Carbapenem-resistant Enterobacteriaceae dispersal from sinks is linked to drain position and drainage rates in a laboratory model system.
Carbapenem-resistant Enterobacteriaceae
Dispersal
Drain
Infection prevention
Sink
Journal
The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
12
11
2018
accepted:
10
12
2018
pubmed:
21
12
2018
medline:
14
6
2019
entrez:
21
12
2018
Statut:
ppublish
Résumé
Hospital sinks, waste traps and drains can harbour carbapenem-resistant Enterobacteriaceae (CRE). To investigate the dispersal of CRE from sinks in which water delivered from the tap flows directly into the drain and from clinical handwash basins with the drain at the rear. The effect of fast and slow drainage rates was also assessed. Waste traps, known to be colonized with CRE, were taken from a hospital and installed within a model laboratory system. New waste traps were also installed and artificially inoculated with CRE. The potential for bacteria to be dispersed from sinks was assessed using cyclone air samplers and/or settle plates. When the waste traps were artificially contaminated and CRE colonization was confined to the waste trap water, significantly fewer bacteria were dispersed from sinks that drained quickly (P = 0.004) and/or from rear-draining sinks (P = 0.002). When the waste traps were naturally contaminated and CRE colonized the trap, pipework and drain, there was significant interaction between sink drainage and position of the drain (P < 0.001). When drainage was slow, dispersal from rear-draining sinks was almost 30-fold less than from sinks with the drain underneath the tap (P < 0.001). When drainage was fast, rear-draining sinks again released comparatively fewer CRE, although, in this case, the difference was not statistically significant (P = 0.7). Contaminated splashes travelled up to 1 m from the sink. 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.
Sections du résumé
BACKGROUND
BACKGROUND
Hospital sinks, waste traps and drains can harbour carbapenem-resistant Enterobacteriaceae (CRE).
AIM
OBJECTIVE
To investigate the dispersal of CRE from sinks in which water delivered from the tap flows directly into the drain and from clinical handwash basins with the drain at the rear. The effect of fast and slow drainage rates was also assessed.
METHODS
METHODS
Waste traps, known to be colonized with CRE, were taken from a hospital and installed within a model laboratory system. New waste traps were also installed and artificially inoculated with CRE. The potential for bacteria to be dispersed from sinks was assessed using cyclone air samplers and/or settle plates.
FINDINGS
RESULTS
When the waste traps were artificially contaminated and CRE colonization was confined to the waste trap water, significantly fewer bacteria were dispersed from sinks that drained quickly (P = 0.004) and/or from rear-draining sinks (P = 0.002). When the waste traps were naturally contaminated and CRE colonized the trap, pipework and drain, there was significant interaction between sink drainage and position of the drain (P < 0.001). When drainage was slow, dispersal from rear-draining sinks was almost 30-fold less than from sinks with the drain underneath the tap (P < 0.001). When drainage was fast, rear-draining sinks again released comparatively fewer CRE, although, in this case, the difference was not statistically significant (P = 0.7). Contaminated splashes travelled up to 1 m from the sink.
CONCLUSION
CONCLUSIONS
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.
Identifiants
pubmed: 30571992
pii: S0195-6701(18)30711-4
doi: 10.1016/j.jhin.2018.12.007
pmc: PMC6504032
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
63-69Investigateurs
Zoie Aiken
(Z)
Oluwafemi Akinremi
(O)
Aiysha Ali
(A)
Julie Cawthorne
(J)
Paul Cleary
(P)
Derrick W Crook
(DW)
Valerie Decraene
(V)
Andrew Dodgson
(A)
Michel Doumith
(M)
Matthew Ellington
(M)
David W Eyre
(DW)
Ryan P George
(RP)
John Grimshaw
(J)
Malcolm Guiver
(M)
Robert Hill
(R)
Katie Hopkins
(K)
Rachel Jones
(R)
Cheryl Lenney
(C)
Amy J Mathers
(AJ)
Ashley McEwan
(A)
Ginny Moore
(G)
Mark Neilson
(M)
Sarah Neilson
(S)
Tim E A Peto
(TEA)
Hang T T Phan
(HTT)
Mark Regan
(M)
Anna C Seale
(AC)
Nicole Stoesser
(N)
Jay Turner-Gardner
(J)
Vicky Watts
(V)
Jimmy Walker
(J)
A Sarah Walker
(A)
David Wyllie
(D)
William Welfare
(W)
Neil Woodford
(N)
Commentaires et corrections
Type : CommentIn
Informations de copyright
Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.
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