{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:13:22Z","timestamp":1791346402904,"version":"4.3.1"},"reference-count":24,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T00:00:00Z","timestamp":1626998400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X21003093_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To investigate the frequency of environmental contamination in hospital areas outside patient rooms and in outpatient healthcare facilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X21003093_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Culture survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X21003093_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>This study was conducted across 4 hospitals, 4 outpatient clinics, and 1 surgery center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X21003093_as4\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We conducted 3 point-prevalence culture surveys for methicillin-resistant\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      , vancomycin-resistant enterococci,\n                      <jats:italic>Clostridioides difficile<\/jats:italic>\n                      ,\n                      <jats:italic>Candida<\/jats:italic>\n                      spp, and gram-negative bacilli including Enterobacteriaceae,\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      ,\n                      <jats:italic>Acinetobacter baumanii<\/jats:italic>\n                      , and\n                      <jats:italic>Stenotrophomonas maltophilia<\/jats:italic>\n                      in each facility. In hospitals, high-touch surfaces were sampled from radiology, physical therapy, and mobile equipment and in emergency departments, waiting rooms, clinics, and endoscopy facilities. In outpatient facilities, surfaces were sampled in exam rooms including patient and provider areas, patient bathrooms, and waiting rooms and from portable equipment. Fluorescent markers were placed on high-touch surfaces and removal was assessed 1 day later.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X21003093_as5\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In the hospitals, 110 (9.4%) of 1,195 sites were positive for 1 or more bacterial pathogens (range, 5.3%\u201313.7% for the 4 hospitals) and 70 (5.9%) were positive for\n                      <jats:italic>Candida<\/jats:italic>\n                      spp (range, 3.7%\u20135.9%). In outpatient facilities, 31 of 485 (6.4%) sites were positive for 1 or more bacterial pathogens (range, 2% to 14.4% for the 5 outpatient facilities) and 50 (10.3%) were positive for\n                      <jats:italic>Candida<\/jats:italic>\n                      spp (range, 3.9%\u201323.3%). Fluorescent markers had been removed from 33% of sites in hospitals (range, 28.4%\u201339.7%) and 46.3% of sites in outpatient clinics (range, 7.4%\u201382.8%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X21003093_as6\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Surfaces in hospitals outside patient rooms and in outpatient facilities are frequently contaminated with healthcare-associated pathogens. Improvements in cleaning and disinfection practices are needed to reduce contamination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2021.309","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T04:31:11Z","timestamp":1627014671000},"page":"1017-1021","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":28,"title":["Microbial bioburden of inpatient and outpatient areas beyond patient hospital rooms"],"prefix":"10.1017","volume":"43","author":[{"given":"Jennifer L.","family":"Cadnum","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basya S.","family":"Pearlmutter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette L.","family":"Jencson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanan","family":"Haydar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle T.","family":"Hecker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy J.","family":"Ray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myreen E.","family":"Tomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elie A.","family":"Saade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curtis J.","family":"Donskey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,7,23]]},"reference":[{"key":"S0899823X21003093_ref15","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2020.1367"},{"key":"S0899823X21003093_ref13","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00793-14"},{"key":"S0899823X21003093_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(93)90207-6"},{"key":"S0899823X21003093_ref3","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2018.342"},{"key":"S0899823X21003093_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2020.06.004"},{"key":"S0899823X21003093_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2021.03.002"},{"key":"S0899823X21003093_ref14","doi-asserted-by":"publisher","DOI":"10.20411\/pai.v4i2.327"},{"key":"S0899823X21003093_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2012.12.010"},{"key":"S0899823X21003093_ref2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1602"},{"key":"S0899823X21003093_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2016.11.005"},{"key":"S0899823X21003093_ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-017-0585-6"},{"key":"S0899823X21003093_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2015.06.015"},{"key":"S0899823X21003093_ref6","doi-asserted-by":"publisher","DOI":"10.2307\/30141404"},{"key":"S0899823X21003093_ref9","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix629"},{"key":"S0899823X21003093_ref16","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2021.97"},{"key":"S0899823X21003093_ref23","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.181"},{"key":"S0899823X21003093_ref17","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16284"},{"key":"S0899823X21003093_ref19","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/22.Supplement_2.S89"},{"key":"S0899823X21003093_ref12","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing, 26th edition","year":"2016"},{"key":"S0899823X21003093_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2019.03.017"},{"key":"S0899823X21003093_ref21","doi-asserted-by":"publisher","DOI":"10.20411\/pai.v4i2.291"},{"key":"S0899823X21003093_ref11","doi-asserted-by":"publisher","DOI":"10.20411\/pai.v4i2.291"},{"key":"S0899823X21003093_ref7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0070175"},{"key":"S0899823X21003093_ref18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1714373"}],"container-title":["Infection Control &amp; 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