Baqiyatallah University of Medical Sciences Hospital Practices and Research 2476-390X 11 1 2026 03 01 Silent Spreaders in NICUs: Novel Surveillance for Neonatal Infection Control 802 803 244725 10.30491/hpr.2026.548366.1510 EN Reza Abdollahi Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran 0000-0002-6742-9712 Journal Article 2025 09 20 Neonatal Intensive Care Units (NICUs) face a persistent challenge in controlling healthcare-associated infections (HAIs), with reported rates ranging from 6% to 25% globally. While traditional infection control strategies have focused on symptomatic patients and high-risk groups, a growing body of evidence suggests that “silent spreaders,” asymptomatic carriers of multidrug-resistant organisms (MDROs) among healthcare workers, parents, and neonates themselves may represent a critical blind spot in current surveillance paradigms. If this is the case, then fundamental assumptions underpinning NICU infection control may warrant reexamination. We argue that existing approaches, which rely heavily on active surveillance cultures (ASCs) and hand hygiene compliance, are structurally ill-suited to detect asymptomatic transmission. Emerging genomic, environmental, and data-driven methodologies offer not merely incremental improvements but a necessary reconceptualization of surveillance itself. https://www.jhpr.ir/article_244725_8328689decd5b575c1b7a02dbe4eef41.pdf