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A groundbreaking study published Thursday in the American Journal of Infection Control (AJIC) has shed light on the alarming risk posed by hospital sinks in the spread of multidrug-resistant bacteria. The study, conducted by a team at the Toho University Omori Medical Center in Tokyo, revealed startling insights into the transmission of superbug carbapenemase-producing Enterobacterales (CPE), following a multispecies outbreak in 2017.
The investigation traced the origins of the outbreak to a pediatric ward, where the first case of CPE was identified in a one-year-old boy suffering from cardiac disease in June 2016. Subsequently, the infection spread, with a 15-year-old boy becoming the second victim nine months later in March 2017. Shockingly, the outbreak eventually extended its reach to a total of 19 pediatric patients.
Upon scrutiny, the study identified a disconcerting correlation between CPE contamination and hospital sinks. Specifically, nine sinks were found to be tainted with CPE, with six located in rooms housing CPE-positive patients and the remaining three in a nurse center, a waste room, and an ice machine.
Genomic analysis of the bacterial strains implicated in the outbreak, including Klebsiella variicola, Klebsiella quasipneumoniae, and Escherichia coli, underscored the resilience and adaptability of these pathogens. Even after replacing all sinks in the pediatric ward and disinfecting them thoroughly with hydrogen peroxide, CPE contamination persisted.
Of particular concern was the discovery that the resistance mechanism could be transmitted between different bacterial species within the hospital environment. The team’s analysis suggested that pathogen transmission could occur through interconnected plumbing systems, allowing CPE to spread from one sink to another.
In response to these findings, a series of preventive measures were implemented, including mandatory hand disinfection after sink usage, introduction of disposable cleaning tools, prohibition of mouth-washing with sink water, and stringent disinfection protocols for items exposed to sink water.
The concerted efforts finally bore fruit, with the outbreak being brought under control in October 2017. Reflecting on the ordeal, Sadako Yoshizawa, Associate Professor in the Department of Microbiology and Infectious Diseases at Toho University, emphasized the pivotal role of sinks and water-related areas in hospital wards in the fight against antibiotic resistance.
“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,” remarked Yoshizawa.
The study’s findings serve as a stark reminder of the urgent need for robust infection control measures in healthcare settings, particularly concerning the often-overlooked risks posed by seemingly innocuous fixtures such as hospital sinks.
