Environmental Surface Contamination in Early Childhood Education Settings: Mapping Evidence on Bacterial Contamination and Antimicrobial Resistance

Background: Environmental surface contamination in early childhood education settings has been recognized as a potential source of exposure to microorganisms. However, the available evidence on bacterial contamination in these environments remains limited, methodologically heterogeneous, and difficult to interpret from an epidemiological perspective. Methods: A scoping review was conducted following Joanna Briggs Institute methodology and reported according to the PRISMA-ScR guidelines. Searches were performed in PubMed/MEDLINE, Embase, Scopus, Web of Science, CINAHL, LILACS, and gray literature sources. Studies reporting bacterial contamination of environmental surfaces and fomites in early childhood education settings were included. Data were extracted and synthesized using descriptive and thematic approaches. Results: Nine studies met the inclusion criteria. Most employed cross-sectional designs and showed substantial variability in sampling strategies, microbiological methods, and outcome definitions. Frequently identified microorganisms included Staphylococcus aureus (including methicillin-resistant strains [MRSA]), Bacillus spp., Pseudomonas spp., Klebsiella spp., Enterococcus spp., and Escherichia coli. Bacterial contamination was consistently reported on high-touch surfaces such as toys, tables, doorknobs, and shared objects. However, most studies did not distinguish between microbial detection, viability, and transmission potential, limiting epidemiological interpretation. Evidence regarding antimicrobial resistance was restricted to a small number of studies and remained fragmented. Conclusions: Evidence on the bacterial contamination of surfaces and fomites in early childhood education settings is scarce, heterogeneous, and predominantly descriptive. Current knowledge is largely limited to documenting the presence of microorganisms, with insufficient evidence to determine their viability or role in transmission processes. Future studies should adopt standardized methodologies and integrate environmental, microbiological, and epidemiological measures to strengthen the understanding of contamination patterns and their public health relevance.