The health-care facility environment is rarely implicated in disease transmission, except among patients who are immuno-compromised. Nonetheless, inadvertent exposures to environmental pathogens (e.g. Aspergillus spp. and Legionella spp.) or airborne pathogens (e.g. Mycobacterium tuberculosis and varicella-zoster virus) can result in adverse patient outcomes and cause illness among health-care workers. Environmental infection-control strategies and engineering controls can effectively prevent these infections.

The occurrence of health-care-associated infections and pseudo-outbreaks can be minimized by, 1) appropriate use of cleaners and disinfectants; 2) appropriate maintenance of medical equipment (e.g., automated endoscope reprocessors or hydrotherapy equipment); 3) adherence to water-quality standards for hemodialysis, and to ventilation standards for specialized care environments (e.g., airborne infection isolation rooms, protective environments or OR-operating rooms); and 4) prompt management of water intrusion into the facility. Routine environmental sampling is not usually advised, except for water quality determinations in hemodialysis settings and other situations where sampling is directed by epidemiologic principles, and results can be applied directly to infection-control decisions.

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