Relation of the Inanimate Hospital Environment to Endemic Nosocomial Infection

WHEREAS many epidemics of nosocomial infection have stemmed from reservoirs of pathogens in the inanimate hospital environment,1 , 2 the contribution of the environment, particularly air, surfaces, and fomites, to the acquisition and spread of endemic nosocomial infection is unclear, and the value of routine microbiologic surveillance of the inanimate hospital environment has been controversial.3 4 5 6 7 8 In 1974 the Committee on Infections within Hospitals of the American Hospital Association concluded: The occurrence of nosocomial infection has not been related to levels of microbial contamination of air, surfaces, and fomites . . . meaningful standards for permissible levels of such contamination do not exist . . .