March 26, 2026
Hospitals track hand hygiene compliance.
But who is tracking shoes?
When we think about infection control in healthcare settings, we typically focus on hand hygiene, surface disinfection, and sterile equipment. But what about the shoes walking through hospital corridors every day? Emerging research reveals that footwear is an underappreciated vector for spreading healthcare-associated pathogens.
The Contamination Reality
Recent studies paint a concerning picture of widespread shoe contamination in healthcare facilities. Research has found that healthcare worker shoes carry Clostridioides difficile (C. diff) at rates ranging from 15% to 60%, with teaching hospitals showing particularly high contamination levels (S. Janežič et al., 2020).
Even more striking, physicians' shoes tested positive for MRSA (methicillin-resistant Staphylococcus aureus) in 56% of cases before patient rounds, increasing to 65% afterward. This is clear evidence that contamination occurs during routine patient care (Heather M. Limper et al., 2024).
Additionally, bacterial contamination of floors has been estimated to account for up to 15% of airborne colony forming units (CFU) as re-dispersal of these pathogens occurs during routine human activity such as walking (A. Hambraeus et al., 1978, S. Paton et al., 2015).
Beyond Contamination: Proof of Transmission
The most compelling evidence comes from molecular studies that trace genetic fingerprints of pathogens. Whole genome sequencing has revealed clusters of genetically identical C. diff strains, differing by ≤2 genetic variations, found on both healthcare workers' shoes and in patient samples (S. Janežič et al., 2020).
In one pilot study, 17.8% of healthcare worker shoes carried C. diff strains that genetically matched infected patients, providing direct evidence of epidemiological links (Andrea C. Büchler et al., 2022).
The Transmission Highway
Observational studies have mapped the contamination pathway with remarkable precision. Researchers found that floors become contaminated rapidly as personnel enter patient rooms, followed by transfer to patients' socks, then bedding, and finally to high-touch surfaces like call buttons and bed rails. Across 14 instances of pathogen detection, floors were consistently the first site where organisms appeared, followed by sock bottoms, then other surfaces (Sarah N. Redmond et al., 2020).
Experimental studies using harmless viral tracers confirmed this pathway, showing that pathogens inoculated on floors in one room were transferred by shoes to adjacent rooms and nursing stations (Maria M. Torres-Teran et al., 2022).
Simple Solution, Significant Impact
The good news? UVZone® Shoe Sanitizing Stations utilize 2 powerful antimicrobial tools, UV-C and ozone, for shoe sole decontamination in healthcare environments. NSF International Laboratories evaluated the efficacy of the UVZone Shoe Sanitizing Station on these challenge organisms:
- Extended spectrum beta-lactamase (ESBL) Escherichia coli ATCC BAA-196
- Pseudomonas aeruginosa ATCC BAA-2108
- Methicillin-resistant Staphylococcus aureus (MRSA) ATCC 33592
- Vancomycin-resistant Enterococcus faecalis (VRE) ATCC 51299
- Carbapenem-resistant Klebsiella pneumoniae (CRE) ATCC BAA-1705
- Candida auris CDC B11903
- Aspergillus brasiliensis ATCC 16404
- Clostridioides difficile ATCC 43598
Log reductions of up to 5.16 Log (C. auris) were achieved in 10 seconds, with an average reduction across all organisms of 4.21 Log.
UVZone's simple step-on, step-off, hands-free functionality makes shoe sanitation part of your facility infrastructure, not part of a costly cycle of consumable disinfectants, shoe covers, sticky mats, and added labor.