Pyjamas and sheets as a potential source of nosocomial pathogens

It is recognised that the most important and frequent mode of transmission of nosocomial infections is through direct contact between a susceptible host and an infected or colonised person. Direct contact is mainly attributed to healthcare workers who do not wash their hands effectively before attending patients. Additionally, susceptible hosts may be infected indirectly via intermediate objects, such as contaminated instruments, needles, dressings, or gloves. A healthcare worker who touches pathogens on contaminated surfaces can then transport these pathogens to patients by the contact route. Indeed, the sources of contamination in 21.1% of 1561 nosocomial outbreaks studied have been attributed to contaminated surfaces. Importantly, most common nosocomial pathogens may persist on surfaces for months and can thereby be a continuous source of transmission. Another form of contact spread is via endogenous transmission of the patient's own flora from one part of the host's body to another. Recently, the notion that airborne transmission of bacteria contributes significantly to hospital-acquired infections is gaining recognition. Although a better understanding of how nosocomial pathogens are transmitted and more rigorous infection control measures are being implemented, it is clear that the current modalities to reduce nosocomial infections are not sufficient, as the rates of nosocomial infections, especially those caused by antibiotic-resistant bacteria, are increasing alarmingly worldwide.