Risk factors for environmental colonization:
(1) large number of debilitated patients, especially in long-term care facilities
(2) ventilator equipment
(3) presence of an epidemic strain
(4) contamination of health care workers, especially the hands
(5) standing water, especially in sinks or around equipment
(6) contaminated environmental fomites (furniture, blood pressure cuffs, bedding, floors, etc)
(7) exposure to antibiotics selecting for resistant bacteria
Sites on patients and healthcare workers that may become colonized:
(1) skin
(2) oropharynx
(3) respiratory tract
(4) digestive tract
Manikal et al identified transfer of colonized patients and colonized providers working at multiple institutions as one way for an entire region to become colonized.
