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Microbiome. 2017 Jul 14;5(1):76. doi: 10.1186/s40168-017-0294-2.

Cleanliness in context: reconciling hygiene with a modern microbial perspective.

Author information

1
Biology and the Built Environment Center, University of Oregon, Eugene, OR, USA. awv@uoregon.edu.
2
Institute of Ecology and Evolution, Department of Biological Sciences, University of Oregon, Eugene, OR, USA. awv@uoregon.edu.
3
Biology and the Built Environment Center, University of Oregon, Eugene, OR, USA.
4
Institute of Ecology and Evolution, Department of Biological Sciences, University of Oregon, Eugene, OR, USA.
5
Energy Studies in Buildings Laboratory, Department of Architecture, University of Oregon, Eugene, OR, USA.
6
Biology and the Built Environment Center, University of Oregon, Eugene, OR, USA. kevinvdw@uoregon.edu.
7
Energy Studies in Buildings Laboratory, Department of Architecture, University of Oregon, Eugene, OR, USA. kevinvdw@uoregon.edu.

Abstract

The concept of hygiene is rooted in the relationship between cleanliness and the maintenance of good health. Since the widespread acceptance of the germ theory of disease, hygiene has become increasingly conflated with sterilization. In reviewing studies across the hygiene literature (most often hand hygiene), we found that nearly all studies of hand hygiene utilize bulk reduction in bacterial load as a proxy for reduced transmission of pathogenic organisms. This treatment of hygiene may be insufficient in light of recent microbial ecology research, which has demonstrated that humans have intimate and evolutionarily significant relationships with a diverse assemblage of microorganisms (our microbiota). The human skin is home to a diverse and specific community of microorganisms, which include members that exist across the ecological spectrum from pathogen through commensal to mutualist. Most evidence suggests that the skin microbiota is likely of direct benefit to the host and only rarely exhibits pathogenicity. This complex ecological context suggests that the conception of hygiene as a unilateral reduction or removal of microbes has outlived its usefulness. As such, we suggest the explicit definition of hygiene as "those actions and practices that reduce the spread or transmission of pathogenic microorganisms, and thus reduce the incidence of disease."

KEYWORDS:

Hand hygiene; Hygiene; Microbial ecology; Microbiome; Microbiota; Skin

PMID:
28705228
PMCID:
PMC5513348
DOI:
10.1186/s40168-017-0294-2
[Indexed for MEDLINE]
Free PMC Article

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