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How long do pathogens persist on surfaces?

Systematic review
Results
Comment

So what's the answer? Given the major interest in hospital acquired infections, one might expect large amounts of useful information presented in a straightforward way, in order that we can organise services to minimise risk to professionals and patients. A systematic review [1] implies that our knowledge is limited.

Systematic review


The review set out to find articles in PubMed relating to survival of pathogens on surfaces using a broad strategy, and following up on any useful citations in studies that had been found, supplemented by checking textbooks on infection control and microbiology. Any report was included, and the range of duration abstracted.

Results


Many reports were found, and there are 126 references, a useful source for others wanting more detailed information. For most pathogens there were only a few citations. The larger the number of citations, the wider the range of persistence.

For bacteria, for example, the range for E coli (11 references) was 1.5 hours to 16 months, and for S aureus, including MRSA (six references), between seven days and seven months. For clinically relevant fungi, the range was up to four months, and for viruses days to months.

Comment


Not the answer to everything, but possibly the only answers that are available. It seemed to be the case that, as one might expect, low temperatures and higher humidity increased persistence. It seems that, whatever the actual answer, persistence of nosocomial pathogens on surfaces is sufficiently long to become a continuous source of transmission in the absence of effective preventive surface disinfection. Keep cleaning effectively is the message that is being heavily reinforced here.

Of course, it is all more complex than this when it comes to hospital acquired infections and the damage they do to individuals and hospitals. The arguments appear to have been simplified to handwashing, and while that is important, along with cleaning surfaces, an effective response will come from a number of different actions combining to reduce the problem. Reading this paper is a start because it helps show one element of this huge problem.

Reference:

  1. A Kramer et al. How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infectious Diseases 2006 6:130 (www.biomedcentral.com/1471-2334/6/130).

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