Preventing Pathogen Spread: Key Takeaways from the SHEA 2026 Conference

If there was one word to describe the Society for Healthcare Epidemiology of America (SHEA) 2026 Conference, it would be “layered,” and not just because I had to dress in layers to brave the Chicago cold! This year’s conference delivered timely reminders and fresh insights into what it takes to prevent pathogen spread across today’s increasingly complex healthcare environments.

One consistent theme emerged: preventing pathogen transmission is rarely about a single solution. Success depends on layered controls, empowered teams and a sustained focus on the patient care environment.

Key takeaways from SHEA 2026

1. Layered risks require layered prevention efforts

Several sessions revisited the hierarchy of controls as a foundational framework for infection prevention. While personal protective equipment (PPE) remains essential, speakers emphasized that it is also the last line of defense. Engineering and administrative controls, coupled with consistent environmental cleaning and disinfection, remain critical upstream interventions.

^{Source: https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(25)00143-0/fulltext}

This concept was illustrated using the Swiss cheese model (shown above), where each intervention, such as safety protocols, training, PPE and environmental health, is illustrated as a slice of cheese that provides an added layer of protection. While each layer has imperfections (or holes), ensuring that each layer addresses a different need reduces the likelihood that gaps will overlap. Presenters showed how small breakdowns across multiple layers can quietly lead to transmission events.

2. Ambulatory care settings are potential transmission “minefields”

Ambulatory and outpatient settings received heightened attention this year, driven in part by projections estimating significant growth in outpatient care. As Hospital at Home (HaH) and other nontraditional care models expand, infection prevention strategies must stretch beyond traditional hospital walls.

With high patient throughput, limited oversight, and variable adherence to infection prevention and control (IPC) practices, speakers described these environments as potential transmission “minefields.” One presenter from the Centers for Disease Control and Prevention (CDC) highlighted the challenges of implementing contact precautions in long-term care settings, where patient rooms function as living spaces and foot traffic is frequent. Altogether, attendees were cautioned against applying inpatient-based practices wholesale to non-acute settings without accounting for differences in resources and workflows.

3. Mobile medical equipment cleaning and disinfection is essential

Another major theme throughout the conference was the primary routes of transmission for emerging multidrug-resistant organisms (MDROs), such as C. auris, and the increasingly clear role of the patient environment. Colonized patients rapidly contaminate their environment, and multiple sessions reinforced that MDROs persist on surfaces, shared equipment and high- touch mobile items, not just through direct patient contact.

Speakers emphasized contact precautions as a bundle of interdependent practices, explicitly calling out medical equipment cleaning and disinfection as essential, not peripheral. When mobile equipment is overlooked or inconsistently disinfected, the bundle breaks down, increasing transmission risk.

^{Source: https://cleenstudy.com/wp-content/uploads/2025/05/cleen-presentation-website-may-2025.pdf}

These discussions reinforced findings I shared in my recent blog where Dr. Donskey et al. (2019) identified mobile equipment as a persistent source of contamination.^1,2

4. Ready‑to‑Use (RTU) disinfectants save time and help simplify cleaning workflows to support EVS compliance and efficiency

Over 300 research posters were presented during the SHEA poster session, addressing healthcare epidemiology, surveillance, implementation science, patient safety and prevention strategies. One poster that stood out evaluated cleaning and disinfection practices before and after transitioning from a dilutable disinfectant to a ready‑to‑use (RTU) wipe.

The study found that while dilutable disinfectants may appear more cost‑effective, they carry greater risk for incorrect preparation and use. In contrast, RTU wipes were associated with more consistent application and fewer opportunities for error in real‑world settings.

Overall, the data demonstrated several operational and compliance advantages of RTU disinfectants, including their ability to:

• Improve adherence to recommended cleaning and disinfection practices
• Increase EVS understanding of product contact times
• Reduce product preparation and use errors
• Decrease time spent gathering supplies
• Improve discharge cleaning efficiency
• Increase cleaning of high‑touch surfaces

Across posters and sessions, speakers also emphasized the importance of EVS empowerment, education, and training. Presenters reinforced that EVS teams are not just task executors, they are infection prevention partners.

Conclusion:

Leaving Chicago, I was reminded that preventing pathogen transmission is not about perfection in any one area. It is about strengthening each layer, closing gaps where possible, and continuing to learn from the science and each other. When people, processes, and products are aligned, those layers of defense begin to work together rather than in isolation.

Now is the time to take these insights back to our own organizations, whether by reassessing environmental cleaning workflows, closing gaps in equipment disinfection, strengthening EVS education, or standardizing products to support compliance. Small, deliberate changes can help protect patients, staff and the environments where care is delivered every day.