Healthcare-associated infections (HAI) especially outbreaks of multi-drug-resistant organisms within hospitals are recognized as a major contributor to morbidity and mortality of hospitalized patients. The healthcare environment can act as an amplifier of HAI during outbreaks. The risk of acquiring HAI are 20 times higher in Low-and-middle-income countries. The purpose of this article is to review the challenges associated with controlling environmental contamination in low and lower-middle income countries (LMIC), highlighting possible solutions. This is a narrative review. A literature search was carried out in Google scholar, PubMed, Science Direct, EBSCOHOST, CENGAGE, Scopus, ProQuest, Clinical Key and African journals online using the key words - Health care Associated Infections (HCAIs) in LMICs, Challenges of HAIs in LMIC, Challenges of Prevention and Control of HAIs in LMICs, Environment of care and infection transmission, Contaminated environment and HAIs. From the accessed databases, 1872 articles related to environmental sources of contamination in healthcare settings were found. Of these, only 530 articles focused on LMICs. However, only 186 articles met the inclusion criteria studies published in English, conducted between 2000 and 2019 and exploring environmental sources of contamination in LMIC healthcare settings). The sources of environmental contamination in healthcare are numerous and commonly associated with poor governance, Inadequate infrastructure, human capacity and inadequate funding. Low awareness exists at all levels as to the role of the environment in healthcare outcomes and may explain in part the low priority given for funding. Leadership and trained personnel, both Infection prevention and control practitioners and cleaners are crucial to drive and sustain the process to reduce environmental contamination in healthcare environments.

中文翻译：

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低收入和中等收入国家医疗机构中环境污染源控制的挑战 - 叙述性回顾。


医疗相关感染（HAI），尤其是医院内多重耐药微生物的爆发，被认为是住院患者发病率和死亡率的主要原因。在爆发期间，医疗保健环境可以充当医院感染的放大器。低收入和中等收入国家发生 HAI 的风险高出 20 倍。本文的目的是回顾低收入和中低收入国家 (LMIC) 控制环境污染所面临的挑战，并强调可能的解决方案。这是一篇叙述性评论。使用关键词 - 中低收入国家医疗保健相关感染 (HCAI)、中低收入国家 HAI 的挑战、中低收入国家医院感染预防和控制的挑战、护理环境和感染传播、污染环境和医院感染。从访问的数据库中，找到了 1872 篇与医疗机构环境污染源相关的文章。其中，只有 530 篇文章关注中低收入国家。然而，只有 186 篇文章符合以英文发表的纳入标准研究，这些研究是在 2000 年至 2019 年间进行的，旨在探索中低收入国家医疗机构中的环境污染源。医疗保健领域的环境污染来源众多，通常与治理不善、基础设施不足、人力能力和资金不足有关。各个层面对环境在医疗保健结果中的作用的认识都较低，这可能在一定程度上解释了资金优先级较低的原因。 领导力和训练有素的人员，包括感染预防和控制从业人员和清洁人员，对于推动和维持减少医疗保健环境中环境污染的过程至关重要。