Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jun 1;9(1):78.
doi: 10.1186/s13756-020-00737-2.

One Health in hospitals: how understanding the dynamics of people, animals, and the hospital built-environment can be used to better inform interventions for antimicrobial-resistant gram-positive infections

Kathryn R Dalton  1 , Clare Rock  2 , Karen C Carroll  3 , Meghan F Davis  4
Affiliations
Review

One Health in hospitals: how understanding the dynamics of people, animals, and the hospital built-environment can be used to better inform interventions for antimicrobial-resistant gram-positive infections

Kathryn R Dalton et al. Antimicrob Resist Infect Control. .

Abstract

Despite improvements in hospital infection prevention and control, healthcare associated infections (HAIs) remain a challenge with significant patient morbidity, mortality, and cost for the healthcare system. In this review, we use a One Health framework (human, animal, and environmental health) to explain the epidemiology, demonstrate key knowledge gaps in infection prevention policy, and explore improvements to control Gram-positive pathogens in the healthcare environment. We discuss patient and healthcare worker interactions with the hospital environment that can lead to transmission of the most common Gram-positive hospital pathogens - methicillin-resistant Staphylococcus aureus, Clostridioides (Clostridium) difficile, and vancomycin-resistant Enterococcus - and detail interventions that target these two One Health domains. We discuss the role of animals in the healthcare settings, knowledge gaps regarding their role in pathogen transmission, and the absence of infection risk mitigation strategies targeting animals. We advocate for novel infection prevention and control programs, founded on the pillars of One Health, to reduce Gram-positive hospital-associated pathogen transmission.

Keywords: HAI interventions; Hospital environment; Hospital-associated infections; Infection control; Infection prevention; One Health.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Interaction of Humans, Animals, Hospital Environment, and the Community in Hospital-Associated Pathogen Transmission
Fig. 2
Fig. 2
Literature Search Methodology
Fig. 3
Fig. 3
Examples of Infection Prevention and Control Strategies within the One Health Domains
Fig. 4
Fig. 4
How Infectious Disease Intervention Strategies relate to the Hierarchy of Controls. Legend: Adapted from the National Institute for Occupational Safety and Health (NIOSH, www.cdc.gov/niosh/topics/hierarchy); PPE: personal protective Equipment
See this image and copyright information in PMC

References

    1. Destoumieux-Garzon D, Mavingui P, Boetsch G, Boissier J, Darriet F, Duboz P, et al. The one health concept: 10 years old and a long road ahead. Front Vet Sci. 2018;5:14. - PMC - PubMed
    1. Okello AL, Bardosh K, Smith J, Welburn SC. One health: past successes and future challenges in three African contexts. PLoS Negl Trop Dis. 2014;8(5):e2884. - PMC - PubMed
    1. Dulon M, Peters C, Schablon A, Nienhaus A. MRSA carriage among healthcare workers in non-outbreak settings in Europe and the United States: a systematic review. BMC Infect Dis. 2014;14:363. - PMC - PubMed
    1. Xue Y, Gyi AA. Predictive risk factors for methicillin-resistant Staphylococcus aureus (MRSA) colonisation among adults in acute care settings: a systematic review. JBI Libr Syst Rev. 2012;10(54):3487–3560. - PubMed
    1. Patel PK, Mantey J, Mody L. Patient hand colonization with MDROs is associated with environmental contamination in post-acute care. Infect Control Hosp Epidemiol. 2017;38(9):1110–1113. - PMC - PubMed

Publication types