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Understanding antibiotic resistance
Understanding antibiotic resistance

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2.1.2 Indirect transmission of pathogens

Indirect transmission occurs when an infected person sheds bacteria into the air, water, food or onto other objects in the environment (known collectively as fomites), which can then infect someone else. Figure 4 summarises these indirect transmission routes.

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Figure 4 Routes of indirect person-to-person transmission of infection.

Fomites are objects in the environment, such as door handles, cups and pens, that are routinely touched and can transmit infections. Healthcare-associated infections (HCAIs) can easily be indirectly transmitted to susceptible patients via fomites. A quarter of HCAIs are caused by antibiotic-resistant bacteria such as MRSA.

In the next activity, you will look at fomites that might transmit HCAIs.

Activity 2 Fomites and healthcare-associated infections

Timing: Allow about 5 minutes

Identify the fomites in this picture of hospital staff in 2001 that might transmit HCAIs.

A photo of a nurse talking to a group of three young doctors.
Figure 5 Hospital staff photographed in 2001.
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Neck ties, stethoscopes, long-sleeved clothing, hospital badges worn at waist height and wrist watches could all brush against patients with infections and act as fomites, transmitting the infection to a susceptible individual. Consequently, in UK hospitals today, all staff must have their arms bare below the elbows and wrist watches and neck ties are banned.

Sanitation and hygiene both play an important role in preventing indirect transmission via the routes summarised in Figure 5. Next, you will look at how sanitation and hygiene prevent faecal–oral transmission and the effect that this could have on antibiotic use.