Research reveals that contamination can spread via connected plumbing
A study recently published by the American Journal of Infection Control (AJIC) has caused widespread concern, reported globally, highlights the “transmission risk of resistant bacteria in hospital sinks”, according to a recent report on the Healthcare in Europe (HIE) website.
The findings are based on infection prevention efforts undertaken in 2017 at the Toho University Omori Medical Center in Tokyo. The study focussed on attempts to control a multispecies outbreak of carbapenemase-producing Enterobacterales, over an extended period described as “months-long”.
A significant conclusion, says the article, was a recognition of the “particular vulnerability for contamination through sinks and other water sources” in the affected paediatric ward.
Worryingly, the outbreak was not even stopped when all the sinks in the ward were replaced.
“Carbapenemase-producing Enterobacterales (CPE) are a major public health threat because of their resistance to widely used antibiotics” says the report, which added that the biological mechanism that enables resistance to many drugs “can be passed from one bacterial species to another, contributing to the growing epidemic of antimicrobial resistance.”
In short, when one outbreak occurs, it has “the potential” to turn into a multi-species outbreak.
The risk posed by connected hand washing facilities
The potential problem with hand washing sinks that are interconnected via common water pipes, is, says the article, a factor that has been under investigation for some time by a variety of organisations.
“Many studies have shown that there is a high risk of CPE contamination in and around hospital sinks.”
This recent report from a Tokyo based academic medical centre centred on the recognition of CPE in a single patient in 2016, which “triggered” an eight month outbreak which finally diminished in October 2017.
The study concluded that the research had revealed that a number of interconnected elements were all contaminated with CPE.
These included:-
- Nine hand washing sinks – with three being in a nurse centre and six in hospital rooms containing CPE-positive patients
- A waste room
- An ice machine.
Finally, the HIE article quoted Associate Professor in the Department of Microbiology and Infectious Diseases at Toho University School of Medicine and Deputy Director of Clinical Laboratory at Toho University Omori Medical Center, who was also a corresponding author of the study.
Sadako Yoshizawa, MD, PhD said
“Our experience highlights the importance of focusing on sinks and other water-related areas in hospital wards, as these are critical for CPE transmission and therefore major fronts in the fight against antibiotic resistance.”
Study highlights transmission risk of resistant bacteria in hospital sinks »
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