{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T22:00:17Z","timestamp":1789077617757,"version":"build-2803163510"},"reference-count":67,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Environ\ufffdHealth\ufffdInsights"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The public health risk of microbial contamination of fomites is evident from the numerous fomite-associated outbreaks that have occurred in several countries. Despite the high-touch nature of door handles across various settings, no comprehensive synthesis of contamination rates and microbial profiles has been performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>The aim of this work was to assess the prevalence and types of microbial contamination on door handles in public and healthcare settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Web of Science, and Scopus for studies published up to July 2024. A systematic review and meta-analysis were conducted according to the PRISMA guidelines. Pooled prevalence estimates were calculated via a random-effects model, and subgroup analyses were performed to assess differences on the basis of pathogen type, handle location, and setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 27 studies met the eligibility criteria. The overall estimation of microbial contamination of door handles revealed a prevalence of 9.96% (95% CI:\u20095.87\u201214.11). Compared with viral contamination which was observed to be 17.73% (95% CI:\u20099.24\u201227.81), bacterial contamination was less common at 6.20% (95%\u2009CI: 2.90\u201210.42). The most predominant bacterial agent was\n                      <jats:italic toggle=\"yes\">Bacillus<\/jats:italic>\n                      spp. (55.74%), followed by\n                      <jats:italic toggle=\"yes\">Acinetobacter baumannii<\/jats:italic>\n                      (25.00%); the most prevalent virus was rotavirus (62.50%). The rate of contamination was higher for toilet door handles (23.04%) than for other public and healthcare handles (7.75%). Hospitals presented slightly higher contamination rates (10.82%) than did public settings (8.97%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This systematic review highlights the widespread microbial contamination of door handles, particularly in public and healthcare environments. While bacterial contamination is predominant, the finding of viruses such as rotavirus, norovirus and even SARS-CoV-2 highlights the stringency of cleaning that has to be applied. These findings emphasise the need for targeted hygiene interventions to reduce the risk of pathogen transmission via door handles, particularly in high-traffic areas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11786302251328550","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T01:21:14Z","timestamp":1745803274000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Microbial Contamination of Door Handles: A Global Systematic Review and Meta-Analysis of Public and Healthcare Settings"],"prefix":"10.1177","volume":"19","author":[{"given":"Peter Ofori","family":"Appiah","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5761-1564","authenticated-orcid":false,"given":"Alex","family":"Odoom","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patience B.","family":"Tetteh-Quarcoo","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0286-3638","authenticated-orcid":false,"given":"Fleischer C. N.","family":"Kotey","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5179-546X","authenticated-orcid":false,"given":"Eric S.","family":"Donkor","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,27]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1908.130465"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12560-010-9026-5"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0025727300042241"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/09603120500115298"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jea.7500165"},{"issue":"5","key":"e_1_3_3_7_2","article-title":"Carriage of multidrug resistant bacteria on frequently contacted surfaces and hands of health care workers","volume":"10","author":"Visalachy S","year":"2016","unstructured":"Visalachy S, Palraj KK, Kopula SS, Sekar U. Carriage of multidrug resistant bacteria on frequently contacted surfaces and hands of health care workers. J Clin Diagn Res. 2016;10(5):DC18-DC20.","journal-title":"J Clin Diagn Res"},{"key":"e_1_3_3_8_2","first-page":"76","article-title":"Bacterial contamination of selected public toilet door handles within Adekunle Ajasin University Campus, Akungba-Akoko, Ondo State, Nigeria","volume":"43","author":"Abiose OF.","year":"2019","unstructured":"Abiose OF. Bacterial contamination of selected public toilet door handles within Adekunle Ajasin University Campus, Akungba-Akoko, Ondo State, Nigeria. Int J Sci Basic Appl Res. 2019;43:76-86.","journal-title":"Int J Sci Basic Appl Res"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apjtb.2017.01.019"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2005.04.246"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-010-0064-6"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-08057-4_2"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.7326\/M15-1192"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.01310-13"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2021.09.001"},{"key":"e_1_3_3_16_2","first-page":"139","article-title":"Prevalence of antibiotic resident bacteria in intensive care units at Hodeida City, Yemen","volume":"12","author":"Alkubati SA","year":"2022","unstructured":"Alkubati SA, Saghir SAM, Alhariri A, et al. Prevalence of antibiotic resident bacteria in intensive care units at Hodeida City, Yemen. J Appl Pharm Sci. 2022;12:139-145.","journal-title":"J Appl Pharm Sci"},{"issue":"2","key":"e_1_3_3_17_2","first-page":"81","article-title":"Prevalence, antibiotic susceptibility and plasmid profile of bacteria isolated from door handles of washrooms of a hospital in Bhopal, Madhya Pradesh","volume":"9","author":"Shrivastava S","year":"2023","unstructured":"Shrivastava S, Khare N. Prevalence, antibiotic susceptibility and plasmid profile of bacteria isolated from door handles of washrooms of a hospital in Bhopal, Madhya Pradesh. Int J Med Microbiol Trop Dis. 2023;9(2):81-84.","journal-title":"Int J Med Microbiol Trop Dis"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2021.111809"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/jam.15526"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18063252"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-6-130"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00135"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/mutage\/ger039"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23513"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2020.282"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1086\/422652"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0008570"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2023.10.023"},{"key":"e_1_3_3_30_2","article-title":"Swab sampling method for the detection of human norovirus on surfaces","volume":"120","author":"Park GW","year":"2017","unstructured":"Park GW, Chhabra P, Vinj\u00e9 J. Swab sampling method for the detection of human norovirus on surfaces. J Vis Exp. 2017;120:e55205.","journal-title":"J Vis Exp"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1086\/501648"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.07.027"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09296-y"},{"issue":"2","key":"e_1_3_3_34_2","first-page":"133","article-title":"Prevalence of human parainfluenza viruses and noroviruses genomes on office fomites","volume":"10","author":"Stobnicka A","year":"2018","unstructured":"Stobnicka A, Go\u0142ofit-Szymczak M, W\u00f3jcik-Fatla A, et al. Prevalence of human parainfluenza viruses and noroviruses genomes on office fomites. Food Environ Virol. 2018;10(2):133-140.","journal-title":"F"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.22207\/JPAM.12.4.58"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.7883\/yoken.JJID.2007.367"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1053\/jhin.2002.1221"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2608.200346"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1177\/1178630220938414"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2020.140540"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2018.156"},{"key":"e_1_3_3_42_2","first-page":"105","article-title":"Inanimate surface and their cross-contamination potential in hospital environments: a systematic review","volume":"16","author":"de Oliveira LG","year":"2021","unstructured":"de Oliveira LG. Inanimate surface and their cross-contamination potential in hospital environments: a systematic review. Rev Cient FAMINAS. 2021;16:105-127.","journal-title":"Rev Cient FAMINAS"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1306801"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.02051-06"},{"key":"e_1_3_3_45_2","first-page":"15","article-title":"The role of door handles in the spread of microorganisms of public health consequences in University of Benin Teaching hospital (UBTH), Benin city, Edo state","volume":"2","author":"Odigie AB","year":"2017","unstructured":"Odigie AB, Ekhiase FO, Orjiakor PI, et al. The role of door handles in the spread of microorganisms of public health consequences in University of Benin Teaching hospital (UBTH), Benin city, Edo state. J Pharm Sci Technol. 2017;2:15-21.","journal-title":"J Pharm Sci Technol"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2021.106836"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.4314\/ajcem.v20i1.5"},{"issue":"6","key":"e_1_3_3_48_2","article-title":"Ten scientific reasons in support of airborne transmission of SARS-CoV-2","volume":"397","author":"Greenhalgh T","year":"2021","unstructured":"Greenhalgh T, Jimenez JL, Prather KA. Ten scientific reasons in support of airborne transmission of SARS-CoV-2. Lancet. 2021;397(6):e380-e381.","journal-title":"Lancet"},{"key":"e_1_3_3_49_2","unstructured":"World Health Organization. Transmission of SARS-CoV-2: implications for infection prevention precautions: scientific brief 09 July 2020. World Health Organization. 2020. Accessed October 7 2024. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/333114\/WHO-2019-nCoV-Sci_Brief-Transmission_modes-2020.3-rus.pdf"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17093132"},{"issue":"11","key":"e_1_3_3_51_2","first-page":"1622","article-title":"Noroviruses: the perfect human pathogens?","volume":"205","author":"Hall AJ.","year":"2012","unstructured":"Hall AJ. Noroviruses: the perfect human pathogens? J Infect Dis. 2012;205(11):1622-1624.","journal-title":"J"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1071\/HI13016"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2016.11.004"},{"key":"e_1_3_3_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmm.2013.02.005"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S223536"},{"key":"e_1_3_3_56_2","doi-asserted-by":"publisher","DOI":"10.1177\/11786302241243239"},{"key":"e_1_3_3_57_2","doi-asserted-by":"publisher","DOI":"10.1021\/acs.est.7b01710"},{"key":"e_1_3_3_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2011.10.007"},{"key":"e_1_3_3_59_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1801550"},{"key":"e_1_3_3_60_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00029-06"},{"key":"e_1_3_3_61_2","doi-asserted-by":"publisher","DOI":"10.3390\/ma14133444"},{"key":"e_1_3_3_62_2","doi-asserted-by":"publisher","DOI":"10.3390\/ma9090736"},{"key":"e_1_3_3_63_2","doi-asserted-by":"publisher","DOI":"10.3390\/su15043394"},{"key":"e_1_3_3_64_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2012.10.002"},{"key":"e_1_3_3_65_2","doi-asserted-by":"crossref","unstructured":"Wojgani H Kehsa C Cloutman-Green E et al. Hospital door handle design and their contamination with bacteria: a real life observational study. Are we pulling against closed doors? 2012. Accessed October 7 2024. https:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0040171","DOI":"10.1371\/journal.pone.0040171"},{"key":"e_1_3_3_66_2","unstructured":"Alvarez EN. The Hospital as Environment: Assessing and Improving the Efficacy and Impacts of Interventions Designed to Reduce Hospital Acquired Infections. PhD thesis UCLA; 2018. Accessed October 7 2024. https:\/\/escholarship.org\/uc\/item\/6kx044nx"},{"key":"e_1_3_3_67_2","unstructured":"Rutala WA Weber DJ. Disinfection and sterilization in healthcare facilities. In: Lautenbach E Malani PN Woeltje KF Han JH eds. Practical Healthcare Epidemiology. Cambridge University Press; 2018:58-81. Accessed October 7 2024. https:\/\/books.google.com\/books?hl=en&lr=&id=gOZNDwAAQBAJ&oi=fnd&pg=PA58&dq=Rutala +W.+A. +%26+Weber +D.+J.+(2018).+Disinfection+chapter.+Practical+Healthcare+Epidemiology +58.&ots=MDGr57wf55&sig=eQ23OvVvtXA5CuU_ufj-1o5-d0k"},{"key":"e_1_3_3_68_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cej.2022.138234"}],"container-title":["Environmental Health Insights"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11786302251328550","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11786302251328550","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11786302251328550","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T19:23:40Z","timestamp":1777404220000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11786302251328550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":67,"alternative-id":["10.1177\/11786302251328550"],"URL":"https:\/\/doi.org\/10.1177\/11786302251328550","relation":{},"ISSN":["1178-6302","1178-6302"],"issn-type":[{"value":"1178-6302","type":"print"},{"value":"1178-6302","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"article-number":"11786302251328550"}}