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To the Editor.—
The response to the inquiry presented only one side of a most complex question. The table on page 579 was published apparently without peer review and certainly without evidence that numbers of bacterial colonies above the "acceptable number of colonies" have been associated with illness among hospitalized patients. This table may be accepted as fact by the unwary and lead to extensive although misguided monitoring of the environment, with waste of laboratory resources and possibly resultant destructive litigation, leading to serious charges.Three of the four examples of environmental contamination resulting in disease represent the result of poor maintenance of air conditioners. Bacteriologic monitoring isn't needed to detect bird feathers in air conditioners! The fourth example, a contaminated nebulizer, is an easily correctable hazard, and one of the many that have been identified promptly by appropriate surveillance techniques.The AHA Committee on Infections Within Hospitals has considered
Wehrle PF. More on Control of Nosocomial Infection in Hospitals. JAMA. 1974;230(3):373. doi:10.1001/jama.1974.03240030015009