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Hospital floors and sinks may pose infection risks, ones that could be overlooked when trying to control the spread of disease.

The floors in patient rooms may be contaminated by bacteria like methicillin-resistant Staphylococcus aureus (MRSA) or Clostridium difficile, according to a new study published in the American Journal of Infection Control. These pathogens, which can cause potentially deadly infections, can be spread when items are dropped on the floor, the researchers noted.

The research team swabbed a number of surfaces, including the floors, clothing, call-buttons and other high-touch items, in 159 rooms at five Cleveland hospitals, according to the study. The study included C. difficile-isolated rooms, and researchers found floors were often tainted by bacteria, most commonly with MRSA, C. difficile and vancomycin-resistant enterococci (VRE). The researchers also found that in 41% of these rooms, at least one high-touch object came in contact with the floor.

The study team said it hopes the results bring more attention to the infection risk posed by floors, which are not often considered in the conversation on infection control.

“Although healthcare facility floors are often heavily contaminated, limited attention has been paid to disinfection of floors because they are not frequently touched,” lead study author Abhishek Deshpande, M.D., Ph.D., an internal medicine physician for the Cleveland Clinic, said in an announcement. The results of our study suggest that floors in hospital rooms could be an underappreciated source for dissemination of pathogens and are an important area for additional research.”

Another recent study noted that hospital sinks may frequently host drug-resistant superbugs like MRSA or VRE. The research, which was published in Applied and Environmental Microbiology, set up five identical sinks in a lab that replicated sinks at the University of Virginia’s hospital in Charlottesville. The researchers then contaminated the sinks with E. coli bacteria, and though colonization began in drain pipes, it inched toward sink strainers before water spread it in the sink.

“This type of foundational research is needed to understand how these bacteria are transmitted, so that we can develop and test potential intervention strategies that can be used to prevent further spread,” Amy Mathers, M.D., an associate professor of medicine at pathology at University of Virginia, told HealthDay.