Hospital Studies & Footwear Evidence

Peer-reviewed research supports footwear and hospital floors as credible reservoirs and potential pathways for moving healthcare-associated pathogens. These studies document contamination and dissemination without overstating that footwear alone causes a specific infection.

Foundational Reviews

Shoe soles as a potential vector for pathogen transmission: a systematic review
Rashid et al., Journal of Applied Microbiology (2016). Review of 13 studies examining footwear as a vector across healthcare, community, and occupational environments.
View the PubMed record

A Review of the Evidence on the Role of Floors and Shoes in the Dissemination of Healthcare-Associated Pathogens
Limper et al. (2024). Recent review reporting contamination of healthcare floors and footwear with MRSA, VRE, Clostridioides difficile, and other HAI-associated organisms.
View the PubMed record

Clinical and Environmental Studies

Evaluation of Hospital Floors as a Potential Source of Pathogen Dissemination
Koganti et al. (2016). A nonpathogenic tracer virus placed on hospital floors spread rapidly to patients’ hands and frequently touched surfaces.
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Transferring bacteria from the floor onto surgical bedsheets
American Journal of Infection Control (2016). The study demonstrated measurable transfer of viable bacteria from contaminated footwear and shoe covers to surgical bedsheets under the tested conditions.
View the study abstract

Effect of wearing shoe covers by medical staff in intensive care units
Ali et al. (2014). Routine shoe-cover use did not reduce the measured ICU infection outcomes, length of stay, or mortality in this study.
View the open-access study

Research links open in a new tab. Findings are summarized within the scope and limitations of each cited study.