February 08, 2019
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Drug-resistant bacteria prevalent in sinks close to hospital toilets

In medical ICU rooms, drug-resistant bacteria are four times more prevalent in sinks located next to toilets than in sinks located farther away, according to study results published in the American Journal of Infection Control.

“Recent findings demonstrate that sink drains can be highly contaminated with carbapenemase-producing organisms, potentially splashing to adjacent counter surfaces and patient care equipment,” Blake W. Buchan, PhD, DABMM, assistant professor of pathology at the Medical College of Wisconsin, and colleagues wrote. “The duration of colonization or persistence of these organisms in sink drains is unknown.”

Buchan and colleagues conducted a surveillance study of sink drains at a 600-bed hospital in Milwaukee, focusing on a 26-bed medical ICU with no documented infections with Klebsiella pneumoniae carbapenemase (KPC)-producing organisms in the past year, to determine the prevalence of blaKPC and KPC-producing organisms in sink drains. Each room had two sinks, including one located next to the toilet with no physical barrier between them. According to the study, researchers swabbed the sink drains to collect specimens from the inner walls for three insertions or until the swab was visibly soiled.

Results showed that of the samples tested, 87% of patient sinks next to toilets tested positive for the blaKPC gene, compared with 21.7% of sink drains located closer to the door. In four of the five rooms in which the sink near the door tested positive, the sink near the toilet also was positive. According to Buchan and colleagues, this suggests a potential source for cross-contamination within the same room.

“A high prevalence of blaKPC positivity was found in sink drains of a unit with no known recent history of KPC-producing organisms. The significance of these findings and the potential risk of transmission of KPC-producing organisms in [the] absence of culturable bacterial strains is still unclear in terms of infection control,” the authors concluded.

“If sinks next to toilets are indeed a reservoir for blaKPC, then additional interventions such as modied hand hygiene practices (eg, dedicated sinks), optimization of sink disinfection protocols (eg, increased frequency, optimal disinfectants), and use of engineering controls (eg, splash shields) may be needed to further mitigate the risk of transmission of KPC-producing organisms among health care providers and patients.” – by Caitlyn Stulpin

Disclosures: The authors report no relevant financial disclosures.