Carbapenem-resistant Enterobacteriaceae dispersal from sinks is linked to drain position and drainage rates in a laboratory model system

Abstract

Conclusion: Slow drainage rates and sink designs with the drain directly underneath the tap increase the risk of CRE present in waste traps and drains contaminating the ward environment.

The role of hospital environment in transmissions of multidrug-resistant gram-negative organisms

“…Key design factors that influenced the environmental contamination were the design of the sink basin, speed of drainage of wastewater, and the location of the sink drains. In an experimental sink model with contaminated sink waste traps, sinks that rapidly drained and or had rear-draining sinks had less environmental contamination [32]. When sink basin drainage was immediately underneath the faucet, environmental contamination occurred regardless of the speed of the drainage but was 8 times greater with slow drainage.…”

“…Sink basin design, water drainage speed, and connectivity of the plumbing system may potentially influence the occurrence and trajectory of MDRGN outbreaks [30][31][32]. In an experimental design, replicate handwashing sinks were inoculated with a green fluorescent protein (GFP)-expressing E. coli and dispersal was measured using settle plates and air sampling [30].…”

“…Sinks could possibly contaminate the immediate surrounding environment for up to 1 m [32]. Key design factors that influenced the environmental contamination were the design of the sink basin, speed of drainage of wastewater, and the location of the sink drains.…”

Bacterial but no SARS-CoV-2 contamination after terminal disinfection of tertiary care intensive care units treating COVID-19 patients

“…Already back in 1974, The Lancet published an article describing isolation of Pseudomonas aeruginosa in hospital sinks (13). Since then, various studies have investigated hospital water supply systems as potential reservoirs for the transmission of pathogenic bacteria in hospitals (14)(15)(16)(17)(18).…”

Washing our hands of the problem

“…The role of sinks and hospital drainage as a source of infection is increasingly recognised, especially in the context of multidrug-resistant Gram-negative bacteria (MDRGNB) [7][8][9][10].…”