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.

中文翻译：

---

医院中的一种健康：如何了解人、动物和医院建筑环境的动态，以便更好地为抗菌药物耐药革兰氏阳性感染的干预措施提供信息。


尽管医院感染预防和控制有所改善，但医疗保健相关感染 (HAI) 仍然是一个挑战，患者发病率、死亡率和医疗保健系统成本都很高。在这篇综述中，我们使用“同一个健康”框架（人类、动物和环境健康）来解释流行病学，展示感染预防政策中的关键知识差距，并探索在医疗保健环境中控制革兰氏阳性病原体的改进措施。我们讨论了患者和医护人员与医院环境的相互作用，这些相互作用可能导致最常见的革兰氏阳性医院病原体（耐甲氧西林金黄色葡萄球菌、艰难梭菌和耐万古霉素肠球菌）的传播，并详细介绍了针对这些病原体的干预措施两个 One Health 域。我们讨论了动物在医疗保健环境中的作用、关于动物在病原体传播中的作用的知识差距，以及缺乏针对动物的感染风险缓解策略。我们倡导以“同一个健康”为支柱的新型感染预防和控制计划，以减少革兰氏阳性医院相关病原体的传播。