The Built Environment and Reservoirs of Antimicrobial Resistance: Are Mitigation and Prevention Possible Using Design and Daily Facility Operations Strategies?

Antimicrobial resistance is a global concern, and the built environment needed for direct care of patients and residents and associated delivery of support services can be a significant reservoir of multidrug-resistant organisms (MDROs). The World Health Organization's latest report on antimicrobial resistance finds "…one in six laboratory-confirmed bacterial infections in people worldwide in 2023 were resistant to antibiotics, and between 2018 and 2023, antibiotic resistance rose over 40%." This review will reflect growing awareness of the role the built environment plays in cross-transmission of MDROs and highlights the need for prevention to protect both patients and health care personnel.