{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T03:24:35Z","timestamp":1792207475318,"version":"4.4.0"},"reference-count":95,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"unspecified","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2732494X25102660_as1\">\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate the evidence for arthropod-associated transmission of pathogens in healthcare facilities and synthesize available literature to support infection prevention practice and policy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X25102660_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a systematic review following PRISMA guidelines. PubMed, Ovid MEDLINE, Embase, and CENTRAL were searched using terms related to insects\/arthropods, microbial transmission, and healthcare-associated infection, supplemented by grey literature and citation tracking. No date, language, or study-type restrictions were applied. After deduplication and screening in Covidence, 73 studies met inclusion criteria. Eligible studies described microbial isolation or transmission involving arthropods within healthcare environments. Data were extracted by multiple reviewers using a standardized manual and verified by a senior author. Analyses were descriptive and focused on identifying evidence of patient transmission and microbial carriage among arthropods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X25102660_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Included studies spanned all world regions, most commonly from Asia and South America. Cockroaches, flies, and ants were the primary arthropods examined, with samples collected from both clinical and non-clinical hospital areas. Six studies investigated direct patient transmission, and three provided genetic or circumstantial evidence linking arthropods to patient infections, including\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      , multidrug-resistant\n                      <jats:italic>Enterobacter cloacae<\/jats:italic>\n                      , and dengue virus. The majority of studies identified arthropods carrying clinically significant bacteria (eg,\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      ,\n                      <jats:italic>Enterococcus faecalis<\/jats:italic>\n                      ,\n                      <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                      ,\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      ), fungi (\n                      <jats:italic>Aspergillus, Candida<\/jats:italic>\n                      ), and viruses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X25102660_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Arthropods in healthcare environments commonly harbor clinically relevant and antimicrobial-resistant microbes, and limited but compelling evidence supports their potential role in patient transmission. Strengthened pest management and environmental hygiene are essential components of infection prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ash.2025.10266","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T05:20:43Z","timestamp":1768195243000},"source":"Crossref","is-referenced-by-count":1,"title":["From infestation to infection: a systematic review of arthropod-mediated microbial transmission in hospitals"],"prefix":"10.1017","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9683-3928","authenticated-orcid":false,"given":"Stephanie","family":"Stroever","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/033ztpr93","id-type":"ROR","asserted-by":"publisher"}],"name":"Texas Tech University Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Patel","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barrett","family":"Meeks","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Schouten","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Stuart","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Hanrahan","sequence":"additional","affiliation":[{"name":"Marshall University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendra","family":"Rumbaugh","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3093-0412","authenticated-orcid":false,"given":"Stephen P.","family":"Diggle","sequence":"additional","affiliation":[{"name":"Georgia Institute of Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"S2732494X25102660_ref50","first-page":"351","article-title":"Potential nosocomial infections by the Zika and Chikungunya viruses in public health facilities in the Metropolitan Area of Recife, Brazil","volume":"7","author":"Krokovsky","year":"2022","journal-title":"J Infect Dis"},{"key":"S2732494X25102660_ref56","doi-asserted-by":"publisher","DOI":"10.1179\/136485906X78463"},{"key":"S2732494X25102660_ref69","first-page":"63","article-title":"Bacterial contamination of collected cockroaches and determination their antibiotic susceptibility in Khorramabad City, Iran","volume":"17","author":"Davari","year":"2023","journal-title":"J Arthropod-Borne Dis"},{"key":"S2732494X25102660_ref77","first-page":"1","article-title":"Ants as vectors of pathogenic microorganisms in a hospital in S\u00e3o Paulo county, Brazil","volume":"7","author":"Felizatti","year":"2014","journal-title":"BMC Res Notes"},{"key":"S2732494X25102660_ref91","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2021.01.029"},{"key":"S2732494X25102660_ref6","unstructured":"6. Centers for Medicare & Medicaid Services, Department of Health and Human Services. 42 CFR 482.42. In: Code of Federal Regulations. 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