Effects of a disinfection device on colonization of sink drains and patients during a prolonged outbreak of multidrug-resistant Pseudomonas aeruginosa in an intensive care unit

Jonge, Evert de; Boer, M.G.J. de; Essen, E. H. R. van; Dogterom-Ballering, Heleen C.M.; Veldkamp, Karin Ellen

doi:10.1016/j.jhin.2019.01.003

Cited by 39 publications

(18 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In line with previous studies (15,16,18), we found Pseudomonas aeruginosa in sinks/siphons in both ICUs. Speci cally regarding the ICU setting, Zhou et al demonstrated that sink traps may act as an important source of Pseudomonas spp.…”

Section: Discussionsupporting

confidence: 93%

See 1 more Smart Citation

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

Hofmänner¹,

García²,

Duvnjak³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: In intensive care units (ICUs) treating patients with Coronavirus disease 2019 (COVID-19) invasive ventilation poses a high risk for aerosol and droplet formation. Surface contamination of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) or bacteria can result in nosocomial transmission.Methods: Two tertiary care COVID-19 intensive care units treating 53 patients for 870 patient days were sampled after terminal cleaning and preparation for regular use to treat non-COVID-19 patients.Results: A total of 176 swabs were sampled of defined locations covering both ICUs. No SARS-CoV-2 ribonucleic acid (RNA) was detected. Gram-negative bacterial contamination was mainly linked to sinks and siphons. Skin flora was isolated from most swabbed areas and Enterococcus faecium was detected on two keyboards.Conclusions: After basic cleaning with standard disinfection measures no remaining SARS-CoV-2 RNA was detected. Bacterial contamination was low and mainly localised in sinks and siphons.

show abstract

Section: Discussionsupporting

confidence: 93%

“…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).…”

Section: Discussionmentioning

confidence: 99%

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

Hofmänner¹,

García²,

Duvnjak³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Many of the other methods used to control outbreaks related to sinks may be costly, labor intensive, and difficult to implement rapidly. These approaches have included placing barriers between sinks and work areas, 6 reducing water flow pressure, 6 ozonation of water, 18 heating and/or sonicating the drain stem, 9,[19][20][21] replacing the P-trap, 9,10,22 and complete elimination of sinks. 23 Another approach that could be implemented rapidly in outbreak settings is the use of disposable plastic sink drain covers that reduce dispersal of organisms from sink drains.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of foam disinfectants in reducing sink-drain gram-negative bacterial colonization

Jones

Mana

Cadnum

et al. 2019

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

Background:Sink drainage systems are not amenable to standard methods of cleaning and disinfection. Disinfectants applied as a foam might enhance efficacy of drain decontamination due to greater persistence and increased penetration into sites harboring microorganisms.Objective:To examine the efficacy and persistence of foam-based products in reducing sink drain colonization with gram-negative bacilli.Methods:During a 5-month period, different methods for sink drain disinfection in patient rooms were evaluated in a hospital and its affiliated long-term care facility. We compared the efficacy of a single treatment with 4 different foam products in reducing the burden of gram-negative bacilli in the sink drain to a depth of 2.4 cm (1 inch) below the strainer. For the most effective product, the effectiveness of foam versus liquid-pouring applications, and the effectiveness of repeated foam treatments were evaluated.Results:A foam product containing 3.13% hydrogen peroxide and 0.05% peracetic acid was significantly more effective than the other 3 foam products. In comparison to pouring the hydrogen peroxide and peracetic acid disinfectant, the foam application resulted in significantly reduced recovery of gram-negative bacilli on days 1, 2, and 3 after treatment with a return to baseline by day 7. With repeated treatments every 3 days, a progressive decrease in the bacterial load recovered from sink drains was achieved.Conclusions:An easy-to-use foaming application of a hydrogen peroxide- and peracetic acid-based disinfectant suppressed sink-drain colonization for at least 3 days. Intermittent application of the foaming disinfectant could potentially reduce the risk for dissemination of pathogens from sink drains.

show abstract

“…tap outlets and sink drain design), heat application, electromechanical vibration, and use of more potent anti-biofilm agents (e.g. acetic acid, oxidising agents) have all shown some success in removing environmental biofilm and facilitating infection control [ 32 – 34 ]. Additionally, sanitising agents based on non-pathogenic probiotic bacteria ( Bacillus spp.)…”

Section: Biofilm In Healthcare Facilitiesmentioning

confidence: 99%

Biofilm exacerbates antibiotic resistance: Is this a current oversight in antimicrobial stewardship?

Bowler

Murphy

Wolcott

2020

Antimicrob Resist Infect Control

161

125

View full text Add to dashboard Cite

Objective To raise awareness of the role of environmental biofilm in the emergence and spread of antibiotic resistance and its consideration in antimicrobial stewardship. Background Antibiotic resistance is a major threat to public health. Overuse of antibiotics, increased international travel, and genetic promiscuity amongst bacteria have contributed to antibiotic resistance, and global containment efforts have so far met with limited success. Antibiotic resistance is a natural mechanism by which bacteria have adapted to environmental threats over billions of years and is caused either by genetic mutations or by horizontal gene transfer. Another ancient survival strategy involves bacteria existing within a self-produced polymeric matrix, which today is termed biofilm. Biofilm similarly enables bacterial tolerance to environmental threats, and also encourages the transfer of antibiotic resistance genes between bacterial species. This natural and ubiquitous mode of bacterial life has not been considered amongst strategies to tackle antibiotic resistance in healthcare facilities, despite its ability to significantly enhance bacterial survival and persistence, and to encourage antibiotic resistance. Conclusion Biofilm must be considered synonymously with antibiotic resistance because of its proficiency in transferring resistance genes as well as its innate phenotypic tolerance to antibiotics. Although biofilm falls outside of the current definition of antimicrobial stewardship, greater awareness of the existence, ubiquity, and consequences of environmental biofilm amongst healthcare practitioners is crucial to improving hygiene practices and controlling the emergence and spread of antibiotic resistance in healthcare facilities.

show abstract

Effects of a disinfection device on colonization of sink drains and patients during a prolonged outbreak of multidrug-resistant Pseudomonas aeruginosa in an intensive care unit

Cited by 39 publications

References 17 publications

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

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

Effectiveness of foam disinfectants in reducing sink-drain gram-negative bacterial colonization

Biofilm exacerbates antibiotic resistance: Is this a current oversight in antimicrobial stewardship?

Contact Info

Product

Resources

About