Appendix F. Areas of Future Research

Guidelines for Environmental Infection Control in Health-Care Facilities (2003)

  • Standardize the methodology and interpretation of microbiologic air sampling (e.g., determine action levels or minimum infectious dose for aspergillosis, and evaluate the significance of airborne bacteria and fungi in the surgical field and the impact on postoperative SSI).
  • Develop new molecular typing methods to better define the epidemiology of health-care associated outbreaks of aspergillosis and to associate isolates recovered from both clinical and environmental sources.
  • Develop new methods for the diagnosis of aspergillosis that can lead reliably to early recognition of infection.
  • Assess the value of laminar flow technology for surgeries other than for joint replacement surgery.
  • Determine if particulate sampling can be routinely performed in lieu of microbiologic sampling for purposes such as determining air quality of clean environments (e.g., operating rooms, HSCT units).
  • Evaluate new methods of water treatment, both in the facility and at the water utility (e.g., ozone, chlorine dioxide, copper/silver/monochloramine) and perform cost-benefit analyses of treatment in preventing health-care associated legionellosis.
  • Evaluate the role of biofilms in overall water quality and determine the impact of water treatments for the control of biofilm in distribution systems.
  • Determine if the use of ultrapure fluids in dialysis is feasible and warranted, and determine the action level for the final bath.
  • Develop quality assurance protocols and validated methods for sampling filtered rinse water used with AERs and determine acceptable microbiologic quality of AER rinse water.
Environmental Services
  • Evaluate the innate resistance of microorganisms to the action of chemical germicides, and determine what, if any, linkage there may be between antibiotic resistance and resistance to disinfectants.
Laundry and Bedding
  • Evaluate the microbial inactivation capabilities of new laundry detergents, bleach substitutes, other laundry additives, and new laundry technologies.
Animals in Health-Care Facilities
  • Conduct surveillance to monitor incidence of infections among patients in facilities that use animal programs, and conduct investigations to determine new infection control strategies to prevent these infections.
  • Evaluate the epidemiologic impact of performing procedures on animals (e.g., surgery or imaging) in human health-care facilities.
Regulated Medical Waste
  • Determine the efficiency of current medical waste treatment technologies to inactivate emerging pathogens that may be present in medical waste (e.g., SARS-coV).
  • Explore options to enable health-care facilities to reinstate the capacity to inactivate microbiological cultures and stocks on-site.