomite samples collected across intensive care settings produced microbial growth. Staphylococcus species were the most frequently identified contaminants, alongside other common pathogens such as Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae. Contamination was notably highest in neonatal intensive care units. Blood pressure cuffs, or sphygmomanometers, demonstrated a 100 percent detection rate for pathogens across evaluated studies, whilst mobile phones and stethoscopes were also frequently contaminated. Several multidrug-resistant strains, including methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci, were routinely isolated. These findings highlight the presence of critical bacterial reservoirs on routinely handled medical items.
Hospital-acquired infections in intensive care units contribute significantly to patient illness and death. When everyday clinical devices such as blood pressure cuffs, stethoscopes, and mobile phones harbour drug-resistant pathogens, they become pathways for disease transmission. Recognising which equipment poses the greatest hazard enables healthcare facilities to focus their infection control efforts, implement targeted hygiene protocols, and protect vulnerable patients from treatment-resistant bacterial infections.
The findings inform developers of hospital disinfection technologies, antimicrobial coatings, and dedicated sterilisation systems for frequently handled clinical tools such as sphygmomanometers and mobile communication devices. Healthcare administrators and infection control teams can use this evidence to design targeted sanitisation protocols. Because this systematic review compiles observational data without testing a specific technology, practical implementation requires engineering partners to translate these contamination insights into validated cleaning or antimicrobial surface solutions ready for clinical use.
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Background: Nosocomial pathogens are known to exacerbate morbidity and mortality in contemporary critical healthcare. Hospital fomites, which include inanimate surfaces, have been identified as “breeding grounds” for pathogens that cause nosocomial infections. This systematic review aimed to deliver incisive insights on nosocomial pathogens in intensive care units (ICUs) and the role of fomites as potential reservoirs for their transmission. Method: An extensive exploration of electronic databases, including PubMed and Scopus, from 1990 to 2023, was carried out between 25 th and 29 th May 2023, per standard PRISMA guidelines. Information were extracted from articles that reported on fomites in the ICU. Studies that did not quantitatively report the fomite contamination, and those that exclusively took samples from patients in the ICU were excluded from the analysis. Results: About 40% of the total samples collected on fomites from all the studies yielded microbial growth, with species of Staphylococcus being the most predominant. Other prevalent microbes were Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Candida spp., Enterococcus sp., and Enterobacter sp. The neonatal intensive care unit (NICU) had the highest proportion of contaminated fomites. Among known fomites, the sphygmomanometer exhibited a 100% detection rate of nosocomial pathogens. This included E. aerogenes, Staphylococcus aureus, coagulase-negative Staphylococci (CoNS), E. coli, and K. pneumoniae. Multidrug-resistant (MDR) bacteria, such as methicillin-resistant S. aureus (MRSA), vancomycin-resistant Enterococci (VRE), extended-spectrum beta-lactamase (ESBL)-producing E. coli, and MDR Pseudomonas aeruginosa were commonly isolated on fomites in the ICUs. Conclusion: Many fomites that are readily used in patient care in the ICU harbour nosocomial pathogens. The most common fomite appeared to be mobile phones, sphygmomanometers, and stethoscopes, with Staphylococcus being the most common contaminant. Consequently, the need for rigorous disinfection and sterilization protocols on fomites in the ICU cannot be overemphasized. Additionally, heightened awareness on the subject among health professionals is crucial to mitigating the risk and burden of nosocomial infections caused by drug-resistant bacteria.
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DOI: 10.1177/11786302241243239
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